GLP-1 use is safe and effective with many pre-existing conditions with the exception of the following: Currently pregnant Currently breastfeeding Currently being treated for cancer Active eating disorder Active gallbladder disease Active substance abuse or dependency Type 1 diabetes Bariatric surgery (within the past 18 months) Pancreatitis within the past 6 months, or a history of pancreatiitis caused by taking a GLP-1 Personal or family history of medullary thyroid cancer or MEN syndrome Personal history of Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
Cardiovascular considerations : The SELECT trial demonstrated cardiovascular risk reduction with semaglutide (a GLP-1 receptor agonist) in patients with obesity and cardiovascular disease
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Co-occurring Anti-diabetic Medications Overall, oral semaglutide users commonly received one (23.9%), two (36.6%), or three (29.1%) co-occurring anti-diabetic medications, these mainly consisting of biguanides (79.5%) and SGLT-2i (42.3%)
McKay NJ et al
The people who run into trouble are those who started closer to the lower end of normal, around 200-300 pg/mL, where even a modest decline pushes them into deficiency