Dr. Paika Podcast

10 Things You Should NEVER Mix with Ozempic or Mounjaro

Dr. Paika Podcast

Show Notes

#Ozempic #Mounjaro #GLP1 #WeightLoss #obesitymedicine Ozempic and Mounjaro are two of the most powerful tools we've ever had for weight loss and metabolic health — but what you combine them with matters. In this video, Dr. Mohammed Paika, MD (board-certified in Internal Medicine and Obesity Medicine, hospitalist for nearly 20 years) breaks down 10 medications, substances, and habits that can quietly work against your GLP-1 treatment: SGLT2 inhibitors, metformin, cannabis/THC, artificial sweeteners and sugar alcohols, compounded/gray-market GLP-1 products, skipping resistance training, SSRIs, caffeine, diuretics, and stacking multiple GLP-1 medications. You'll learn the actual physiology behind each risk, real warning signs to watch for, and what to do instead — so your treatment stays safer, easier to stick with, and more effective. 🎓 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 📩 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 📚 The Weight Equation & The Physician’s Physique Physician-written, evidence-based guides to obesity, weight loss, nutrition, metabolism, exercise, body composition & healthier living. https://www.drmohammedpaika.com/books 👥 Metabolic Health Community Live Q&As, evidence-based education, accountability, workouts, nutrition guidance & community support. https://www.skool.com/metabolic-health-community-5316 Timestamps 0:00 Intro — Why This List Matters 0:42 Meet Dr. Paika + The Ground Rule 1:50 #1 SGLT2 Inhibitors (Euglycemic DKA Risk) 4:34 #2 Metformin 6:59 #3 Cannabis & THC Products 9:12 #4 Artificial Sweeteners & Sugar Alcohols 11:37 Quick Break + Free Resources 13:04 #5 Compounded/Gray-Market GLP-1s 15:25 #6 Skipping Resistance Training 17:57 #7 SSRIs & Serotonergic Medications 20:03 #8 Caffeine 22:12 #9 Diuretics 24:37 #10 Stacking Multiple GLP-1 Medications 26:58 The Bottom Line 27:32 What to Watch Next Sources & References: Ozempic (semaglutide) FDA label — https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/209637s035,209637s037lbl.pdf Mounjaro (tirzepatide) FDA label — https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/215866s041lbl.pdf SGLT2 inhibitors + GLP-1 → euglycemic DKA — https://pmc.ncbi.nlm.nih.gov/articles/PMC11454998/ Metformin + GLP-1 GI overlap (Diabetes Care) — https://diabetesjournals.org/care/article/47/2/280/153929/ Cannabinoid Hyperemesis Syndrome (StatPearls) — https://www.ncbi.nlm.nih.gov/books/NBK549915/ Sweeteners & gut microbiome (Nature) — https://www.nature.com/articles/nature13793 FDA alert: compounded semaglutide dosing errors — https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-patients-dosing-errors-associated-compounded Protein + resistance training for muscle preservation (BJSM) — https://pubmed.ncbi.nlm.nih.gov/28698222/ FDA removes GLP-1 suicidality warning — https://www.fda.gov/drugs/drug-safety-communications/fda-requests-removal-suicidal-behavior-and-ideation-warning-glucagon-peptide-1-receptor-agonist-glp Caffeine & gastric acid secretion (PNAS) — https://www.pnas.org/doi/10.1073/pnas.1703728114 FDA kidney injury warning, GLP-1-related dehydration — https://healthesystems.com/workerscomprehensive/fda-requires-new-kidney-injury-warning-for-all-glp-1-drugs/ GLP-1/GIP/glucagon receptor pharmacology (tirzepatide, retatrutide) — https://www.nature.com/articles/s41421-024-00700-0 ⚕️ MEDICAL & EDUCATIONAL DISCLAIMER⚕️ MEDICAL & EDUCATIONAL DISCLAIMER This content is for general educational and informational purposes only and is not medical advice or a substitute for care from your health

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Oct 22, 2026

#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.

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