GLP-1s: Gut issues & autoimmunity?

Sub-Squad

Sub-Squad

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Hi everyone,

I'm seeing conflicting reports about how GLP-1 meds affect IBS and autoimmune conditions. Anyone care to share their experiences?

Just so you know, I'm not currently overweight. I used to be, but I got to a healthy weight on my own about a decade ago (went from a BMI of nearly 35 to around 21) so I am considered a normal weight. But I'd really like some relief from my chronic conditions and I'm willing to give this a shot.

For the IBS/gut-condition angle, a thread on GLP-1s and gut conditions collects experiences that might be relevant to your situation.
 
I've had IBS with diarrhea since childhood, which was severely limiting. I had trouble going to places where I didn't know where the restrooms were and anxiety about eating out. I'd tried bland diets, meditation, and anti-diarrheal meds, but nothing really helped. Ozempic made my IBS better basically overnight. I've been taking it for about 2 and 1/2 years, and that alone has made it worth it.
 
I had IBS-D with such bad pain it was crippling, plus chronic fissures, and some bowel leakage for more than 3 decades. Doctors were generally unhelpful, basically saying, "We don't see anything wrong." but it was awful.

Within about a week of my first injection, my gut and bowel issues were pretty much gone. Except I had to start dealing with constipation, LOL. But it changed my life. The constant pain and itching that had controlled my life vanished.

I had to stop the meds for around three weeks before a surgery in February, and it was horrible. All the pain came back in just a couple of weeks. I'm back on it now, and really hoping it improves soon. Even if I didn't need to keep off the 70 or so pounds I lost, I'd stay on this for life just for the improvement in my quality of life.
 
Not IBS, but I've been taking 0.25mg for almost 2 years now to slow my digestion because of long-term GI problems they can't figure out. I started on a GLP-1 after they removed 14 inches of my colon due to diverticulitis.

It's been seriously amazing for me. I can mostly live a normal life now.
 
I have an idea for IBS - I learned this from a specialized clinic that treats complex chronic illnesses:

Specifically, enteric-coated peppermint oil capsules - they're a pro-kinetic and will help bacteria move out of the small intestine. I felt a lot better after just one week. After taking it for longer, I rarely have IBS anymore.

If you get 'peppermint burps,' you may need to use some Betaine HCL to raise stomach acid.

It's an inexpensive, low-risk supplement, so it's worth a shot!

Some people might also need to try the low-FODMAP diet. Good luck!
 
I'm on Ozempic for my autoimmune nr-axSpA, and I haven't had bowel issues or a diverticulitis flare-up since I started! My inflammation went down radically on the fourth day, and so did a lot of the other pain and problems!
 
I haven't gotten any relief from my autoimmune or digestive troubles. Actually, I'm more constipated than ever, instead of having diarrhea. That's just me, though. It seems that reduced inflammation can be a side effect of Oz, but it's not the main goal, and it doesn't happen for everyone. (Weight loss doesn't happen for everyone, either).

I think there are other medications that are made specifically for inflammation and autoimmune problems that would work better. I can't imagine insurance companies covering Ozempic for inflammation; it's pretty expensive. Wouldn't you be better off using something that's proven to work?
 
Just curious - did any rheumatologists tell you that losing weight would make RA symptoms better? Did you see any improvement or not?

A rheumatologist told me that and said all my symptoms were about my weight, even though I had the diagnosis before I gained the weight.
 
I think it basically cured my IBD overnight. I can even eat foods that used to trigger it. Although I still try to be careful and not overdo it.

Honestly, that's one of the biggest reasons I think I'll stay on this drug. My triggers are simple ingredients, so they were affecting almost everything I ate, and it was so stressful.
 
I had IBS-D after a bad eating disorder and a case of food poisoning. For 5 years, it was awful: rushing to the bathroom and avoiding anything that might trigger it. I tried the low-FODMAP diet. Now, within the first week of taking the lowest dose (0.25mg) of Ozempic, my IBS is almost gone.
 
I can't speak to IBS or AI directly, but I can say that the meds I had to take for T2D gave me almost constant diarrhea, and it was really hard to live with. Ozempic has cleared it, even though I still take the meds that cause the problem. I am reducing them, though. It seems like the ozempic has canceled out the diarrhea. I know IBS is more than just that, but IIRC that's one of the side effects. So from that point of view, Ozempic has been great. Maybe ozempic won't get rid of IBS, but it might make it easier to deal with.
 
Vinnie_1986 said:
Just curious - did any rheumatologists tell you that losing weight would make RA symptoms better? Did you see any improvement or not?

A rheumatologist told me that and said all my symptoms were about my weight, even though I had the diagnosis before I gained the weight.
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That's awful! Doctors dismiss women's pain all the time. Weight can be a factor, but it's rarely the only thing. I'm sorry that happened to you.
 
For constipation, I would strongly suggest psyllium husk. You can get it in Metamucil, but it's cheaper to buy a bag of the pure husk. Just mix with plenty of water and drink quickly! It really helps.
 
Kelly_1976 said:
For constipation, I would strongly suggest psyllium husk. You can get it in Metamucil, but it's cheaper to buy a bag of the pure husk. Just mix with plenty of water and drink quickly! It really helps.
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Just a warning: be careful when taking psyllium husk. It needs a lot of water. It can cause blockages if you don't drink enough! I usually take chia seeds in my morning oats instead. Or try eating dried dates. They're full of fiber.
 
I've been having crazy period problems since starting Ozempic, even though I haven't had a period in years because of my IUD. Last week, I felt like I was dying and went to the ER thinking it was appendicitis or something. Turns out it was just my period deciding to show up after a long vacation. Wild!
 
The visceral fat reduction is one of the more underappreciated GLP-1 mechanisms - it shows up in inflammatory markers, fertility improvements, and gut symptom changes even without major weight loss. For IBS and autoimmune overlap, the GI motility changes cut both ways: slower gastric emptying can ease some symptoms while worsening others, which is why individual response varies more than the general framing suggests. Starting without elevated metabolic markers is an increasingly common use case as the mechanism data expands.
 
GLP-1s consistently slow gastric motility, which helps IBS-D but can go too far with IBS-C. For autoimmune conditions the data is more mixed - some people see inflammation markers improve, others report flares during dose adjustments. If your main concern is IBS rather than weight, the motility effect is the most predictable and well-documented benefit.
 
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