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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\u2014essentially, taking a smaller dose of something than is normally prescribed\u2014has taken off among some users of GLP-1 medications<\/a>, including semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound, Mounjaro).<\/p>\n In fact, in a recent survey<\/a> conducted by the health care software company Tebra, 36 percent of GLP-1 users reported microdosing their medication\u2014and one in four of those users had been doing so for over six months. Influencers on TikTok<\/a>\u2014where most of the survey participants first heard about microdosing\u2014claim 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. <\/p>\n 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\u2019re really not into this trend. <\/p>\n Remind me. How exactly do GLP-1s work? <\/p>\n 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>, a registered dietitian specializing in obesity and vice president of clinical strategy at Vida Health<\/a>. \u201cThey also impact the brain, particularly the hypothalamus, the area that controls hunger, by activating appetite-suppressing neurons,\u201d she says. <\/p>\n 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\u2014all of which contribute to weight loss.<\/p>\n GIP (or glucose-dependent insulinotropic polypeptide) is another hormone in some of these medications. It improves insulin sensitivity and fat metabolism<\/a> and is often found in combination with GLP-1s in tirzepatides.<\/p>\n Both GLP-1s and GIPs are tied to plenty of other compelling health benefits outside of weight loss, including diabetes management<\/a>, reduced heart disease risk<\/a>, and, potentially, dementia prevention<\/a>. These could be especially helpful during the menopausal transition, when the diagnosis of these conditions increases<\/a>.<\/p>\n What does it mean to microdose GLP-1s?<\/p>\n As the term implies, microdosing GLP-1s entails taking a smaller dose (or a less frequent dose) than what\u2019s 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>, a registered dietitian and diabetes expert. <\/p>\n \u201cFor a GLP-1 agonist such as a semaglutide like Ozempic, the lowest dose for starting is usually 0.25 milligrams weekly,\u201d says Richard Siegel, MD<\/a>, codirector of the Diabetes and Lipid Center at Tufts Medical Center. \u201cWith microdosing, the initial dose may be as low as 0.05 milligrams weekly, with a slower increase in the dose than usual.\u201d Full doses can range all the way up to 2.4 milligrams<\/a> per week, depending on the brand and the specific needs of the person being prescribed the medication.<\/p>\n The concept of microdosing reportedly dates back to the <\/a>\u2019<\/a>90s<\/a>, when it was part of clinical drug development, before it was adopted by psychedelics users (and then GLP-1 users). But it\u2019s experimental, and there are currently no robust clinical trials supporting its safety or efficacy in this context. \u201cMost of the information we have on microdosing of GLP-1s is anecdotal,\u201d Zimmermann says. That\u2019s why you won\u2019t find professional organizations like the American Diabetes Association recommending it. <\/p>\n Instead, microdosing is considered an \u201coff-label\u201d practice. \u201cOff-label prescribing is legal and common<\/a> in medicine, mainly when supported by clinical experience, expert guidance, or emerging evidence,\u201d says Zimmermann. \u201cBut since the pharmaceutical company doesn\u2019t support that use, it means the provider is taking responsibility for monitoring safety and outcomes.\u201d <\/p>\n What this means is that you can\u2019t 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<\/a> or Hers<\/a> that provides compounded medications (although these options are not approved by the FDA<\/a>)\u2014or make a plan with a health care provider who\u2019s on board with adjusting your existing prescription\u2014in order to microdose.<\/p>\n What are the supposed benefits?<\/p>\n Again, there is minimal research on microdosing, but proponents tout a few potential perks:<\/p>\n Milder side effects: Ozempic, Zepbound, and other similar medications can cause gnarly gut issues (nausea, vomiting, diarrhea). \u201cMicrodosing may be done to reduce the risk of side effects, most notably gastrointestinal side effects such as nausea and constipation,\u201d says Dr. Siegel. In fact, these side effects are largely why it\u2019s standard practice for clinicians and pharmaceutical companies<\/a> alike to recommend a dosing schedule that gradually brings patients up to their maintenance dose.<\/p>\n 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: \u201cMost GLP-1 medications cost approximately $1,000 per month without insurance, and the price varies with insurance,\u201d says Zimmermann. Considering that the pharmacy benefit manager CVS Caremark removed its coverage for Zepbound<\/a> in July, it\u2019s 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\u2014more on this later.<\/p>\n Getting those other health benefits: \u201cWe\u2019ve also seen people leverage microdosing to take advantage of the anti-inflammatory<\/a> effects, and for others\u2014especially peri- and postmenopausal women\u2014to help with fat redistribution<\/a>,\u201d Zimmermann adds. But much more research is needed to truly understand how effective these practices are and at what dosage. <\/p>\n Tapering off of GLP-1s: Zimmermann says microdosing could help people wean off a GLP-1 once they hit their goal weight\u2014though more research is needed. \u201cStudies<\/a> 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\u2019t made when on the medication,\u201d she says. Microdosing could be \u201cpart of step-down support as a way to help sustain appetite regulation and provide a \u2018soft landing\u2019 after complete discontinuation.\u201d<\/p>\n I\u2019m not overweight, but I want the other benefits. Can I microdose?<\/p>\n You could, but given the lack of evidence behind it, don\u2019t expect incredible results. (Or for your insurance to cover it.)<\/p>\n First of all, \u201cthere is no current evidence that microdosing is the best way to lose \u2018a little weight,\u2019\u201d says Dr. Siegel. A smaller dose may likely only offer smaller benefits, Zimmermann adds. \u201cCertain effects, like appetite suppression, can still occur at low doses, while others, like substantial weight loss or blood sugar changes, require higher dosing,\u201d she says. <\/p>\n As mentioned earlier, people try microdosing because they\u2019re interested in getting other potential health perks. But we need a lot more research before we can draw any conclusions. \u201cSome studies have shown that results can be achieved on microdoses, but they haven\u2019t been validated in evidence-based guidelines,\u201d says DeGore. So take the hype you hear about the anti-inflammatory potential of microdosing with a hefty grain of salt for now. <\/p>\n How do you microdose GLP-1s?<\/p>\n People who microdose often \u201ccount clicks\u201d to measure out a smaller dose of the med than what\u2019s listed on the label, Zimmermann says. <\/p>\n 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\u2019s 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. <\/p>\n 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.)<\/p>\n 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 \u201copens up the chance to give too much or too little of the drug,\u201d 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.<\/p>\n Certain GLP-1 pens don\u2019t even click. \u201cTirzepatide [Mounjaro and Zepbound] comes in a pen that does not allow for clicking doses,\u201d 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. <\/p>\n 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\u2014and definitely requires a doctor\u2019s sign-off and supervision.<\/p>\n Needless to say, it\u2019s complicated. That\u2019s why all the experts interviewed for this story said it\u2019s imperative that you talk to your doctor for specific dosing advice, rather than following tips from TikTok influencers. <\/p>\n Can microdosing really save money?<\/p>\n It\u2019s 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<\/a>) 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\u2019re using, and your dosage. <\/p>\n However, keep in mind that GLP-1s have an expiration date, says Dr. Siegel. \u201cFor example, the semaglutide pen is not recommended to be used more than 56 days once started,\u201d 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\u2019re given a set number with each month\u2019s prescription), and reusing needles is never safe.<\/p>\n Is microdosing GLP-1s safe?<\/p>\n The experts in this story concur that microdosing weight loss meds might be safe under supervision from a licensed health care professional\u2026but with a giant asterisk. \u201cSince microdosing is considered an off-label use, I would recommend using it with caution, as it\u2019s important to have the appropriate health literacy and understanding of how GLP-1s work,\u201d says DeGore. There are considerable risks involved, including the risk of messing up your dose<\/a> or of using compounded medications, which are not FDA approved for safety, quality, or efficacy, says Zimmermann.<\/p>\n If your physician deems it appropriate for you, they should show you exactly how to \u201ccount clicks\u201d or otherwise properly administer the correct dose. \u201cThere is limited research on microdosing GLP-1, so the body\u2019s long-term response remains unpredictable and there may be adverse side effects,\u201d Zimmermann adds.<\/p>\n Is it even effective?<\/p>\n
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