We see patients in Bend, Oregon and Seattle, Washington, and by telehealth across California, Oregon, and Washington
The urges associated with them rely on dopamine, a powerful neurotransmitter, and other natural brain opioids
A 2019 review in Hormone and Metabolic Research documented these outcomes, while the landmark STEP 1 trial (Wilding et al., NEJM 2021) established 14.9% average weight reduction with semaglutide with direct relevance to androgen-driven conditions where adipose tissue is itself a hormonal organ
In their paper on the study, published in JAMA Ophthalmology , the researchers noted that the substantially increased risk of NAION observed in patients on semaglutide appears not to be due to differences in baseline characteristics between the cohorts. They proposed the possibility that expression of the GLP-1 receptor in the human optic nerve and GLP-1 RA-induced enhanced sympathetic nervous system activity might influence optic nerve head perfusion and potentially increase the risk of NAION. Another notable finding was that the greatest risk of NAION appeared to be within the first year following the prescription of semaglutide, a temporal association that supports a potential drug-induced risk of NAION, the researchers pointed out
Pharmacokinetic parameters that may not have been elucidated in humans should also be considered as the reason for these differences
