Seeking Advice on GLP-1 Prescription Concerns
I'm looking for some insights for a post on the AskDocs subreddit. A bit about me: I’m a 37-year-old female with a medical background that includes iron deficiency anemia, a cholecystectomy, and hormonal migraines. I manage my ADHD with 20 mg of Adderall taken 2-3 times daily. In addition, I take 50 mg of Zoloft for PMDD and 40 mg of Nexium for acid reflux, which became necessary after my gallbladder surgery. During my menstrual cycle, I use Tranexamic acid as a preventive measure against anemia. Luckily, a recent blood test from last November showed I'm no longer anemic. I also occasionally use Maxalt for migraine relief and Singulair for allergies, and I alternate between plant-based and heme iron supplements. I maintain a good fitness level despite my weight of 213 pounds. My routine includes CrossFit, weightlifting, cardiovascular exercises, and regular walking, with a resting heart rate around 58 bpm. Previously, I managed to lose weight before my iron infusions, but ever since, it seems impossible to shed any pounds regardless of my diet or exercise frequency. This shift has been extremely frustrating. Before my infusions, losing weight was relatively straightforward for me. I am eager to explore GLP-1 medications, yet my physician has reservations about prescribing them due to my history of anemia and my reliance on Adderall. While Adderall does significantly reduce my appetite, the pounds still refuse to budge. When I initially started taking it in 2019, I did see some weight loss, and until 2024, I fluctuated between 185 and 195 pounds based on my cyclical patterns. After getting a copper IUD in 2022, I noticed an initial weight loss that brought me joy, especially since I had previously been on hormonal birth control. My doctor is particularly worried about the potential for muscle loss associated with GLP-1 use. I'm aware that muscle wasting can occur, but I intend to keep exercising regardless. Although I have reservations about the side effects and the prospect of long-term medication, I am more concerned about my current weight plateau and its negative impact on my mental well-being. Therefore, I'm asking: considering my health background, would I be an appropriate candidate for GLP-1 medications? Additionally, I've come across information regarding ferritin levels in relation to GLP-1 prescriptions. Is there a specific reference range for ferritin levels when considering GLP-1 treatment?
Answers (1)
2/4/2026, 2:01:06 AM
OpenHealth AI
It's understandable to feel frustrated about weight management, especially after working hard on your fitness without seeing the desired results. Given your medical history and current situation, it's crucial to weigh the potential benefits of GLP-1 medications against any concerns related to your specific health background.
Main Points:
- Weight Management Challenges: Your persistent difficulty losing weight, despite exercise and diet, is significant and understandably discouraging.
- Considerations for GLP-1 Use: While GLP-1 medications can aid in weight loss, there are concerns about muscle loss and your history of anemia that need careful consideration.
- Ferritin Levels and GLP-1: Monitoring ferritin levels is essential, especially since your anemia was previously a concern.
Explanation:
GLP-1 (glucagon-like peptide-1) medications are used primarily for weight management and diabetes control. They work by decreasing appetite and slowing digestion, leading to weight loss. However, your doctor is understandably cautious because of your past anemia and dependency on stimulants like Adderall, which can affect appetite itself.
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Muscle Loss Concerns: There is some evidence that GLP-1 medications can lead to muscle loss, particularly in individuals who are already at risk or don’t consume adequate protein. Your active lifestyle can mitigate some of these risks, but appropriate nutritional support (especially protein intake) becomes even more crucial.
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Ferritin and GLP-1 Treatment: Regarding ferritin - which reflects the stored form of iron in your body - there isn't a universally standardized reference range when considering GLP-1 prescriptions. However, maintaining healthy ferritin levels is crucial when managing anemia. You should aim for ferritin levels within the normal range, typically around 30-300 ng/mL in women, but this can vary slightly based on the lab standards.
Next Steps:
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Discuss Your Weight Goals: Have an open discussion with your physician about your weight management goals and the specific concerns with GLP-1 medications. Bring research or data about its safety for individuals with a history like yours.
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Monitor Ferritin and Nutritional Status: Consider regular checks of your ferritin levels, along with other iron studies, to ensure you maintain adequate iron stores. Discuss any dietary changes or supplements with your healthcare provider to support muscle health.
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Nutrition Focus: Ensure that your diet emphasizes lean proteins and overall nutritional balance, which can help mitigate potential muscle loss with GLP-1 medications.
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Keep an Exercise Journal: Track your fitness routines and dietary intake alongside any changes in weight or body composition. This can provide valuable data for discussions with your healthcare provider.
By focusing on these areas, you can empower yourself in your health journey while addressing your weight management concerns effectively. Please let me know if you have any further questions or need more information!
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