Dr. Spencer Nadolsky

Very reasonable. And honestly, it's needed sometimes. In other countries, they have clickable pens that you can do. Well, Ozempic actually has a clickable pen, and that's here in the United States. But Wegovy doesn't have it. Zetbound doesn't have it. Manjaro doesn't have it. So you see a lot of people going to the compounding route, which is kind of going by the wayside now.

But like in other countries, there are quick pens that you can do terzapatide in between doses. And it really is needed. It's more for semaglutide. Semaglutide is not as well tolerated. So it's nice to have that for semaglutide. But even terzapatide, the starting dose is 2.5. And sometimes I'm like, I really wish I could do a one milligram because this person's a high responder to this stuff.

But like in other countries, there are quick pens that you can do terzapatide in between doses. And it really is needed. It's more for semaglutide. Semaglutide is not as well tolerated. So it's nice to have that for semaglutide. But even terzapatide, the starting dose is 2.5. And sometimes I'm like, I really wish I could do a one milligram because this person's a high responder to this stuff.

But like in other countries, there are quick pens that you can do terzapatide in between doses. And it really is needed. It's more for semaglutide. Semaglutide is not as well tolerated. So it's nice to have that for semaglutide. But even terzapatide, the starting dose is 2.5. And sometimes I'm like, I really wish I could do a one milligram because this person's a high responder to this stuff.

They're losing weight too quickly, even on the lowest dose. It would be nice to just go a little bit lower, even half of that. But you can. You'd have to You have to get the vials, and the vials are a single-use vial, or you'd have to inject the pen into and make your own bacteriostatic violators. It's ridiculous. And then it starts getting a little bit potentially dangerous there.

They're losing weight too quickly, even on the lowest dose. It would be nice to just go a little bit lower, even half of that. But you can. You'd have to You have to get the vials, and the vials are a single-use vial, or you'd have to inject the pen into and make your own bacteriostatic violators. It's ridiculous. And then it starts getting a little bit potentially dangerous there.

They're losing weight too quickly, even on the lowest dose. It would be nice to just go a little bit lower, even half of that. But you can. You'd have to You have to get the vials, and the vials are a single-use vial, or you'd have to inject the pen into and make your own bacteriostatic violators. It's ridiculous. And then it starts getting a little bit potentially dangerous there.

So yeah, it would be nice if, and that comes down to, and we can get into the corporate greed, the pharmaceutical greed, but they don't want people splitting them up because otherwise we could just prescribe 15 milligrams of Zepbound or Monjaro and just have them split up into the smaller doses and have it last longer. They don't want that.

So yeah, it would be nice if, and that comes down to, and we can get into the corporate greed, the pharmaceutical greed, but they don't want people splitting them up because otherwise we could just prescribe 15 milligrams of Zepbound or Monjaro and just have them split up into the smaller doses and have it last longer. They don't want that.

So yeah, it would be nice if, and that comes down to, and we can get into the corporate greed, the pharmaceutical greed, but they don't want people splitting them up because otherwise we could just prescribe 15 milligrams of Zepbound or Monjaro and just have them split up into the smaller doses and have it last longer. They don't want that.

Yeah. So I went to med school late 2000, so 2007. That's right when these drugs started coming out. You know, Bayeta was the first one, exenatide, but it was for type 2 diabetes. It wasn't on the radar to use these for weight loss. At the time, people were really focusing on basically phentermine. A noradrenergic sympathomimetic drug. It has amphetamine-like properties, but not addictive.

Yeah. So I went to med school late 2000, so 2007. That's right when these drugs started coming out. You know, Bayeta was the first one, exenatide, but it was for type 2 diabetes. It wasn't on the radar to use these for weight loss. At the time, people were really focusing on basically phentermine. A noradrenergic sympathomimetic drug. It has amphetamine-like properties, but not addictive.

Yeah. So I went to med school late 2000, so 2007. That's right when these drugs started coming out. You know, Bayeta was the first one, exenatide, but it was for type 2 diabetes. It wasn't on the radar to use these for weight loss. At the time, people were really focusing on basically phentermine. A noradrenergic sympathomimetic drug. It has amphetamine-like properties, but not addictive.

A little bit of an upper. But yeah, noradrenaline, noradrenergic. And that was basically what people used. I started going early on to obesity medicine conferences, and there was some weird stuff that they were promoting. They got HCG and all sorts of stuff that people were trying to use, HCG diets, but a lot of phentermine.

A little bit of an upper. But yeah, noradrenaline, noradrenergic. And that was basically what people used. I started going early on to obesity medicine conferences, and there was some weird stuff that they were promoting. They got HCG and all sorts of stuff that people were trying to use, HCG diets, but a lot of phentermine.

A little bit of an upper. But yeah, noradrenaline, noradrenergic. And that was basically what people used. I started going early on to obesity medicine conferences, and there was some weird stuff that they were promoting. They got HCG and all sorts of stuff that people were trying to use, HCG diets, but a lot of phentermine.

And if people remember Phen-Phen, Phentermine was one of the components in Phen-Phen, but it was not the bad component. Phenfluramine was the one that caused heart valve issues. And so they took that one off the market, but kept Phentermine around. It had been around since the 1950s. So once I got to residency, which was 2011, right in 2012, Q-Simia was approved and

And if people remember Phen-Phen, Phentermine was one of the components in Phen-Phen, but it was not the bad component. Phenfluramine was the one that caused heart valve issues. And so they took that one off the market, but kept Phentermine around. It had been around since the 1950s. So once I got to residency, which was 2011, right in 2012, Q-Simia was approved and

And if people remember Phen-Phen, Phentermine was one of the components in Phen-Phen, but it was not the bad component. Phenfluramine was the one that caused heart valve issues. And so they took that one off the market, but kept Phentermine around. It had been around since the 1950s. So once I got to residency, which was 2011, right in 2012, Q-Simia was approved and

And that is a combination of fentramine and topiramate. Topiramate works in GABA. They think that's part of why it works for appetite suppression. But think about different receptors, lower doses of each, so you get fewer side effects. The fentramine can cause people to have insomnia, dry mouth, heart palpitation.