Weight Loss

Semaglutide is a GLP-1 agonist. GLP-1 is a hormone in our body that is responsible for the regulation of your appetite. By mimicking this hormone, Semaglutide activates nerve cells in your brain that are involved in monitoring your level of hunger. The activation of these nerve cells decreases your appetite and allows you to “feel full” faster. Ultimately, you’re not as hungry, so you eat less and you lose weight!

There are a number of name brand versions of Semaglutide on the market, including Wegovy, Ozempic, and Rybelsus.

These medications are in HIGH demand. We finally have a safe, effective weight loss medication. When demand goes up, so does the price.

The cost of the name brand medications can run $800-$1,200 per month! Yikes. These name brand medications also require you to meet very specific criteria for a prior authorization with your insurance company. If you’d like to see if these medications are covered through your insurance, then we recommend contacting your primary care provider to start the process.

Another issue with the name brand weight loss medications is access. When demand goes up, supply goes down. The name brand versions of Semaglutide are often on back order. Patients have reported not being able to get Semaglutide for up to 8 months!

For these reasons, we obtain Semaglutide through a very high-quality compounding pharmacy. This means they make the medication on site at their pharmacy. Don’t worry about safety, because compounding pharmacies are under rigid state regulations.

As a provider, any time we prescribe a compounded medication we are then obligated to tell you that a FDA version of the medication is available. But, most patients are happier to more quickly receive a less expensive version of Semaglutide.

Unfortunately, we don’t “just sell medication.” Remember, weight loss is a team sport. At Pazona MD in Nashville, we believe in forming partnerships with patients. We aren’t going to just send you medication, some needles and syringes, and say “good luck.” There is a nuance to dosing the medication. Side effects, even if mild, need to be managed. Lastly it’s important we help you address the other important pillars of weight loss:

• Dietary choices
• Exercise
• Optimal sleep
• Stress management
• Hormone imbalances

For these reasons, The Pazona MD Nashville Weight Loss Program involves a monthly membership fee. Like any strong relationship, we are committing to each other.

Think of a weight loss partnership with our team as an investment in your health and future. You are investing money and time into this weight loss program for a future return of:

• Lower grocery and restaurant bills because you simply don’t eat as much
• Fewer doctor visits for medical illnesses
• Fewer medications for diseases of obesity (e.g. high blood pressure, diabetes, heart disease)
• Less joint and muscle pain from carrying extra weight
• Higher self-esteem

Review the cost for medication above.

They compound (mix) the Semaglutide with Levocarnitine (L-carnitine). Levocarnitine is a chemical that is made in the brain, liver, and kidneys. It helps the body turn fat into energy. When taken as a supplement, it acts as an energy booster and fat burner.

Semaglutide is administered as a painless injection into the subcutaneous fat in the abdomen weekly. The dosage is gradually increased over a period of 4-5 months to reduce gastrointestinal side effects. At the moment, there is not a pill form of Semaglutide available from a compounding pharmacy. The injections also allow us to deliver a more precise dosage, so you get the right amount of the medication for your body.

No, the medication only requires refrigeration after opening. The medication is shipped to us frozen, we store it in the freezer until it is dispensed. After the vial is opened you can store medication in the refrigerator despite the label on the vial stating “store in freezer.” It is only required to be frozen prior to opening.

Despite the label on the bottle stating “discard after 28 days,” the medication is safe to use until the printed expiration date on the vial. After the medication is compounded at the pharmacy, it is shelf stable for 90 days. Our team has confirmed with the compounding pharmacy that they are required to have that on vial for regulatory purposes, but it is safe to use until the expiration date printed on vial.

Common side effects include:

• Gastrointestinal upset/nausea
• Indigestion/heartburn/GERD
• Feeling “blue”
• Fatigue
• Abdominal bloating
• Diarrhea
• Constipation
• Hypoglycemia

If you've experienced any of these side effects, let our team know! That’s why we’re here as your partner — so you don’t have to play doctor.

The most common side effect of Semaglutide is minor nausea. Drinking a small glass of OJ, a cup of oatmeal, or something else bland, seems to settle any minor tummy issues in the morning. You’ll find this nausea most common when starting the medication, and with certain dose escalations.

If you’ve recently bumped up the dose, we may back off for a week or hold on further dose increases. More is not always better.

The other common cause of nausea is EATING TOO MUCH! You do need some discipline with food portions, otherwise your body will remind you that you’re on the Semaglutide with some tummy pains.

The other side effect we’ve seen is fatigue. We don’t want you NOT eating, just eating reduced portions. Severe caloric restriction can lower your metabolism and make you sleepy. Working out and sleeping 8 hours can combat feeling tired as well.

Semaglutide is the only FDA approved weight loss medication proven to be safe and effective to stay on long term. Once titrated to appropriate or maximum dosage, you can continue on Semaglutide as a maintenance medication in order to continue your weight loss goals or maintain your goal weight. In studies, patients have been on this medication for up to a year.

Patients who are a part of the Pazona MD Weight Loss Program have averaged a 20-45 lb weight loss at 3 months. More importantly, patients are KEEPING the weight off. Now that’s impressive!

Although we all want a “magic medication” that will allow us to lose weight with little to no effort, this is just not practical. Your weight loss depends on how well, or poorly, you address the other facets of your lifestyle. Luckily for you, Semaglutide makes it more challenging to overeat. Since diet is 80% of the battle, you’ll be well on your way to your goal weight.

Dosing titration as follows based on tolerance:

Week 1-3: 10 units
Week 4-6: 20 units
Week 7-9: 30 units
Week 10-12: 40 units
Week 13-15: 50 units

We will re-evaluate dosage at 50 units and may continue to titrate up by 10 units every 3 weeks to a total of 100 units weekly to achieve the desired effect.

Our team did extensive research into all available weight loss medications. Although patients have success with a variety of programs, we believe strongly that Semaglutide is the best option for most patients. It is the right combination of safe AND effective.

HCG is a hormone that is also supposed to suppress your appetite. However, in studies, HCG alone has been shown to not be an effective weight loss medication. Most patients lose weight on HCG because they are placed on a highly restrictive diet of only 500 calories per day. For reference, most adults need 1,500 – 2,000 calories a day to maintain a healthy weight.

Phentermine is another popular weight loss drug. It was the “safer” of the two weight loss medications from the “Fen-Phen” craze several years ago. It is a stimulant. Therefore, it can worsen high blood pressure, cause heart racing, and cause anxiety. Phentermine is also only indicated for a couple of months. On the other hand, Semaglutide is a weight loss medication that you can stay on for over a year.

Semaglutide is also known as “Ozempic,” which is used for diabetes management. When combined with certain diabetic medications, Semaglutide can cause a decrease in your blood sugar. If you are taking medications for diabetes, please let us know. We will coordinate care with your PCP or endocrinologist prior to initiating Semaglutide. However, it is very important to monitor your blood sugar closely while taking Semaglutide.

As with any medication, there are potential side effects; some of these side effects are more common than others. Although rare, Semaglutide can cause an elevation in pancreatic enzymes. Symptoms of pancreatitis can include sudden onset of severe abdominal pain. It is not contraindicated to use if you’ve had a history of pancreatitis, however, we will continue to monitor your tolerance and symptoms closely. This is another added benefit of our weight loss program at Pazona MD: You’re initiating the medication in a controlled environment where symptoms and lab work are assessed immediately.

Good question! First and foremost, your mental health is very important and takes priority. It is safe to take Semaglutide with antidepressant medications. A potential side effect of Semaglutide is “feeling a little blue” shortly after initiating the medication. This typically improves once your body becomes acclimated to the medication. However, if you feel as though you’re experiencing this side effect, or your mental health is worsening, please let our team know immediately. Again, we are here for you every step of the way throughout this journey, that includes your physical and mental wellbeing!

Yes, Semaglutide is safe to take if you have hypothyroidism and can be taken with common medications used to treat hypothyroidism (levothyroxine or armour thyroid). We do recommend continuing annual visits and lab monitoring with your PCP for management of this condition. Please be sure to let us know if you have a family or personal history of medullary thyroid cancer, although this specific form of thyroid cancer is very rare, Semaglutide is contraindicated in these cases.

It is recommended that women of childbearing age use some form of contraceptive while taking Semaglutide. Due to limited studies, it is also recommended to discontinue the medication two months prior to trying to conceive.