Semaglutide Alternatives from the Women's Health and Hormone Doctor!

November 12, 2022

Semaglutide Alternatives from the Women's Health and Hormone Doctor!

By Dr. Nicole Sundene

Female Hormone Specialist

Semaglutide is the newest “Naturopathic” weight loss fad I am already sick of talking about because it is not natural and it is not Naturopathic. So I basically wrote this blog so that when patients with just 5-15 pounds to lose ask me if they should try Ozempic for weight loss, I can just text them: “NO!” with a link to my research here that concludes we should take a “wait and see” approach unless it is for severe obesity caused by insulin resistance.

Let’s review the current existing research and separate the facts from all the false marketing materials I am seeing my patients bring me about the shot. Much of what these weight loss centers, even the Naturopathic ones, are stating about this shot is grossly untrue. We will also discuss the natural alternatives to Ozempic and how Naturopathic nutrition works to lower insulin naturally without medication.


If you need the hormone balancing nutrition program I specifically designed to help balance female hormones and insulin you can pick up my Hormonal Diet Program.  I should of course first disclose that I have my own hormone program, as a hormone doctor, and of course I think is much better for women's hormones and health, and safer than taking a weekly diabetes shot before we get started.

For my patients that are doing the shot against my advice we are in agreement they are working on their nutrition while using the weight loss shot so they have solid healthy habits in place for when they reach their goals and eventually go off the shot. Because Insulin is the "Mother of Female Hormone Imbalance" the diet program I have already designed does work to lower insulin over time. Nutrition and treating insulin resistance at it's root cause....nutrition takes time. Especially when diabetes runs in my patient's family, and they are genetically predisposed to higher insulin levels.

I must also admit that I never participate in Naturopathic fads. I never prescribed HCG, or HGH, I don't give my patients IV's because I am a classic Bastyr trained Naturopathic Doctor and prefer to treat my patients at their “Root Cause.”  So I will offer a second opinion on the safety of this weight loss medication so that in the event women choose to use this shot they do so fully informed and not lied to as I see in the existing marketing hype.

There is no question about the weight loss shot's efficacy. I do see it helping my insulin resistant patients lose weight but we have to look at the long term side effects and existing research before you go signing yourself up for $300/month for the rest of your life as an Ozempic Test Bunny please read this blog!


Semaglutide also known as Ozempic, Rybelsus, and Wegovy became approved in 2021 for obesity. These weekly shots or pills are  currently hitting every weight loss center near me, along with their marketing materials to my patients that are only 5-30 pounds overweight and are reading marketing materials that they are “natural” “thyroid boosting” “immune boosting” and “good for them.” So my “Norwegian Rant” today includes all the latest research on the safety and efficacy of these drugs to burst the Utopian bubble with the realities that the new “Skinny Shot” has REAL safety issues and potential long term consequences women should be educated on before remotely considering. 

The take home message if you don’t want to read my entire rant about semaglutide injections for weight loss is to wait and see unless you are severely obese and have tried everything natural with me including testing your hormones, balancing your hormones, improving your nutrition, counseling , exercise, and stress management

Grab a cup of herbal tea and let's go over this weight loss shot together and look at the pro’s and cons. 


I believe the safest option is to first do everything correctly to avoid taking weight loss medication, such as using my Hormone Balancing Diet program to naturally lower insulin. But that is just how I think and practice medicine and always use natural alternatives and herbal medicine before prescription drugs. 

I also must be honest and confess that I do sincerely believe that whether you are going to do semaglutide shot or not you will need my program. My patients following my program on the shot are doing really well and I am seeing their insulin numbers come down over time with their weight to the point they are planning to taper off the shots and use my hormone program for maintenance. 


Otherwise the most clear cut side effect is dependency with semaglutide. We may never be able to get you off the shot if you do not adhere to a proper clean Naturopathic nutrition and exercise program. 


YES! Anything that stimulates receptors in the hormone system will somewhat “mess up” hormones. Here is what you need to know to protect yourself from the latest marketing nonsense about a new drug with a fresh black box warning for thyroid cancer. 

Is it worth risking thyroid and hormone health as well as the other potential side effects of semaglutide medications? Not yet in my humble biochemistry opinion.

Let's separate the facts from the fiction so that women are fully informed up front of the potential side effects and risks of becoming dependent upon semaglutide therapy for the rest of their lives. 


Semaglutide is a synthetic peptide drug that is manufactured in a lab. Semaglutide is made of amino acids and is a man made chemical that is NOT natural in my opinion as it has two different amino acid changes from the actual natural or endogenous form and only mimics it by 94%. So anyone purporting that semaglutide is “natural” or calling it a “natural peptide” is either intentionally lying or very stupid when it comes to biochemistry. Most likely they making fraudulent claims which is morally and legally wrong. 

First off, calling semaglutide “natural” is like calling the thyroid hormone synthroid or levothyroxine “Natural” when it is chemically manufactured. Nor is synthroid derived from a “Natural source” so calling such a medication natural is a false statement and biochemical FRAUD. The synthetic thyroid hormone from the pharmacy does not come from a natural source like Armour thyroid, but instead comes from synthetic manufacturing. Synthetic manufacturing is also the case with semaglutide and thus is not actually “natural peptides.”

Semiglutide only mimics natural human GLP-1 by 94% and is not the same exact “natural peptide.” This is an annoying false claim that is inaccurate and misleading for women. I have zero respect for any Naturopathic Doctors that are purporting this as a “Natural Peptide” or “Natural and Safe” weight loss system. There are risks, we don’t know the long term consequences beyond a few years, and it's not 100% natural. So please consider these factors before deciding to shoot up with Semaglutide!

My gravest concern aside from cancer is the autoimmune research I found that we will discuss below. The fact that some patients are making antibodies to semaglutide and their own natural GLP-1 after receiving the shot is concerning and may result in some new form of an autoimmune disease at some point that doctors have never seen before. As a doctor with chronic pain from an autoimmune disease, I find this gravely concerning, because once the antibodies form, it is difficult to get them to stop. I know this very well because this is what many autoimmune patients seek me out to help with and it can take a solid 6-12 months to get Hashimoto's antibodies down if not longer.


Any Naturopathic Doctor, Endocrinologist,  or Weight Loss Clinic falsely labeling their semaglutide weight loss shot as “Natural” or “Natural peptides” should have their license revoked for either being stupid or a scam artist. Patients are not medically trained to know the difference between natural and synthetic man made chemicals. This is the #1 sign you are being lied to by an unethical doctor that is desperate for money and now hopping on the Semaglutide Gravy Train. 

Sorry if I sound rude but I am disgusted by the utter lack of ethics from some of the people in the medical industry that are capitalizing on something they have falsely led consumers to believe is natural. It only takes a few bad Naturopathic Doctors to make our entire profession look horrible to MD’s and the public. If someone wants to offer the shot to patients that is their professional choice, but they should at least be honest about the ingredients and side effects. 


Since early 2022 women are calling me, texting me and asking me daily thanks to misleading marketing scams in my profession about the latest weight loss shot or “Skinny Shot” semaglutide, or Ozempic I felt compelled to post the research of the “Other side” of the shot like Ozempic Face, Rebound Weight Gain, Dependency, Gallbladder Disease, Thyroid Cancer, Diabetic Retinopathy, Immune Response, Autoimmunity to endogenous GLP-1, Nausea, Vomiting, Diarrhea, GI Adverse side effects, loss of lean muscle, appetite control, eating behavior changes, intestinal obstruction, serious allergic reaction, anaphylaxis, increased heart rate, increased hospitalization for heart failure, potential kidney failure, unknown long term cardiac risk from stimulating the GLP-1 receptors in the heart and increasing heart rate over the long term, rats given semaglutide had increased thyroid and endocrine system cancer [1-13]. 

For most of my patients that is all they need to read and know that in my mind it’s a solid NO for the big O shot. For everyone else that wants to dig through these research studies that currently exist both bad and good I will break down each research study demonstrating side effects in detail. If you are going to choose to use semaglutide at least be properly informed and not a victim of marketing hype that is not true or supported by research, data, and facts we currently are lacking. 


Any patient that knows me well knows I hate most medications, especially all new medications. This is because I have been working in Family Medicine for over twenty five years on both the prescription and natural side and I have seen all the shiny new drugs that were once regularly used by patients recalled. I have also seen bad side effects from drugs, that I have never seen with herbal medicine and nutrition in Naturopathy. 

But dozens of times in my career have I sat at a “Drug Rep Lunch” with a fancy shiny new drug that sounds too good to be true, only for the FDA to recall it, or the company to recall it themselves just a few years later. 

I can go on and on about watching Vioxx, Accutane, Fen Phen, Baycal, Bextra, Premarin, Prempro, Zantac/Ranitidine, come and go but we will focus on semaglutide today.

Doctors that have been around a while are generally less Utopian about a new drug and instead a bit skeptical of anything new, as we should be. Patient safety should always come first, and doctor’s have taken an oath to “First, Do No Harm.”

So the truth about semaglutide at this point, is that if you are taking a new drug that has not been tested long term, you have essentially signed yourself up as a “Test Bunny” for the drug as nobody really knows its long term effects until the Test Bunny group of people all try it for twenty years. This is why many new drugs do not survive the five year mark because they are shown to cause serious adverse side effects within a few years. 

So we cannot just get sucked into the marketing as women, and we do not need to have unrealistic expectations of our perimenopausal and menopausal bodies and risk a potentially dangerous shot just to lose 5-10 pounds.  

 So today I will discuss the questions patients are most frequently asking about the weight loss shot semaglutide, what you should know about it’s risks and potential benefits. 

Ok #1 as a Naturopathic Doctor that has been around since Herbal Phen Fen, regular Phen Fen, the HCG diet, the HGH diet, Keto Diet, Celery Juice, etc…. I must disclose up front that I never participated in any of those other weight loss programs as I see them as scams, and not in a woman’s best interest for her long term health. 

I will admit I do have many patients on this weight loss shot right now, and they are doing it against my advice and we have just agreed to disagree about it. The one positive thing I do actually see happening to consider is that it does reduce hunger and cravings. A lot of my patients are using the appetite suppressant effect along with my hormone balancing diet program, knowing that the recipes are all designed to balance the female hormones and insulin resistance that naturally occurs with aging induced hormone imbalance in women. 

This way when we do finally decide to take the semaglutide shot away they are eating in a manner that is continuing to balance their hormones and are already on a system that they can sustain to prevent the rebound weight gain that is the main concern I have for many of my patients that are severely overweight.

I worry my obese patiuents cannot afford to gain more weight back after they discontinue the shot, and the research studies indicate that discontinuing the shot may be the problem. Once you start the shot you may not be able to stop, you may end up twice as overweight as you started if you do stop the shot. 


Getting people hooked on drugs for free is the ultimate drug dealer scam. So are the first month of semaglutide shots really “free?” If the shot is something you may have to be dependent on for the rest of your life to maintain your weight, it is a bait and switch scheme. 

This is the #1 bait and switch game that drug manufacturers play to get patients hooked on their medication, so they are stuck paying for it for the rest of their lives. At this point we don’t know how long you will need to take the semaglutide shot for, in order to maintain weight loss.  Since most research studies are conducted for two years this is not a quick fix but something you may need to pay >$1000.month for two years or longer! The problem is that most research finds discontinuing the shot results in going back to being obese [13]. You may need to afford to stay on this medication for two years or even longer [14-17]. 

If you are rich and famous and can afford to potentially be addicted to a shot for $1000/month then that is one thing. Most of my patients cannot afford that risk financially. In a New England Journal of Medicine 2021 research study, semaglutide was found to be the inferior choice for doctors to combine with metformin in diabetes, which makes me wonder if some of this new weight loss shot push is because the manufacturer is losing out on diabetes business they once had. 

Before starting this shot ask yourself if it is affordable for you to continue paying for it weekly for the rest of your life. If you can afford to be twice as overweight as you are right now should you experience “Rebound Weight Gain,” and if you can afford to risk the side effects that potentially include cancer


Semaglutide is being misrepresented in a very clever biochemical way by weight loss centers. First of all they are categorizing the benefits of all peptides into one entire group of benefits. We cannot just refer to “peptides” or “natural peptides” as just one thing. Peptides can be natural or synthetic and are represented by many different drugs. 

This is like me stating the benefit of all herbal medicines that have ever existed and say these benefits are for nettles. Just because nettles are an herbal medicine and other herbal medicines also have benefits does not mean that nettles share that same benefit for being in the same descriptive category. 

Peptides are a description of a type of medication or a class of medications doctors refer to as “Peptide Therapy.” 

Peptides are a category of drugs made from amino acids designed to treat MANY different conditions like Diabetes and  Multiple Sclerosis. Stating the benefits of all of these peptides as a whole when stating the benefit of using just one form of a peptide is fraudulent marketing and is happening at weight loss centers everywhere. Most women are not educated enough to understand they are being lied to.

While it is one thing for a weight loss center to honestly offer this shot, inform people it is synthetically manufactured and has a black box cancer warning with it but may be the only solution to stubborn weight loss… 

What truly disturbs me as a Naturopathic Doctor are the other Naturopathic weight loss clinics that are upright lying to women and telling them these are “Natural peptides” or “peptide therapy” that is “good for their thyroid and heart” when there is a clear black box warning for thyroid cancer, and demonstrated research I will discuss that causes an increased heart rate and potential increased risk for heart failure. 

Currently nobody knows the actual long term side effects of using semaglutide. So anyone purporting it as the safe and natural is crazy in my medical opinion. 

Any doctor or clinic that says semaglutide is “natural” and “good for you” and acting like they actually know what is going to happen to you twenty years from now from taking weekly semaglutide shots is a liar, and clearly lacking good ethics. 


Semaglutide is merely mimicking just ONE TYPE of peptide that occurs in the body. Many doctors and weight loss centers are using the word “Natural Peptide” incorrectly to mislead the patient into falling victim that this is 100% natural and safe. This is a chemically manufactured medication that does contain natural amino acids but they are manufactured in a lab into a protein sequence that is not “natural.” 

This is NOT like how we give women bioidentical hormones from yams or soy. This is not manufactured as the exact same chemical your body naturally makes. Semaglutide is only 94% similar to the natural form. I believe doctors using the word “Natural” for semaglutide products are making false statements and misleading patients. 


Whether you have chosen to avoid semaglutide or are choosing to go against my advice and do it anyway, I do recommend to my patients on the injections that they follow my Hormone Balancing Diet designed to help balance female hormones, insulin resistance, and weight gain. By eating my hormone balancing diet you can lose weight without an expensive weekly injection and avoid its inevitable side effects.

While I originally designed the diet to treat my hormonal acne patients, I have since used it for balancing female hormones and insulin. So for those on the injections they still need a solid Hormone Balancing nutrition program in place or they will not be able to ever stop the shot, and will likely have the same “Rebound Weight Gain” that I had to deal with when patients stopped their HCG Diets that I also told them not to lose and then we had to work to help them lose eighty pounds instead of forty. 

So this is why I approach this new shot with dread because ultimately patients may end up in the same metabolic mess after using HCG and diets that are too restrictive in calories!


Moral of the story. You cannot cheat the system. When you try to cheat the system and lose weight without a solid nutrition plan in place, you will fail and either gain double the weight back, or never be able to stop the semaglutide injections and need to pay for them for the rest of your life. For a drug that has only been approved since 2017 we are already seeing gallbladder disease, intestinal obstruction, and cancer as potential consequences. The majority of diabetes drugs already have class action lawsuits related to cancer, so before I even looked at the existing research on semaglutide I knew that it would have cancer listed as a potential side effect. 


The safer, more cost effective alternative to being an unpaid Lab Test Bunny for Semaglutide shots is using proper nutrition and herbal medicine for weight loss and hormone balancing. My Hormone Balancing Diet has helped many women achieve hormone balance and optimal weight in my practice and I trust it works when patients properly follow it. Whether you are going to choose to risk it and try the shot or not, my program will help you achieve success and you will STILL need a hormone balancing diet program that specifically lowers insulin like the shot in place in order to withdraw from the semaglutide shot without the risk of rebound weight gain. 

So I do have a handful of obese patients using the shot with my program and planning to taper off the shot towards just my program. I do hear that it is easier for them to adhere to the program because they have less hunger and cravings. So I am going to state the positive about the shot without overinflating it.

One concerning side effect I am already seeing in my practice with these patients is higher than normal total estrogen levels. Since most hormone doctors just test the estradiol and not the total hormone levels, this is most likely missed and likely the mechanism behind increased endocrine cancer from semaglutide.


Proper nutrition and herbal medicine is the better natural alternative to risking dependency on semaglutide injections.  I truly believe my Hormone balancing diet program is a safer, better, anti-aging option that has me looking and feeling my best at forty-seven.

My own Naturopathic health journey involves struggling with postpartum depression, anxiety, weight gain from insulin resistance after the birth of my daughter. So I have been through it and know exactly how to test and treat hormonal weight gain. 

The best part about my hormone balancing diet program is the majority of my patients say it is super easy to follow, they are saving money on the recipes, they enjoy eating clean, and they look and feel amazing! Investing in nutrition is always the better alternative than prescription drugs. To follow my simple Mind/Body/Spirit Naturopathic program and improve your health and weight via nutrition and herbal medicine. 

To pick up my Hormone balancing diet program visit:

If you need my help with using natural medicine, herbs, and natural hormones for your female hormones, insulin resistance, or weight loss I would be happy to help you!  Simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit. For those doctors and nurses, and researchers that want to review the existing semaglutide research, we will dive deeper into the existing peptide therapy research studies. 


In clinical trials, semaglutide led to an average weight loss of approximately 15% at 68 weeks among participants without type 2 diabetes, with sustained results observed at the two-year mark. That is 15-20 pounds for the average woman. I see women in my practice losing that much weight a lot faster than over two years. Occasionally I hear my patients telling me they lost thirty pounds in just one month on my Hormone Balancing Diet Program. Very often women lose the 15-60 pounds they need to lose in three to six months of working with me using herbal medicine and natural hormones. So if we can use an alternative to semaglutide then we should because the weight loss may not be as dramatic as women expect. 

Especially, when the main concern with semaglutide use is the potential for dependency and affordability. In a trial extension, participants who withdrew from semaglutide treatment regained 11.6 percentage points of lost weight by week 120, resulting in a net loss of 5.6%. Cardiometabolic improvements observed with semaglutide reverted towards baseline at week 120, indicating that ongoing treatment might be necessary to maintain weight loss and health improvements [1].


Semaglutide is a newer drug that has only been FDA approved for diabetes since 2017. While semaglutide has shown promise in treating Type 2 Diabetes and obesity, there are several concerns to consider before using it for weight loss. The long-term safety of semaglutide is still uncertain, as there is no complete Phase IV clinical trial investigating its side effects, efficacy, and safety in the long run. Until more comprehensive studies are conducted, it is advisable to avoid the risk of a new medication until the long term studies have been conducted. For mild or moderate weight loss the shot is simply ludicrous and should not be used. 


Semaglutide carries a black box warning for thyroid C-cell tumors in the US, based on rodent studies. Though medullary thyroid carcinoma (MTC) is rare, regulatory authorities require additional monitoring of MTC incidence in the US for at least 15 years, with results expected by 2035-2037. Semaglutide is contraindicated in patients with a personal or family history of thyroid disease, thyroid cancer, MTC and patients with multiple endocrine neoplasias (MEN) type 2 in the US [2]. As a doctor that specializes in Hashimoto's I would not recommend taking this drug as my Hashimoto's patients are more likely to have benign thyroid nodules. Hypothyroidism, or low thyroid function is also associated with thyroid nodules. However, nodules can sometimes become cancerous over time. Therefore I do not recommend any of my thyroid disease patients take Ozempic.


In the SUSTAIN-6 trial, an increase in diabetic retinopathy complications (DRP) were reported for semaglutide compared to placebo. In PIONEER 6, unadjudicated diabetic retinopathy complications occurred in 5.8% of oral semaglutide-treated and 4.8% of placebo-treated patients [2]. 

Early worsening of pre-existing diabetic retinopathy complications was secondary to the initial and rapid improvement in glycemic control in SUSTAIN-6. A large trial is ongoing (FOCUS trial, NCT03811561) assessing the long-term effects of semaglutide on diabetic retinopathy complications in patients with Type 2 Diabetes. Until then, caution should be exercised when using semaglutide in patients with diabetic retinopathy complications [2].


Semaglutide can trigger an immune response, leading to the production of antibodies against the drug. In some cases, these antibodies may cross-react with endogenous GLP-1. Clinical trials revealed that 2.9% of patients treated with Wegovy, a semaglutide formulation, developed anti-semaglutide antibodies. Among these patients, 56% had antibodies that cross-reacted with endogenous GLP-1. The impact of anti-semaglutide antibodies on treatment efficacy and hypersensitivity reactions remains unknown and may potentially cause a new type of brand new unknown autoimmune disease, with unpredicatble symptoms [2].


Phase 3 trials have shown that oral and subcutaneous semaglutide can cause gastrointestinal disturbances, such as nausea, vomiting, and diarrhea. Higher doses of both formulations are often associated with more frequent stomach adverse effects. A dose escalation scheme is advised, starting with a low dose. Stomach complaints with semaglutide generally occur during dose escalation in the first 8-12 weeks of treatment and wane over time. Overall, the adverse effects are mild to moderate in severity and often self-limiting [2].


Although it is unclear exactly why, the patients in the research study receiving weekly injections of semaglutide had increased adverse gallbladder events. GLP-1RA treatment, including semaglutide, has increased the risk of gallbladder events. 

In the SUSTAIN program, 1.4% of patients treated with semaglutide developed a gallbladder event, mainly cholelithiasis. In the PIONEER program, cholelithiasis occurred more often in the semaglutide-treated group (0.6% vs. 0.1% with placebo). Gallbladder events have not been linked to mortality. The cause of these gallbladder events is unclear, with several potential mechanisms being suggested [2, 3].


Another concern is the potential loss of lean muscle mass in patients experiencing more than 15% weight loss with semaglutide. This issue can arise when patients consume too few calories to maintain adequate protein intake, leading to muscle loss. This is why Ozempic face happens, and skin can look droopy, losing it's elasticity as is common with menopause and hormone imbalance such as hypothyroidism.


Individuals taking semaglutide may observe a decrease in facial fullness, referred to as "Ozempic face," due to rapid and significant weight loss leading to facial fat loss, looser skin, and more prominent wrinkles. Coupled by the fact that most insulin resistant weight loss patients in my practice eat a high carb low protein diet, so without correcting the protein deficiency and continuing to eat carbs their facial skin will become very saggy. At minimum take a protein shake if choosing to risk taking this drug. Especially if you are in menopause and already have lost a lot of collagen and skin turgor and elasticity from it. 

Aggressive weight loss can also result in nutrient deficiencies, muscle loss, and collagen loss, which may contribute to the appearance of facial aging [6].


Importantly, semaglutide may impact appetite control by interacting with specific brain cells and chemicals, potentially leading to changes in eating habits or food intake behavior. This alteration in the brain's appetite-regulating pathways could cause nausea or contribute to the development of eating disorders [7].


Although no cases of gastric outlet obstruction have been reported with semaglutide, healthcare providers should be aware of potential risks and monitor patients closely for symptoms. A case of a 29-year-old male with type-1 diabetes experiencing symptoms of intestinal obstruction after a single injection of semaglutide highlights this concern [8].


Clinical trials have reported mental health issues such as suicidal behavior and ideation with weight management products, including semaglutide. Healthcare providers should closely monitor patients for signs of depression, suicidal thoughts, or unusual mood changes. Semaglutide should be avoided in patients with depression, or a history of suicidal behavior and discontinued in patients who develop depressed thoughts or suicidal ideation.


Severe allergic hypersensitivity reactions, such as anaphylaxis and angioedema, have been reported in patients using semaglutide. It is advised to avoid its use in patients with a history of reactions to semaglutide and exercise caution in those with a history of reactions to other GLP-1 analogs [2]. 


SUSTAIN 6 and PIONEER 6 trials showed no signals of pancreatic adverse events with semaglutide. A meta-analysis of available cardiovascular outcome trial data argues against any effect of GLP-1RA on pancreatitis and pancreatic cancer incidence. A subtle and asymptomatic increase in plasma lipase and amylase levels is consistently found but is not associated with pancreatic events. The FDA and EMA concluded that a causal association between incretin-based drugs and pancreatitis or pancreatic cancer is inconsistent with the current data [2].


Semaglutide, like all GLP-1RAs, increases heart rate, as reported in research studies. However, it did not lead to an increase in cardiovascular outcomes. The effect of GLP-1RAs on heart rate is important in patients with heart failure. While the semaglutide cardiovascular outcome trial did not show an increased incidence of hospitalization for heart failure, studies with other GLP-1Ras, like liraglutide, in heart failure patients showed an increased incidence of serious cardiac events. The underlying mechanisms for the GLP-1RA-induced heart rate increase remain unclear [9, 10].


Initial case reports suggested that GLP-1RA treatment could cause acute kidney injury (AKI) in some patients. In the SUSTAIN program, acute kidney failure was only reported in SUSTAIN 6, where its occurrence was similar between semaglutide and placebo. In the PIONEER program, acute kidney injury occurred in 2.0% of patients treated with oral semaglutide and 2.3% of placebo-treated patients [11, 12].


For women with under 100 pounds to lose, they likely do not need semaglutide and can lose the weight with diet, hormone, and nutrition changes.  My Mind/Body/Spirit Naturopathic Hormone Balancing Program works to naturally help balance female hormones, insulin, and inflammation similar to the benefits purported with the semaglutide shot. So for those of you seeking natural alternatives to semaglutide or needing a program to maintain the benefits of semaglutide without rebound weight gain please use my hormone balancing diet program. 


Semaglutide, a peptide medication, is used for the long-term management of Type 2 Diabetes and Obesity. As a glucagon-like peptide-1 (GLP-1) receptor agonist, stimulates insulin production, slows gastric emptying, extends satiety, and suppresses appetite. While semaglutide has demonstrated efficacy in managing blood glucose levels and promoting weight loss, it is crucial to be aware of its potential risks before considering its use for weight loss purposes. Semaglutide is approved for treating type 2 diabetes since 2017, and weight loss in those with a BMI >30 since 2021. 

Nevertheless women that do not have much weight to lose are seeking to use it for mild to moderate weight loss. Many clinics now are helping some of these individuals engage in off-label use of the medication for weight loss, which can potentially harm their health in exchange for a quick way to drop a few pounds, which the research studies show will just return when you stop the shot.


Semaglutide is available in both injectable and oral forms. Ozempic, the injectable form, is administered weekly via injectable pens in doses ranging from 0.5 mg to 2 mg. Rybelsus, the oral form, comes in 7 mg or 14 mg tablets and is taken daily. Wegovy, another injectable form for weight management, is administered through a weekly pen injection at a higher dose of 2.4 mg.


Semaglutide has shown promise in managing type 2 diabetes and obesity, with significant weight loss results observed in clinical trials. However, it is essential to consider the potential risks associated with its use. The long-term safety of semaglutide remains uncertain,

and there are concerns about various side effects, including gastrointestinal disturbances, gallbladder events, diabetic retinopathy complications, and potential effects on the heart and kidneys.

Given these potential risks, patients and healthcare providers must carefully weigh the benefits and risks of semaglutide treatment. It is strongly advised to consult with a medical professional before considering semaglutide for weight loss or other purposes. As more research and long-term studies become available, we will gain a clearer understanding of the safety profile of this medication. Until then, it is essential to approach semaglutide treatment cautiously and stay informed of the latest research findings.


Of course I have to recommend my Hormone balancing diet program designed specifically to help balance female hormones, manage weight, insulin resistance, and inflammation through my years of research and experience helping women with hormone imbalance. Proper nutrition and herbal medicine is the tried and true, time tested way to lose weight properly, healthfully, and maintain it over the long run. 

The eight weeks of recipes, meal plans, and grocery shopping lists put together by my nutritionist will ensure you have plenty of healthy ideas to help you reach your weight loss goals. If you need my help with your hormones or weight loss, simply visit my SCHEDULE page to treat yourself to a Naturopathic Hormone Consultation.  

Dr. Nicole Sundene

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for MenopauseThyroidHashimotosPMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food AllergiesDigestion, Dermatology, Acne, Psoriasis,  Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. 

She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!


  1. Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, Lingvay I, McGowan BM, Oral TK, Rosenstock J, Wadden TA, Wharton S, Yokote K, Kushner RF; STEP 1 Study Group. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022 Aug;24(8):1553-1564. doi: 10.1111/dom.14725. Epub 2022 May 19. PMID: 35441470; PMCID: PMC9542252. 
  2. Smits MM, Van Raalte DH. Safety of Semaglutide. Front Endocrinol (Lausanne). 2021 Jul 7;12:645563. doi: 10.3389/fendo.2021.645563. Erratum in: Front Endocrinol (Lausanne). 2021 Nov 10;12:786732. PMID: 34305810; PMCID: PMC8294388. 
  3. Committee for Medicinal Products for Human Use (CHMP) . Assessment Report “Rybelsu” (EM/95374/2020) (2020). Available at: 
  4. Alabduljabbar, K., Al-Najim, W., & le Roux, C. W. (2022). The impact once-weekly semaglutide 2.4 mg will have on clinical practice: a focus on the STEP trials. Nutrients, 14(11), 2217. Ida, S., 
  5. Kaneko, R., Imataka, K., Okubo, K., Shirakura, Y., Azuma, K., ... & Murata, K. (2021). Effects of antidiabetic drugs on muscle mass in type 2 diabetes mellitus. Current diabetes reviews, 17(3), 293-303
  6. Tay JQ. Ozempic face: A new challenge for facial plastic surgeons. J Plast Reconstr Aesthet Surg. 2023 Apr 20;81:97-98. doi: 10.1016/j.bjps.2023.04.057. Epub ahead of print. PMID: 37126934
  7. Gabery S, Salinas CG, Paulsen SJ, Ahnfelt-Rønne J, Alanentalo T, Baquero AF, Buckley ST, Farkas E, Fekete C, Frederiksen KS, Helms HCC, Jeppesen JF, John LM, Pyke C, Nøhr J, Lu TT, Polex-Wolf J, Prevot V, Raun K, Simonsen L, Sun G, Szilvásy-Szabó A, Willenbrock H, Secher A, Knudsen LB, Hogendorf WFJ. Semaglutide lowers body weight in rodents via distributed neural pathways. JCI Insight. 2020 Mar 26;5(6):e133429. 
  8. Shemies, R. S., Abdalbary, M., Nasreldin, E. K., Fouda, A. Y., Abdel-Razik, A., Alsulaimani, A. A., & Abdelsalam, M. Semaglutide Induced Gastric Outlet Obstruction: A. 
  9. Seufert, J., Nauck, M., Rosenstock, J., Hansen, T., Vrazic, H., & Vilsboll, T. (2018). P2857 Increase in pulse rate with semaglutide did not result in increased adverse cardiac events in subjects with type 2 diabetes in the SUSTAIN 6 cardiovascular outcomes trial. European Heart Journal, 39(suppl_1), ehy565-P2857. 
  10. Hozawa A, Ohkubo T, Kikuya M, Ugajin T, Yamaguchi J, Asayama K, Metoki H, Ohmori K, Hoshi H, Hashimoto J, Satoh H, Tsuji I, Imai Y. Prognostic value of home heart rate for cardiovascular mortality in the general population: the Ohasama study. Am J Hypertens. 2004 Nov;17(11 Pt 1):1005-10. doi: 10.1016/j.amjhyper.2004.06.019. PMID: 15533725.
  11. Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, Lingvay I, Rosenstock J, Seufert J, Warren ML, Woo V, Hansen O, Holst AG, Pettersson J, Vilsbøll T; SUSTAIN-6 Investigators. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016 Nov 10;375(19):1834-1844. doi: 10.1056/NEJMoa1607141. Epub 2016 Sep 15. PMID: 27633186. 
  12. Husain M, Birkenfeld AL, Donsmark M, Dungan K, Eliaschewitz FG, Franco DR, Jeppesen OK, Lingvay I, Mosenzon O, Pedersen SD, Tack CJ, Thomsen M, Vilsbøll T, Warren ML, Bain SC; PIONEER 6 Investigators. Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2019 Aug 29;381(9):841-851. doi: 10.1056/NEJMoa1901118. Epub 2019 Jun 11. PMID: 31185157. 
  13. Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, Lingvay I, McGowan BM, Oral TK, Rosenstock J, Wadden TA, Wharton S, Yokote K, Kushner RF; STEP 1 Study Group. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022 Aug;24(8):1553-1564. doi: 10.1111/dom.14725. Epub 2022 May 19. PMID: 35441470; PMCID: PMC9542252.
  14. Garvey WT, Batterham RL, Bhatta M, Buscemi S, Christensen LN, Frias JP, Jódar E, Kandler K, Rigas G, Wadden TA, Wharton S; STEP 5 Study Group. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022 Oct;28(10):2083-2091. doi: 10.1038/s41591-022-02026-4. Epub 2022 Oct 10. PMID: 36216945; PMCID: PMC9556320.
  15.  Weghuber D, Barrett T, Barrientos-Pérez M, Gies I, Hesse D, Jeppesen OK, Kelly AS, Mastrandrea LD, Sørrig R, Arslanian S; STEP TEENS Investigators. Once-Weekly Semaglutide in Adolescents with Obesity. N Engl J Med. 2022 Dec 15;387(24):2245-2257. doi: 10.1056/NEJMoa2208601. Epub 2022 Nov 2. PMID: 36322838; PMCID: PMC9997064.
  16.  Heise T, Mari A, DeVries JH, Urva S, Li J, Pratt EJ, Coskun T, Thomas MK, Mather KJ, Haupt A, Milicevic Z. Effects of subcutaneous tirzepatide versus placebo or semaglutide on pancreatic islet function and insulin sensitivity in adults with type 2 diabetes: a multicentre, randomised, double-blind, parallel-arm, phase 1 clinical trial. Lancet Diabetes Endocrinol. 2022 Jun;10(6):418-429. doi: 10.1016/S2213-8587(22)00085-7. Epub 2022 Apr 22. PMID: 35468322.
  17. Ghusn W, De la Rosa A, Sacoto D, Cifuentes L, Campos A, Feris F, Hurtado MD, Acosta A. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA Netw Open. 2022 Sep 1;5(9):e2231982. doi: 10.1001/jamanetworkopen.2022.31982. PMID: 36121652; PMCID: PMC9486455.
  18. Strain WD, Frenkel O, James MA, Leiter LA, Rasmussen S, Rothwell PM, Sejersten Ripa M, Truelsen TC, Husain M. Effects of Semaglutide on Stroke Subtypes in Type 2 Diabetes: Post Hoc Analysis of the Randomized SUSTAIN 6 and PIONEER 6. Stroke. 2022 Sep;53(9):2749-2757. doi: 10.1161/STROKEAHA.121.037775. Epub 2022 May 18. PMID: 35582947; PMCID: PMC9389936.
  19. Yabe D, Deenadayalan S, Horio H, Kaneto H, Jensen TB, Terauchi Y, Yamada Y, Inagaki N. Efficacy and safety of oral semaglutide in Japanese patients with type 2 diabetes: A subgroup analysis by baseline variables in the PIONEER 9 and PIONEER 10 trials. J Diabetes Investig. 2022 Jun;13(6):975-985. doi: 10.1111/jdi.13764. Epub 2022 Mar 3. PMID: 35112504; PMCID: PMC9153832.
  20.  Wharton S, Batterham RL, Bhatta M, Buscemi S, Christensen LN, Frias JP, Jódar E, Kandler K, Rigas G, Wadden TA, Garvey WT. Two-year effect of semaglutide 2.4 mg on control of eating in adults with overweight/obesity: STEP 5. Obesity (Silver Spring). 2023 Mar;31(3):703-715. doi: 10.1002/oby.23673. Epub 2023 Jan 18. PMID: 36655300.
  21. Gullaksen S, Vernstrøm L, Sørensen SS, Ringgaard S, Laustsen C, Funck KL, Poulsen PL, Laugesen E. Separate and combined effects of semaglutide and empagliflozin on kidney oxygenation and perfusion in people with type 2 diabetes: a randomised trial. Diabetologia. 2023 May;66(5):813-825. doi: 10.1007/s00125-023-05876-w. Epub 2023 Feb 6. PMID: 36746803.
Location: 14300 N Northsight 
Blvd Ste 124
Scottsdale, AZ 85260
Ph: 480-837-0900
Fax: 480-409-2644
© Copyright 2024 | Scottsdale Naturopathic Hormones 
map-markersmartphone linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram