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The word microdosing might make you think of LSD and magic mushrooms, but the term has gained a totally new meaning in the Age of Ozempic. Microdosing—essentially, taking a smaller dose of something than is normally prescribed—has taken off among some users of GLP-1 medications, including semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound, Mounjaro).
In fact, in a recent survey conducted by the health care software company Tebra, 36 percent of GLP-1 users reported microdosing their medication—and one in four of those users had been doing so for over six months. Influencers on TikTok—where most of the survey participants first heard about microdosing—claim the practice can save you money, lessen unpleasant side effects, and unlock other health benefits, like protecting your heart and curbing inflammation…all while you still lose weight.
Naturally, the health team at Oprah Daily had a lot of questions. Are the benefits real? Could it really save money? Is it safe? Can anyone do it? So we tapped experts for clarity. And spoiler alert: They’re really not into this trend.
Remind me. How exactly do GLP-1s work?
GLP-1s (full name: glucagon-like peptide-1 receptor agonists, or GLP-1 agonists) help the pancreas release insulin, reduce blood sugar, slow the rate of stomach emptying, and increase feelings of fullness, explains Gretchen Zimmermann, RD, a registered dietitian specializing in obesity and vice president of clinical strategy at Vida Health. “They also impact the brain, particularly the hypothalamus, the area that controls hunger, by activating appetite-suppressing neurons,” she says.
The result: GLP-1 users feel less hungry, have a more muted blood sugar response after eating, and experience less mental chatter around hunger and cravings—all of which contribute to weight loss.
GIP (or glucose-dependent insulinotropic polypeptide) is another hormone in some of these medications. It improves insulin sensitivity and fat metabolism and is often found in combination with GLP-1s in tirzepatides.
Both GLP-1s and GIPs are tied to plenty of other compelling health benefits outside of weight loss, including diabetes management, reduced heart disease risk, and, potentially, dementia prevention. These could be especially helpful during the menopausal transition, when the diagnosis of these conditions increases.
What does it mean to microdose GLP-1s?
As the term implies, microdosing GLP-1s entails taking a smaller dose (or a less frequent dose) than what’s typically prescribed. In theory, this means that the GLP-1s could still support weight loss, blood sugar management, and more, but to a lesser extent, says Jess DeGore, RD, a registered dietitian and diabetes expert.
“For a GLP-1 agonist such as a semaglutide like Ozempic, the lowest dose for starting is usually 0.25 milligrams weekly,” says Richard Siegel, MD, codirector of the Diabetes and Lipid Center at Tufts Medical Center. “With microdosing, the initial dose may be as low as 0.05 milligrams weekly, with a slower increase in the dose than usual.” Full doses can range all the way up to 2.4 milligrams per week, depending on the brand and the specific needs of the person being prescribed the medication.
The concept of microdosing reportedly dates back to the ’90s, when it was part of clinical drug development, before it was adopted by psychedelics users (and then GLP-1 users). But it’s experimental, and there are currently no robust clinical trials supporting its safety or efficacy in this context. “Most of the information we have on microdosing of GLP-1s is anecdotal,” Zimmermann says. That’s why you won’t find professional organizations like the American Diabetes Association recommending it.
Instead, microdosing is considered an “off-label” practice. “Off-label prescribing is legal and common in medicine, mainly when supported by clinical experience, expert guidance, or emerging evidence,” says Zimmermann. “But since the pharmaceutical company doesn’t support that use, it means the provider is taking responsibility for monitoring safety and outcomes.”
What this means is that you can’t just get an official prescription for a microdose of a brand-name GLP-1, says Dr. Siegel. Instead, you have to work with a company like Noom or Hers that provides compounded medications (although these options are not approved by the FDA)—or make a plan with a health care provider who’s on board with adjusting your existing prescription—in order to microdose.
What are the supposed benefits?
Again, there is minimal research on microdosing, but proponents tout a few potential perks:
Milder side effects: Ozempic, Zepbound, and other similar medications can cause gnarly gut issues (nausea, vomiting, diarrhea). “Microdosing may be done to reduce the risk of side effects, most notably gastrointestinal side effects such as nausea and constipation,” says Dr. Siegel. In fact, these side effects are largely why it’s standard practice for clinicians and pharmaceutical companies alike to recommend a dosing schedule that gradually brings patients up to their maintenance dose.
Saving money: Dr. Siegel says some people may turn to microdosing to make a prescription last longer when paying out of pocket. The appeal is understandable: “Most GLP-1 medications cost approximately $1,000 per month without insurance, and the price varies with insurance,” says Zimmermann. Considering that the pharmacy benefit manager CVS Caremark removed its coverage for Zepbound in July, it’s likely that more people will consider microdosing to help stretch out those very expensive prescriptions. However, certain medications have shorter shelf lives, which limits how long you can stretch out a supply and thus limits the money-saving potential—more on this later.
Getting those other health benefits: “We’ve also seen people leverage microdosing to take advantage of the anti-inflammatory effects, and for others—especially peri- and postmenopausal women—to help with fat redistribution,” Zimmermann adds. But much more research is needed to truly understand how effective these practices are and at what dosage.
Tapering off of GLP-1s: Zimmermann says microdosing could help people wean off a GLP-1 once they hit their goal weight—though more research is needed. “Studies and clinical trials show that when people stop taking GLP-1s, the appetite often comes back, and in many cases there is rapid weight regain, especially if nutrition and behavior changes weren’t made when on the medication,” she says. Microdosing could be “part of step-down support as a way to help sustain appetite regulation and provide a ‘soft landing’ after complete discontinuation.”
I’m not overweight, but I want the other benefits. Can I microdose?
You could, but given the lack of evidence behind it, don’t expect incredible results. (Or for your insurance to cover it.)
First of all, “there is no current evidence that microdosing is the best way to lose ‘a little weight,’” says Dr. Siegel. A smaller dose may likely only offer smaller benefits, Zimmermann adds. “Certain effects, like appetite suppression, can still occur at low doses, while others, like substantial weight loss or blood sugar changes, require higher dosing,” she says.
As mentioned earlier, people try microdosing because they’re interested in getting other potential health perks. But we need a lot more research before we can draw any conclusions. “Some studies have shown that results can be achieved on microdoses, but they haven’t been validated in evidence-based guidelines,” says DeGore. So take the hype you hear about the anti-inflammatory potential of microdosing with a hefty grain of salt for now.
How do you microdose GLP-1s?
People who microdose often “count clicks” to measure out a smaller dose of the med than what’s listed on the label, Zimmermann says.
What that means: For some GLP-1s (particularly semaglutide options like Ozempic), the drug is administered using an injector pen. The pens are twisted to measure out one’s weekly prescribed dose. Each twist, which makes a clicking sound, corresponds to an incremental amount of the medication. The specific dose-to-clicks number depends on how much drug the pen contains. A pen with 1 milligram total of semaglutide needs 18 clicks for a 0.25 milligram dose, while a pen containing 0.5 milligrams of semaglutide will require 36 clicks to get that same 0.25 milligram dose.
So when microdosing, if your typical dose is 18 clicks on a 1 milligram pen for 0.25 milligrams, microdosing 0.05 milligrams (the lowest possible dose, per Dr. Siegel) would entail counting 4 clicks (rounding up from 3.6) and administering that amount instead. (Clearly, this is not an exact science.)
However, not all GLP-1s come in auto-injector pens. Compounded medications, for example, come in a vial, and you administer the drug via syringe, says Zimmermann. In this case, a person would measure a smaller dose into the syringe, which “opens up the chance to give too much or too little of the drug,” she says. Plus, frequent piercing of compounded GLP-1 vials, if not done carefully, can also introduce bacteria into the medication and potentially contaminate it.
Certain GLP-1 pens don’t even click. “Tirzepatide [Mounjaro and Zepbound] comes in a pen that does not allow for clicking doses,” Zimmermann adds. Instead, someone looking to microdose might have to adjust how often they administer the med to get microdosing effects, or even switch medications if their doctor deems that appropriate.
Microdosing is also harder with oral GLP-1s. It may involve cutting pills or reducing the number of days per week that you take the medication—and definitely requires a doctor’s sign-off and supervision.
Needless to say, it’s complicated. That’s why all the experts interviewed for this story said it’s imperative that you talk to your doctor for specific dosing advice, rather than following tips from TikTok influencers.
Can microdosing really save money?
It’s possible! With smaller doses, one could theoretically go longer before needing to pay for a refill, depending on the brand and specific dosage of the pen, says Dr. Siegel. So if you, say, went from using up a whole Ozempic pen (which costs just shy of $1,000 without a prescription) once a month to using up a whole pen once every two months, that could save you $6,000 in a year. The specifics will really depend on your insurance coverage, the type of drug you’re using, and your dosage.
However, keep in mind that GLP-1s have an expiration date, says Dr. Siegel. “For example, the semaglutide pen is not recommended to be used more than 56 days once started,” he says. Depending on your dosage, you might not use up the whole pen by the expiration date (and thus would be wasting leftover medication). You also might not have enough pen needles to cover all of the microdoses (you’re given a set number with each month’s prescription), and reusing needles is never safe.
Is microdosing GLP-1s safe?
The experts in this story concur that microdosing weight loss meds might be safe under supervision from a licensed health care professional…but with a giant asterisk. “Since microdosing is considered an off-label use, I would recommend using it with caution, as it’s important to have the appropriate health literacy and understanding of how GLP-1s work,” says DeGore. There are considerable risks involved, including the risk of messing up your dose or of using compounded medications, which are not FDA approved for safety, quality, or efficacy, says Zimmermann.
If your physician deems it appropriate for you, they should show you exactly how to “count clicks” or otherwise properly administer the correct dose. “There is limited research on microdosing GLP-1, so the body’s long-term response remains unpredictable and there may be adverse side effects,” Zimmermann adds.
Is it even effective?
We just don’t know enough yet to say for sure. “There has been modeling done to explore alternative dosing regimens of GLP-1s that simultaneously reduce costs and maintain weight-loss efficacy, but there’s limited evidence and no formal guidelines to support this practice,” Zimmermann says.
In certain cases, some people might find microdosing a helpful way to avoid unwanted side effects of GLP-1s or save some money. But that little dose might not provide meaningful benefits, particularly for weight loss. “Weight loss from microdosing is likely modest and short-term, highly variable, and not guaranteed—and there is still the problem of long-term maintenance if new habits are not adopted and the drug is discontinued,” Zimmermann says.
So…should I try it?
Ultimately, microdosing sounds appealing, but its results aren’t guaranteed or backed by much evidence. “I do not generally recommend microdosing given the lack of documented benefit in trials,” says Siegel, although he adds that he’d be happy to discuss the uncertainties with patients if they had questions.
“GLP-1s are powerful medications and should be prescribed only by medical professionals who have completed comprehensive medical assessments, including running labs,” adds Zimmermann. “Until there are further clinical trials and professional organizations like the American Diabetes Association endorse the practice of microdosing, I would be reluctant to recommend it.”
If you’re determined, please don’t just DIY your jabs at home. “Any microdosing should be done under supervision with your provider and appropriate lab work,” says DeGore. “If you are seeking weight loss and are interested in using GLP-1s, be sure to have additional support for behavior and lifestyle change.”
There’s no denying that GLP-1s have been game-changing for many Americans struggling with weight. But they’re powerful medications, and tinkering with your dose can backfire (and we don’t even know if it’ll work how you want it to). As with many other health trends that start on TikTok, microdosing is one that should be considered with a not-so-micro dose of skepticism.
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