02/22/2026
For all of those taking GLP-1 agents:
In the Butsch et al study of 461,382 GLP-1 users, 12.7% were newly diagnosed with a nutritional deficiency at 6 months, most commonly vitamin D deficiency (7.5%). This lack of vitamin D increased to 13.6% of GLP-1 users at 12 months. Diagnoses of muscle loss, B vitamin deficiencies, dehydration, and mineral deficiencies (calcium, selenium, and zinc) also rose over time.
In another study involving 18,746 adults with T2D, GLP-1 users had a 49% higher risk for vitamin D deficiency than SGLT2 inhibitor users, a 32% higher risk for vitamin D deficiency than DPP-4 inhibitor users, and a 54% higher risk for lower levels of ferritin (iron) than SGLT2 inhibitor users.
A prospective pilot study of 51 adults with T2D showed markedly reduced intestinal iron absorption after 10 weeks of semaglutide therapy.
A register-based cohort study involving 439 patients with T2D and hereditary hemochromatosis showed that GLP-1 users also had 26%-30% lower ferritin levels than SGLT2 inhibitor users.
In a dietary analysis of 69 GLP-1 users, most failed to meet recommended intakes for vitamin D, iron, calcium, and protein; separate case reports linked GLP-1 use to severe thiamine deficiency, including cases of Wernicke encephalopathy and beriberi.
If you are taking any GLP-1, I suggest both blood work and a Tissue Mineral Analysis to make sure you're nutritional levels are optimal. Call us at 513-563-4321 to set up an appointment.
J. Urbina, L. E. Salinas-Ruiz, C. Valenciano, and B. Clapp, “ Micronutrient and Nutritional Deficiencies Associated With GLP-1 Receptor Agonist Therapy: A Narrative Review,” Clinical Obesity 16, no. 1 (2026): e70070, https://doi.org/10.1111/cob.70070.
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