Show Notes
#Retatrutide #GLP3 #WeightLoss #GLP1 #ObesityMedicine How long does retatrutide actually stay in your system? Retatrutide, the triple-hormone drug people call "GLP-3" or "reta," has a half-life of about 6 days. That one number explains when side effects hit and why the dose has to climb slowly. It also explains why a short pause before surgery may not be enough, and why the drug lingers for about a month after your last shot. I'm Dr. Mohammed Paika, board-certified in internal medicine and obesity medicine. In this video, I walk you through the 4 clocks retatrutide sets in your body and what the phase 3 trials really show, including up to 30.3% weight loss. You'll learn about the side effects people aren't talking about, like changes in skin sensation and heart rate. I also explain why the "research use only" vials sold online are a serious risk. Retatrutide is not FDA-approved. The regulated routes are a clinical trial, Lilly's limited early access program (through your doctor) or waiting for approval. 📩 FREE GLP-1 Diet Cookbook + Weekly Newsletter Get weekly evidence-based insights on GLP-1s, metabolic health, nutrition, exercise & longevity. https://www.drmohammedpaika.com/newsletter 🎓 Complete GLP-1 Weight Loss Masterclass — Lifetime Access Comprehensive education on GLP-1 medications, nutrition, exercise, muscle preservation, side effects & long-term success. Includes the companion eBook, quizzes, 12-week exercise program, certificate & future course updates at no additional cost. https://www.drmohammedpaika.com TIMESTAMPS 00:00 The ER patient who "wasn't taking anything" 01:42 What retatrutide is: 3 signals instead of 2 02:34 What the trials show 03:20 Is retatrutide FDA-approved? How people get it legally 04:02 Retatrutide's half-life: about 6 days 04:27 Why it lasts so long 05:07 Clock 1: the 7-day clock and side effects 06:13 The new side effect: dysesthesia 06:52 Heart rate and heart safety 07:30 Missed dose: there's no official rule 08:11 Clock 2: building up to steady state 08:50 How the trials raised the dose 09:43 Why vials make dosing dangerous 10:34 Clock 3: how long retatrutide stays in your system 11:31 What changes how fast you clear it 12:26 Why side effects don't stop when you stop 12:57 Surgery, endoscopy and sedation 13:42 Pregnancy and contraception 14:15 The vial problem: "research use only" 14:57 What's really in the vial? 15:41 My position as your doctor 17:11 Clock 4: what happens when you stop 17:37 Why your body defends its old weight 18:21 What the stopping data shows 18:55 My own weight-regain story 19:42 Muscle is the real stake 20:31 The plan 21:27 Protecting your muscle on GLP-1s REFERENCES (FULL LIST AVAILABLE ON REQUEST) Urva S, et al. LY3437943, a novel triple GIP, GLP-1, and glucagon receptor agonist in people with type 2 diabetes: a phase 1b trial. Lancet. 2022;400:1869–1881. https://www.sciencedirect.com/science/article/abs/pii/S0140673622020335 Jastreboff AM, et al. Triple-hormone-receptor agonist retatrutide for obesity — a phase 2 trial. N Engl J Med. 2023;389(6):514–526. https://www.nejm.org/doi/full/10.1056/NEJMoa2301972 Eli Lilly and Company. Retatrutide TRIUMPH-4 phase 3 results. December 11, 2025. https://investor.lilly.com/news-releases/news-release-details/lillys-triple-agonist-retatrutide-delivered-weight-loss-average Eli Lilly and Company. TRIUMPH-2 and TRIUMPH-3 results; BLA planned Q1 2027. July 23, 2026. https://investor.lilly.com/news-releases/news-release-details/lillys-triple-agonist-retatrutide-successful-two-additional Sanyal AJ, et al. Retatrutide for metabolic dysfunction-associated steatotic liver disease: a randomized phase 2a trial. Nat Med. 2024. https://www.nature.com/articles/s41591-024-03018-2 Axios. Unapproved obesity drug spawns a black market frenzy. August 24, 2026. https://www.axios.com/2026/08/24/unapproved-obesity-drug-spawns-a-black-market-frenzy The Partnership for Safe Medicines. The retatrutide black market: patient safety groups warn of growing
More from Dr. Paika Podcast
#Testosterone #TRT #LowTestosterone #GLP1 #weightloss Is “male menopause” real, and do you actually need testosterone therapy? As an internal medicine and obesity medicine physician, I break down what the research really shows about low testosterone after 50, including: How common true late-onset hypogonadism actually is (hint: far less than the ads suggest) Why excess weight is the #1 fixable cause of low testosterone, and how GLP-1s like Ozempic and Mounjaro may help your own testosterone come back How to get tested properly (morning, fasting, repeated) What TRT can and can’t do, according to the Testosterone Trials What the TRAVERSE trial showed about heart safety, plus the side effects that did go up The newest FDA label changes and the HHS proposal A simple 5-question checklist to work through with your doctor before you ever start TRT 📘 FREE GLP-1 Diet Cookbook (high-protein meals for a smaller appetite): https://drmohammedpaika.com/newsletter 🎓 GLP-1 Masterclass (calorie and protein targets, side effects, and a 12-week home strength program): https://drmohammedpaika.com This video is for educational purposes only and is not medical advice. Talk to your own doctor before starting, stopping, or changing any medication. TIMESTAMPS 0:00 Is low testosterone really the answer? 1:34 Is “male menopause” even real? 3:13 The biggest driver of low testosterone: weight 4:04 How GLP-1s may raise your own testosterone 5:00 The other side: semaglutide and low T 6:03 How to know if you actually have low testosterone 7:28 What TRT really does: the Testosterone Trials 8:54 Is testosterone safe for your heart? (TRAVERSE) 10:29 FDA label changes and the HHS proposal 11:04 On a GLP-1 and testosterone at the same time? 12:06 Should everyone consider hormone therapy? 13:08 5 questions to ask before starting TRT 14:24 What to watch next 📚 REFERENCES Gray A, et al. Massachusetts Male Aging Study. J Clin Epidemiol. 1991;44:671-684. Feldman HA, et al. Massachusetts Male Aging Study. J Clin Endocrinol Metab. 2002;87:589-598. Wu FCW, et al. European Male Ageing Study: late-onset hypogonadism. N Engl J Med. 2010;363:123-135. Corona G, et al. Weight loss and obesity-associated hypogonadism (meta-analysis). Eur J Endocrinol. 2013;168:829-843. Portillo-Canales S, Dhindsa S, et al. Incretin-based drugs and testosterone in men. ENDO 2025 abstract RF27-03; Endocr Pract. 2026;32:696-703. Liao B, Able C, et al. Semaglutide and hypogonadism/ED in non-diabetic men. SMSNA 2023 abstract 157; Able C, et al. Int J Impot Res. 2024. Bhasin S, et al. Testosterone therapy in men with hypogonadism: Endocrine Society guideline. J Clin Endocrinol Metab. 2018;103:1715-1744. Mulhall JP, et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol. 2018;200:423-432. Snyder PJ, et al. Effects of testosterone treatment in older men (Testosterone Trials). N Engl J Med. 2016;374:611-624. Qaseem A, et al. Testosterone treatment in men with age-related low testosterone: ACP guideline. Ann Intern Med. 2020;172:126-133. Lincoff AM, et al. Cardiovascular safety of testosterone-replacement therapy (TRAVERSE). N Engl J Med. 2023;389:107-117. Snyder PJ, et al. Testosterone treatment and fractures in men with hypogonadism. N Engl J Med. 2024;390:203-211. U.S. FDA. Class-wide labeling changes for testosterone products. Feb 28, 2025. U.S. HHS. Request to update testosterone replacement therapy labeling. June 18, 2026 (proposed). U.S. FDA. Removal of boxed warnings on menopausal hormone therapy. Nov 2025. Wilding JPH, et al. STEP 1. N Engl J Med. 2021;384:989-1002. Jastreboff AM, et al. SURMOUNT-1. N Engl J Med. 2022;387:205-216.
#GLP1 #Microdosing #Zepbound #Ozempic #WeightLossMaintenance Microdosing Zepbound & Ozempic: How Low Can You Go and Still Keep the Weight Off? You hit your goal weight. Now the question is: do you have to stay on this dose forever? More and more people are cutting their GLP-1 dose to a fraction or stretching their shots to every 10 to 14 days, hoping to save money, cut side effects, and keep the weight off. I'm Dr. Mohammed Paika, a board-certified internal medicine and obesity medicine physician and practicing hospitalist. In this video I break down what the research actually shows about lower-dose GLP-1 maintenance, and what it doesn't show yet.
#Ozempic #Mounjaro #GLP1 #Tirzepatide #WeightLossDoctor Should you split your weekly Ozempic, Wegovy, Mounjaro, or Zepbound shot into two smaller doses? Lots of you have asked me about this in the comments. People split their dose to ease the nausea in the first few days and keep food noise down late in the week. In this video, I explain what the pharmacokinetics predict, what the clinical trials did and didn’t test, and the hidden risks most people never hear about. As an obesity medicine physician, I walk you through half-life, steady state, peak and trough levels, and a simple model of what splitting does to your drug levels. Then I cover the safer, approved ways your doctor can smooth out your week instead. 📩 FREE GLP-1 Diet Cookbook + Weekly Newsletter Get weekly evidence-based insights on GLP-1s, metabolic health, nutrition, exercise & longevity. https://www.drmohammedpaika.com/newsletter
#FoodNoise #GLP1 #Ozempic #WeightLoss #ObesityMedicine Can't stop thinking about food, even right after a full meal? That constant chatter has a name: food noise. I explain what it is, why GLP-1 medications like Ozempic, Wegovy, Mounjaro and Zepbound quiet it, and why it often returns when people stop them. You'll learn the 2 drivers behind it, a simple test to tell real hunger from food noise, and 9 evidence-based strategies to turn it down, with or without medication. Every claim is referenced below. 📩 FREE GLP-1 Diet Cookbook + Weekly Newsletter Get weekly evidence-based insights on GLP-1s, metabolic health, nutrition, exercise & longevity. https://www.drmohammedpaika.com/newsletter 🎓 Complete GLP-1 Weight Loss Masterclass — Lifetime Access Comprehensive education on GLP-1 medications, nutrition, exercise, muscle preservation, side effects & long-term success. Includes the companion eBook, quizzes, 12-week exercise program, certificate & future course updates at no additional cost. https://www.drmohammedpaika.com
#GLP1 #Menopause #Tirzepatide #Semaglutide #WeightLoss Not losing weight on a GLP-1 after menopause? You’re not imagining it, but your body isn’t broken and the medication hasn’t stopped working. In this video, I’m Dr. Mohammed Paika, board-certified in internal medicine and obesity medicine. I break down what the research really shows about GLP-1s like tirzepatide (Mounjaro, Zepbound) and semaglutide (Ozempic, Wegovy) after menopause. You’ll learn what menopause does to fat, muscle and metabolism, and how much weight women actually lose at each stage of menopause in the clinical trials. I’ll show you why real-world results can lag, what the newest hormone therapy studies show and why they don’t prove cause and effect, and how to protect your muscle and bones. I’ll also walk you through the 5-step plan I use with my midlife patients. 📩 FREE GLP-1 Diet Cookbook + Weekly Newsletter https://www.drmohammedpaika.com/newsletter 🎓 Complete GLP-1 Weight Loss Masterclass — Lifetime Access Comprehensive education on GLP-1 medications, nutrition, exercise, muscle preservation, side effects & long-term success. Includes the companion eBook, quizzes, 12-week exercise program, certificate & future course updates at no additional cost. https://www.drmohammedpaika.com TIMESTAMPS 0:00 Why weight loss feels harder after menopause 1:56 What menopause does to your body 4:15 Do GLP-1s still work after menopause? 7:12 Why it feels harder in real life 9:06 Hormone therapy and GLP-1s: what the data shows 11:21 Free GLP-1 Diet Cookbook 11:44 Protecting your muscle and bones 13:42 GLP-1 Masterclass 14:12 The 5-step midlife GLP-1 plan 15:35 A real viewer example 16:41 Final thoughts 📚 REFERENCES Greendale GA, et al. Changes in body composition and weight during the menopause transition (SWAN). JCI Insight. 2019;4(5):e124865. Lovejoy JC, et al. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes. 2008;32(6):949-958. Pontzer H, et al. Daily energy expenditure through the human life course. Science. 2021;373(6556):808-812. Karppinen JE, et al. Age but not menopausal status is linked to lower resting energy expenditure. J Clin Endocrinol Metab. 2023;108(11):2789-2797. Thomson ZO, et al. Weight loss outcomes in premenopausal versus postmenopausal women during behavioral weight loss interventions. Menopause. 2021;28(3):337-346. Tchang BG, et al. Body weight reduction in women treated with tirzepatide by reproductive stage (SURMOUNT post hoc). Obesity. 2025;33:851-860. García-Pérez LE, et al. Tirzepatide weight reduction by sex: SURMOUNT-1 to -4 post hoc. Presented at EASD 2024. Castaneda R, et al. Sex, not age, predicts weight loss outcomes with tirzepatide. Obesity. 2026;34(Suppl 2):132-145. Huvinen E, et al. Body weight loss with semaglutide 7.2 mg is independent of menopausal status (STEP UP post hoc). Presented at the European Congress on Obesity, 2026. Castaneda R, et al. Impact of reproductive stage and menopausal hormone therapy on weight loss outcomes with tirzepatide. Presented at The Menopause Society Annual Meeting, 2025. Nedeltcheva AV, et al. Insufficient sleep undermines dietary efforts to reduce adiposity. Ann Intern Med. 2010;153(7):435-441. Hurtado MD, et al. Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use. Menopause. 2024;31:266. Castaneda R, et al. Menopause hormone therapy and tirzepatide-associated weight loss in postmenopausal women. Lancet Obstet Gynaecol Womens Health. 2026;2(2):e118-e128. Hurtado MD, et al. Semaglutide reduces body weight regardless of menopause status (STEP and OASIS 4 post hoc). Presented at ObesityWeek, 2025. Papadakis GE, et al. Menopausal hormone therapy is associated with reduced total and visceral adiposity (OsteoLaus). J Clin Endocrinol Metab. 2018;103(5):1948-1957. Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med. 2021;384(11):989-1002. Look M, et al. Body c