On the November morning when the sulfur burps started, Derron Borders was welcoming potential college students on the graduate faculty the place he works in New York. Each couple of minutes, irrespective of how laborious he tried to cease, one other foul-smelling cloud escaped his mouth. “Burps that style and scent like rotten eggs—I believe that’s what I typed in Google,” he informed me.
Ultimately, Borders discovered that his diabetes remedy was guilty. Sulfur burps look like a considerably uncommon facet impact of semaglutide, tirzepatide, and different medicine of their class, often known as GLP-1 receptor agonists. Over the previous a number of years, these medicines have grow to be more popular underneath the model names Ozempic, Wegovy, and Mounjaro, as a diabetes remedy and a weight-loss drug. And as prescription numbers rise, a wierd and ugly facet impact has been rising extra obvious too.
GLP-1 receptor agonists are well-known to trigger gastrointestinal signs, together with stomach ache, diarrhea, and vomiting. In clinical trials of semaglutide for weight reduction, 44 % of members skilled nausea and 31 % had diarrhea. (The identical circumstances stricken solely about one-sixth of members who acquired a placebo.) Burping, a.ok.a. “eructation,” confirmed up in about 9 % of those that received the drug, versus lower than 1 % of those that took a placebo. The FDA lists eructation as a doable facet impact for semaglutide and tirzepatide alike.
However I couldn’t discover any data within the clinical-trial studies or FDA reality sheets about sulfur burps specifically, and neither Novo Nordisk nor Eli Lilly, the businesses that make these medicine, responded to my inquiries. Laura Davisson, the director of medical weight administration at West Virginia College Well being Sciences, informed me that greater than 1,000 of her clinic’s sufferers are presently on a GLP-1 receptor agonist, and about one-fifth expertise sulfur burps at first. For all however a handful of those sufferers, she stated, the difficulty goes away after just a few months. Holly Lofton, an obesity-medicine specialist at NYU, guesses that it impacts simply 2 % of her sufferers.
Specialists aren’t positive why taking GLP-1 receptor agonists may result in having smelly burps, however they’ve some theories. Davisson proposed that semaglutide boosts the variety of micro organism in sufferers’ digestive tracts that produce hydrogen sulfide, a fuel that may be expelled from both finish of the digestive tract, and that smells (as Borders discovered) like rotten eggs. She additionally famous that the medicine decelerate digestion, which may give the abdomen extra time to interrupt down meals and produce fuel. On this scenario, Lofton informed me, the putrid air could escape most readily up by the mouth, as a result of it’s lighter than the liquids and semi-solids that additionally fill the abdomen. “No matter’s on prime will come up,” she stated.
Consuming greater than ordinary whereas on the medicines appears to be a standard set off. Davisson stated that sure meals, corresponding to dairy, might also result in extra odorous emissions. “Generally it’s a matter of trial and error,” she stated. “Some suggestions that we give persons are issues like: Don’t eat actually heavy meals; don’t eat massive parts without delay; don’t eat proper earlier than mattress.” Along with these behavioral approaches, Craig Gluckman, a gastroenterologist at UCLA Well being, informed me he recommends antacids and anti-gas medicines to sufferers with GLP-1-agonist-related sulfur burps. (On-line, apple-cider vinegar is often really helpful as a repair, however Gluckman stated he wouldn’t suggest it.)
The suppliers I spoke with stated that, usually, sufferers are inclined to expertise sulfur burps after they’re first beginning an Ozempic-like drug, or elevating their dose. That was the case for Crystal Garcia, an HR administrator in Texas who began taking semaglutide from a compounding pharmacy after her physician informed her she was prediabetic. (Garcia vlogs about her expertise with weight-loss medicine.) Three months later, whereas out to breakfast at a restaurant, Garcia’s household began to complain a couple of gross and eggy scent. Garcia figured that the scent was coming from the meals, nevertheless it lingered within the automobile after the meal. The household questioned whether or not Garcia’s younger son had had an accident. “I used to be like, it couldn’t be me. There’s no method,” she informed me. However when she burped once more, she was pressured to alter her thoughts.
Many sufferers are unaware that sulfur burps are a doable facet impact of their remedy till they begin, nicely, burping sulfur. For some time, Borders had no concept that his diabetes drugs may be the wrongdoer; when he noticed a doctor’s assistant to debate his challenge, “Ozempic didn’t even come up,” he stated. The facet impact is comparatively new to physicians. Earlier GLP-1 agonists didn’t appear to supply sulfur burps so incessantly, Lofton stated. In her follow, the phenomenon wasn’t actually obvious till Ozempic hit the American market in 2018, and even then, she discovered about it solely from her sufferers. “I’d by no means heard of sulfur burps earlier than I began prescribing this drugs,” she stated.
Although the sulfur burps are (bodily) innocent, some sufferers do cease taking their diabetes or weight-loss medicine due to them, Lofton informed me. However most, together with Garcia and Borders, find yourself sticking with their program. As unhealthy because the unwanted effects could also be, sufferers suppose the medicine’ advantages are value it. “I’ve had a affected person say that her burps smelled like poop,” Davisson stated. However even then, she didn’t wish to cease the remedy.
