Semaglutide is generally considered a safe medication and has shown efficacy in lowering the risk of cardiovascular disease. However, recent clinical studies, namely the PIONEER and SUSTAIN analyses, have uncovered a concerning 266% increased risk of blood clots in diabetic patients using this drug. Can Semaglutide Cause Blood Clots?
The exact mechanisms are not known at this time and further research as needed. Here are some possible reasons on why semaglutide would increase risk of blood clots.
Semaglutide induced Diarrhea
Diarrhea is a common side effect of being on semaglutide type medications. In these studies diarrhea increased by 166%. Dehydration induced by diarrhea is likely a contributing factor to increasing risk of blood clots. The resulting dehydration from frequent diarrhea could potentially elevate the risk of blood clots, including conditions such as deep vein thrombosis, particularly in high-risk individuals who already suffer from diabetes and obesity
Patients with diabetes
Diabetes is often referred to as the mother of all diseases due to its widespread impact on health. Individuals diagnosed with diabetes frequently experience a range of associated comorbid conditions. These can include limited mobility, which affects daily activities, an increased risk of infections that can complicate treatment, heart failure, lung issues, and chronic kidney disease. Each of these conditions contributes to a heightened risk of developing blood clots, which can lead to serious health complications.
Obesity
Patient’s for overweight have limited mobility and increase abdominal pressures which may impede blood flow through the major blood vessels such as inferior vena cava and portal veins. In addition, obesity is associated with increased inflammation which is independent risk factor for forming blood clots. in fact, the risk of forming blood clots is directly correlated to obesity, the higher the BMI, the higher the risk of clot formation.
Homocysteine levels
Semaglutide is a medication that has been linked to a decrease in the production of stomach acid. When the production of gastric acid is reduced, it can lead to a lower absorption rate of essential nutrients, particularly vitamin B12. This deficiency in vitamin B12 can have significant health implications, as lower levels of this vital vitamin are associated with increased levels of homocysteine in the blood. Elevated homocysteine levels can raise the risk of blood clot formation, which can lead to serious cardiovascular issues.
Moreover, patients who are already taking acid-reducing medications, such as TUMS, omeprazole or famotidine, may experience even higher rates of vitamin B12 deficiency. This is due to the additional suppression of stomach acid caused by these medications, which further impairs the absorption of B12. Therefore, it is crucial for individuals on semaglutide to monitor their vitamin B12 levels regularly and consider supplementation. B12 injection can be particularly helpful in this situation as they avoid issues with intestinal B12 absorption.
Tips to reduce complications
- Increase fluid intake to prevent dehydration.
- Avoiding long flights and avoiding prolonged sitting for long periods of time.
- Regular exercise and increasing overall mobility.
- B12 supplementation , preferably injection as B12 absorption rates can be variable.
- Zinc supplementation may be helpful. there is very limited data supporting its use however semaglutide lowers zinc levels and this could be a contributing factor to formation of blood clot.
Did I miss something? Let me know in the comments below
