Medical Eligibility for GLP-1: Who Can Use It
Not everyone should use Semaglutide or Tirzepatide. This guide covers who is eligible, medical screening required, and contraindications.
Basic Eligibility Requirements
YES - Good Candidates:
- BMI > 27 with health condition (diabetes, hypertension)
- BMI > 30 even without health conditions
- Prior weight loss attempts failed
- Motivated to maintain lifestyle changes
- Age 18-75 (primary range)
- No contraindications (see below)
NO - Not Eligible:
- History of medullary thyroid cancer (personal or family)
- Multiple Endocrine Neoplasia type 2 (MEN2)
- Pregnant or planning pregnancy
- Current pancreatitis or gallbladder disease
- Severe kidney disease (eGFR < 15)
- Uncontrolled diabetic retinopathy
- Severe psychiatric conditions (need evaluation)
Medical Screening Required
Before starting GLP-1, EkoPeptide requires:
Essential Labs (Blood Tests)
- Fasting Blood Glucose: Check for diabetes
- A1C: 3-month average blood sugar
- Lipid Panel: Cholesterol levels
- Kidney Function (Creatinine, eGFR): Ensure kidneys handle medication
- Liver Function Tests: Ensure liver health
- Electrolytes (Na, K, Cl): Baseline before appetite suppression changes
- TSH: Thyroid baseline
EkoPeptide can refer you to accredited lab partners and help interpret results.
Vitals Assessment
- Blood pressure (baseline)
- Resting heart rate
- Weight and height (BMI calculation)
- Waist circumference
Medical History Review
- Prior weight loss attempts and methods
- Family history (cancer, diabetes, thyroid)
- Current medications (interactions?)
- Allergies (especially to medications)
- Pregnancy status
- Psychiatric history (if any)
Conditions That Need Extra Caution
Type 2 Diabetes
GLP-1 GOOD for diabetics - actually helps. BUT: If on other diabetes drugs (metformin, sulfonylureas), dosage may need adjustment. Risk of low blood sugar. Requires doctor oversight.
High Blood Pressure
GLP-1 often IMPROVES blood pressure. But rapid weight loss + blood pressure meds = excessive lowering possible. Monitor closely. May need to reduce BP meds.
History of Eating Disorders
GLP-1 suppresses appetite. If you have history of anorexia/bulimia, appetite suppression could be triggering. Psychiatric evaluation recommended first.
Gastroparesis or Stomach Issues
GLP-1 slows gastric emptying intentionally. If you already have slow digestion, this could worsen. Usually still ok but needs monitoring.
Kidney Disease (Mild-Moderate)
GLP-1 safe in mild kidney disease (eGFR 30-60). Moderate (eGFR 15-30) requires careful monitoring. Severe (eGFR < 15) contraindicated.
Gout or High Uric Acid
Rapid weight loss can trigger gout attacks. If history of gout, discuss with doctor. May need allopurinol alongside GLP-1.
Drug Interactions to Consider
GLP-1 has few interactions but some matter:
Diabetes Medications: If on sulfonylureas (glibenclamide, glipizide), GLP-1 increases low blood sugar risk. Dose reduction usually needed.
Blood Pressure Medications: Rapid weight loss = need for dose reduction. Don't stop on your own. Doctor monitors and adjusts.
Birth Control Pills: Nausea/vomiting can reduce effectiveness. Use backup contraception first 4 weeks.
Warfarin (Blood Thinner): Weight loss affects warfarin dosing. Requires frequent INR monitoring.
Most Other Meds: No significant interactions. GLP-1 doesn't affect cytochrome P450 metabolism.
Age Considerations
Age 18-40: Excellent candidates. Metabolism fast, recovery quick, results optimal.
Age 40-60: Still excellent candidates. Results slightly slower than younger ages but very good. May have comorbidities requiring oversight.
Age 60+: GLP-1 still works. But more medical complexity. Additional monitoring needed. Kidney function particularly important to check.
Age < 18: Generally not approved. Only in exceptional pediatric obesity cases with expert supervision.
Pregnancy & Breastfeeding
Pregnant: GLP-1 is CONTRAINDICATED (forbidden). Pregnancy is 9-month condition where weight loss inappropriate. Animal studies show potential fetal impact. Stop GLP-1 if pregnancy planned or occurs.
Breastfeeding: Unknown safety. Recommended to stop GLP-1. If must continue, discuss with doctor - most recommend waiting until nursing complete.
Trying to Conceive: Stop GLP-1 ideally 3 months before conception planning. Allows metabolism to stabilize.
Surgical Considerations
If surgery planned:
- Tell anesthesiologist you're on GLP-1
- Usually pause injection 3-5 days before surgery
- Resume after surgery when eating normally (typically week 1-2 post)
- Fasting before surgery is ok (GLP-1 reduces hunger anyway)
Red Flags - Stop GLP-1 Immediately
Severe abdominal pain: Could indicate pancreatitis. Seek emergency care.
Signs of thyroid cancer: Lump in neck, difficulty swallowing, persistent hoarseness. Get ultrasound immediately.
Severe dehydration: Dark urine, severe dizziness, inability to drink. IV fluids may needed.
Gallbladder pain: Upper right abdomen pain with fever. May need emergency ultrasound and care.
The Screening Process at EkoPeptide
- Initial WhatsApp Consultation: Basic medical history, eligibility questions
- Lab Ordering: If eligible, we order screening labs at partner facilities
- Results Review: Doctor reviews labs, checks for contraindications
- Telemedicine Consultation: Personal doctor call, medication education, prescription
- Medication Delivery: Express Lagos delivery
- Ongoing Monitoring: Weekly check-ins first month, monthly thereafter
Next Steps
Start with a WhatsApp consultation. If appropriate, we’ll arrange baseline labs and clinician review before any medication is dispensed.
EkoPeptide doctors assess your eligibility • Fast Lagos labs • Confidential evaluation
References
Medically Reviewed by Dr. Chukwuemeka Okonkwo
MBBS, FMCP - Endocrinology
Content reviewed by qualified healthcare professionals for accuracy.