How Semaglutide Works
Semaglutide mimics GLP-1, a hormone released in response to eating. It supports:
- Insulin secretion when glucose is high
- Glucagon suppression to reduce liver glucose output
- Delayed gastric emptying
- Appetite suppression
This makes it effective for glucose control and weight reduction when paired with lifestyle support.
Who Should Not Take Semaglutide
1. Thyroid Cancer or MEN 2 Syndrome
Semaglutide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia type 2 (MEN 2)¹.
2. Pregnancy and Breastfeeding
Semaglutide is not recommended in pregnancy or during lactation². It should be discontinued at least 2 months before trying to conceive.
3. History of Pancreatitis
Cases of acute pancreatitis have been reported following semaglutide use³ ⁴. Patients with prior episodes should be evaluated carefully.
4. Severe Kidney or Liver Disease
Caution is advised in patients with moderate to severe renal or hepatic impairment, especially transplant recipients⁵.
5. Known Allergic Reactions
Avoid semaglutide in known allergy to the drug or its components.
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Use With Caution: Special Considerations
Patients may still qualify for semaglutide but require provider supervision if:
- Using insulin or sulfonylureas (risk of hypoglycemia)
- Having GI disorders like gastroparesis
- Managing thyroid disease or taking multiple medications
Conditions Requiring Pre-Screening
Kidney & Liver Function
- Creatinine, eGFR, and liver enzyme levels should be evaluated⁵
Cardiovascular Evaluation
- Semaglutide may improve cardiovascular outcomes, but heart rhythm concerns may warrant individualization¹
Disclose Your Full Health History
Before starting semaglutide, share:
- Thyroid cancer, pancreatitis, or GI history
- Pregnancy or conception plans
- Current medications and allergies
- Kidney and liver function data
When to Consider Alternatives
Your provider may suggest:
- Different GLP-1 RAs
- Metformin, SGLT2 inhibitors
- Lifestyle-focused non-drug options
How Eden Can Help
Eden connects you with:
- Licensed GLP-1 prescribers
- Medical history screening
- Personalized dose guidance and lifestyle support
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Final Thoughts
Who should not take semaglutide? Patients with MTC, pancreatitis, pregnancy, or significant organ disease may need to avoid or delay use. With professional evaluation, semaglutide can be safe and effective for the right candidates.
Disclaimer
This content is for informational purposes and is not a substitute for medical advice. Always consult a licensed provider before starting or stopping any medication.