So— I’m on a low dose of Zepbound (a GLP1+GIP) for mcas/hEDS, and it’s been a game-changer. (2.5mg/mL, I started back in March 2026. Detailed description of my experience here.)
I no longer have constant concussion-type symptoms (which I’ve had for 5 years, debilitating levels of symptoms) and my joints don’t go out of place as much because the inflammation has gone waaay down. Also pretty minimal side effects, and my weight just went down to the weight I was stable at for 10 years before a migraine med (that didn’t even help the migraines) made me temporarily hypothyroid a couple years ago. I basically fluctuated in a ten pound range for a decade without any conscious effort, and now I’m back to that point. (And my thyroid markers are back to what they were before the migraine med. Topiramate was terrible for me.) I’m not “skinny”, just kind of… vaguely average sized, but that’s my normal.
It’s been a miracle drug for me that’s given me my brain back, so I don’t want people to be discouraged from it for pain/chronic illness reasons!! An MCAS study found that no one in their (admittedly small/preliminary) n=30 study became underweight in it and suggested it’s more of a “weight normalizing” med than a “weight loss” med.
The weight loss hype is obscuring the medical benefits and also the weight loss dosage protocol is terrible (they go up in dose so fast!). If you stay on the lowest effective dose (or even microdose if that’s an option for you, tho that generally requires paying out of pocket), it has way fewer side effects. Tirzapetide (eg zepbound) also seems better tolerated and more effective for the chronic illnesses it helps (basically any condition that involves chronic inflammation) than semaglutide (eg ozempic).
Conditions it seems to help with:
Hashimoto’s and Graves’ disease (+ other thyroid issues) - this review goes a bit more in depth about GLP1’s immunomodulation and inflammation regulation effects
Rheumatoid arthritis (improved arthritis symptoms independent of weight loss)
Addiction and substance abuse
Multiple sclerosis (including remyelination - the remyelination study was on rodents, but I’ve seen a ton of MS patients talking on Reddit about how after being on a glp1 for a while, their imaging showed remyelination, which is wild to me), and here’s one on physical activity of MS patients on glp1. (There are a looot more studies on MS and glp1s, MS has had more research in this area for longer than a lot of others.)
Long COVID (preliminary study, but there’s currently an n=1000 study in the works that should be out next year)
Neurodegenerative conditions (mostly neuroprotective, iirc it doesn’t reverse the effects of existing Alzheimer’s/dementia, but it has shown some evidence of improving cognition in Alzheimer’s patients)
probably some I’m forgetting (eg anecdotal reports of it helping with OCD, PTSD, etc, which makes sense because of how trauma and inflammation and the immune system are linked). Basically any time I think of a condition that involves chronic inflammation, I do a search to see if someone’s studied it re glp1s yet, and usually the answer is yes.
ETA: I should probably mention the on-label/approved uses like liver disease, diabetes, sleep apnea, cardiovascular risks.
A lot of these studies were done before the pharmaceutical companies got involved, it’s a lot of practitioners (esp rheumatologists) seeing their patients’ symptoms drastically improve on a GLP1 another doctor (like a pcp) prescribed for diabetes or weight loss or the like, and doing case studies or collaborating with universities for small preliminary studies over the past 5+ years.
Larger studies will probably have more pharm funding, now that the pharm companies are aware of these possibilities. but if it gets us on-label approval for using these meds to treat the above conditions and have them covered by insurance, I’m not gonna complain.
…the downside: if you’re using these meds for chronic health issues and you talk about the symptom improvement on a glp1 related forum, everyone tries to say it’s because of the weight loss. Even when the symptom relief happened within hours of your first dose. 9_9 it’s maddening. And disturbing. It says how much people have internalized this belief that “your health issues are because of your weight” even when that’s… often not the case. (Often it’s the other way around!)
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