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Circulation 143(21):e984e1010

Cardioprotective Effects of Glucagon-Like Peptide 1 Receptor Agonists in Heart Failure: Myth or Truth

The medication's primary gastrointestinal side effectsparticularly nausea, vomiting, and diarrheacan lead to dehydration if fluid intake is inadequate or losses are not appropriately replaced

Even so, because of the known side effects, the medication is always started at a low dose and periodically escalated following a fixed schedule, he says

When patients lose significant weight on incretin-based therapiesoften 10-15% or more of initial body weight in clinical trials such as the STEP program (semaglutide) and SURMOUNT trials (tirzepatide)the reduction in subcutaneous fat decreases the body's natural insulation layer, making environmental temperatures feel colder than before

Act early, not late The 5% rule applies here