It felt inevitable that two of the biggest wellness buzzwords of our day — microdosing, usually as in psychedelics, and GLP-1 medications — would join forces to make a viral progeny.
But while it sounds a bit like an AI hallucination, “Microdosing GLP-1” is very real: People are taking tiny amounts of GLP-1, short for glucagon-like peptide 1 and sold under brand names like Ozempic, Wegovy and Mounjaro to treat diabetes and obesity.
Some are drawn to it for ongoing weight management and because of the cost; paying for a fraction of the full dosage can be a way of staying on it longer, albeit at a lower effectiveness. But in some circles, microdosing GLP-1 is also being touted as a panacea for inflammation, the next frontier in longevity, and a potential breakthrough for women navigating perimenopause.
Proponents point to emerging research on the drug’s potential to treat arthritis and fatty liver disease, improve cardiac health and prevent or slow the progression of Alzheimer’s. A single X post where scientist Andrew Huberman discusses the topic with a performance medicine doctor has been viewed over 234,000 times.
A microdosing GLP-1 journey
When you type the search term into Instagram, Kiki Petty’s videos on the subject are among the top results. In her twenties and thirties, Petty struggled with binge eating and endless dieting, “mostly unsuccessfully,” describing herself as “obese.” After having her youngest child at 40, she lost a significant amount of weight on a weight loss program.
Shortly thereafter, though, Petty started experiencing symptoms often associated with perimenopause, such as mood swings, anxiety, irregular periods and hot flashes. “And just maintaining that weight,” she said. “I’d gotten into a groove for about a year post weight loss, and all of a sudden it felt like things were changing, yet I was still doing all the things I needed to do.” She regained about half the weight she’d lost.
Petty, who lives in Nashville, went to her gynecologist and says she was offered an antidepressant without any testing. So she began to look into hormone fluctuation on her own, mostly via the menopause influencer Dr. Mary Claire Haver on social media, which led her to take gut health supplements and focus on her mental health. She talked about it with her doctor, who prescribed HRT, which she took for a year and a half. “I really thought that was going to be the miracle that I needed,” she said. “But I never felt like I had all these symptoms handled. Definitely not the weight, which kept piling on, to be frank.” It was “mentally taxing and depressing, just not feeling like yourself when you can’t pinpoint it. It’s this very mysterious, ‘What’s wrong with me?’”
She wondered if it was related to inflammation associated with insulin resistance, which can impact women nearing menopause and is linked to brain fog and weight gain, especially around the middle. Last February, Petty’s doctor prescribed her semaglutide, the diabetes and obesity management medication sold under brand names including Ozempic and Wegovy. “It was not microdosing. We started with the baseline dosing, and what I learned about myself is that I cannot tolerate semaglutide,” said Petty. “That did not work for me. I was so sick on that.”
She took a break, and a few months later tried an alternative GLP-1 medication, tirzepatide, sold under brand names such as Mounjaro and Zepbound. She began on the base dose of 2.5 milligrams. Within the first month, she felt “the effects of the inflammation going down, less aches and pains, less brain fog.” She upped her dosage to 5 mg, which is the lower end of a dosage range that can go up to 15 mg, and lost the weight she wanted to. Now, she’s titrating back down “low and slow.” She said 2.5 mg and below is technically “microdosing” for this GLP-1.
In practice, microdosing these “peptides,” as Petty calls them, means getting her GLP-1 compounded at a pharmacy and delivered to her home in a kit that comes with syringes and alcohol pads for injecting at home. She gets personalized dosing through a telehealth platform; right now, that means a weekly injection. Some inject “teensy” amounts twice a week, once every 10 days or once a month.
Last September, Petty partnered with the telehealth platform EllieMD, which offers weight management programs that can include prescriptions for GLP-1. She now coaches women, who find her via social media, on their own microdosing journeys.
Is microdosing GLP-1 recommended?
The question, of course, is whether the benefits touted by proponents of microdosing GLP-1 bear out — and whether you should be doing this at all.
“I don’t know of any scientific nor perceived health benefits from the ideas of microdosing that are being shared on social media or online,” said Dr. Kelly Anderson, medical director at Felix, a Canadian telehealth platform that offers prescription weight loss treatments. “There are no studies and no evidence as to the efficacy [of] microdosing, therefore I am unaware of any benefits. We just don’t have enough information at this stage.”
Anderson discouraged microdosing as a way to eke out a prescription for longer. “I do not recommend this as a cost-savings measure,” she said. “I prefer to recommend medication use as close to the manufacturer’s recommendations as possible, or that which is supported by research.”
The dietician perspective on microdosing GLP-1
But Jaclyn Pritchard, registered dietician and leader of the weight management program at Cleveland Clinic Canada, thinks there is room for “personalization” when taking GLP-1 medications. “This ‘microdosing,’ or just giving a lower dose than what is suggested, is what we do,” said Pritchard. In her experience, some people don’t respond well to the starting dose, or the schedule at which they take that dose. “This is saying to someone: ‘You’re not tolerating this dose very well, let’s try to do half of that, and see how you do.’ If that’s going well, let’s keep doing that for two or three weeks, and then maybe we’ll increase it a little bit.”
Pritchard added that “microdosing” is a pharmacological term that refers to one per cent of the therapeutic dose. “But normally, we’re dosing below the therapeutic dose.”
Other patients “microdose” for weight management when they come to the end of a weight loss program. “As we’ve defined obesity, it’s a chronic condition. You may need to be on this for the rest of your life to treat your chronic condition, just like we would treat high cholesterol or diabetes.” She underscored that this should be done with a medical professional, while making appropriate lifestyle changes. “These are strong medications, and they have specific indications for use.”
Definitely don’t go ordering a vial of this online and microdosing yourself willy-nilly. “Depending on the dose that someone is giving themselves, they could experience some significant side effects,” Pritchard said. “What can happen is that someone goes to eating too little.” This can lead to low food intake and significant nutrient deficiencies. “It’s feeding the fad cycle of restriction and then maybe overeating.”
It’s improper use like this, she added, that has led to much of the negative perception that surrounds this category in general.
When it comes to perimenopause symptoms, especially insulin resistance, Pritchard said that microdosing GLP-1 could potentially be part of a larger toolkit but only with the guidance of a healthcare professional. “Work with someone to help make sure you’re doing it in the best way,” she said. “Are there other things you could be adding to your diet to support your perimenopausal weight? Are you meeting your protein and fibre requirements? Are you feeding your gut properly? Are you managing your blood sugars? It’s so important to look at it holistically.”
Petty, for her part, believes that she will be microdosing GLP-1 for the rest of her life. “The GLP-1 has been the most freeing thing, and has been so good for my mental health because I don’t think about food all the time,” she said. “I also know that inflammation is one of the biggest culprits for disease progression. If I can keep inflammation at bay, I want to do that.”
It is a tool, she said, that she wants to have in her toolbox forever.
