6 Nutrient Deficiencies DESTROYING Your Energy on Ozempic, Wegovy & Zepbound

Added: 2026-05-09

[00:00:00]Hey guys, Dr. James here. If you are on a GLP-1, Wegovy, Ozempic, Zepbound, and you are exhausted, fatigued, can't get off the couch, you are not lazy, you are not depressed, it's probably not Ozempic personality. You are likely dealing with a peptide-induced nutrient deficiency.

[00:00:17]Here's the deal, no doctors are checking for this. Today, I'm going to walk you through the six nutrients your body is burning through right now, and which symptoms to watch out for, including why your hair might be falling out. And at the end, I'm going to pull up a patient's real blood work panel and show you exactly how this plays out in blood work. Let's dive in. So, here is why this is happening. GLP-1 medications decrease your hunger levels, and they slow down your digestion. We know this.

[00:00:39]So, as a result, we typically eat dramatically less food while we're on a GLP-1. Less food coming in means less raw building block materials, aka nutrients, for our bodies to make energy. But, there's another underlying mechanism there. When we eat dramatically less food, or we decrease our caloric intake, a lot of times our stomach acid reduces as well. So, typically, we don't actually break down our food as efficiently. We need to break down our food into the simplest form to be able to absorb nutrients in the small intestine. So, it's actually a double whammy. We're taking in less nutrients as it is, and we're not breaking them down as well. And this is exactly how you can eat clean on a GLP-1 and still be walking around nutrient deficient and tired. So, here are the six big nutrient deficiencies that I see in my practice, ranked by what I see most. Numero uno is vitamin B12. This one's at the top of the list because it's getting hit from both sides. You're usually eating less things that contain B12 in it, and with lower stomach acid, our bodies don't break down the nutrients as well, so the B12 is just simply not getting absorbed. Now, if you pair this with a person who already has some level of leaky gut just from intestinal damage from wear and tear through the years, now all of a sudden we add in a GLP-1 and it slows down the rate the food is actually digested, we've just added insult to to on the problem. So, what are some of the symptoms that you might see here?

[00:01:58]Typically, terrible fatigue, brain fog, numbness and tingling in the hands and feet, and you guessed it, hair falling out. And the part that should really get your attention here is that B12 deficiencies often lead to neurological issues. That's where the numbness and tingling comes from. It's actually impacting your nerves, and this takes a long time to reverse. Once you start having that happen, it might take months to get rid of those symptoms. So, it's best not to ignore it. The problem is that most doctors aren't even checking your B12 levels. Now, most patients just go to the drugstore, they grab something off the shelf, and they say, "Hey, I'm taking B12." But, it's usually the wrong form. Most patients are taking cyanocobalamin or inactive forms of B12 that are not very helpful. In my practice, I typically use methylcobalamin, so the active form of B12. And this activated form helps assist your body in absorption and using it efficiently. So, don't waste your money on cheap products. Here's the functional medicine piece. If you look at the standard lab range for B12, if you if you have a like a 250 to a 300 score, where where I typically see most patients that are deficient, your doctor's going to tell you that you're fine. But, that is way too low. Bottom of the range is way too low. We want to see people north of 600, ideally around 1,000 to 1,500. Remember real fast, this is not medical advice. If being deficient is enough to damage your nerves, taking way too much can cause problems, too. So, it needs to be monitored. Number two is iron, specifically a marker called ferritin.

[00:03:17]This matters huge for menopausal women.

[00:03:20]I want the men watching this to pay special attention to it, as well. You need to check your ferritin as a guy, too. Men think iron doesn't really apply to them until your food intake on a GLP-1 drops, or the absorption goes down, and then all of a sudden you're deficient. And ferritin is the marker that matters. A lot of doctors will still check iron or serum iron. It's almost always normal for people, even people with severe iron absorption issues. We have to check this because if your ferritin's way too low, it's going to be a massive source of fatigue likely for you, shortness of a breath. It may be a reason why you're not losing weight. But then, on the other end, if it starts to go way too high, I see this just as often, it doubles as a marker for inflammation. Cuz so it can actually show you that your body's inflamed and inappropriately storing iron. Number three is magnesium. I call it the everything mineral. Did you know it runs over 300 enzyme reactions in the body?

[00:04:10]So it's responsible for a lot. And these symptoms can cluster together when you have a deficiency. Poor sleep, anxiety, muscle cramps, constipation, restless legs, and fatigue. If you're a woman in perimenopause or menopause and you're not sleeping at night, low magnesium and low progesterone are the two biggest things that you could be focusing on.

[00:04:28]Intuitively, poor sleep equals not a lot of energy and definitely can stall your weight loss in a hurry. Now, the form of magnesium matters a lot. So I like to use magnesium glycinate specifically for sleep and nervous system relaxation. So anxiety and anything sleep related. If you're needing to use it for constipation purposes, magnesium citrate tends to be the best. If you go to the drugstore and you just grab something off the shelf, just make sure it's not magnesium oxide. Usually, we don't use that at all. It's poorly absorbed and can cause diarrhea. Number four is actually going to be vitamin D. Symptoms of low vitamin D are poor mood, fatigue, getting sick all the time since it impacts your immune function, muscle weakness, and hair thinning. Here's the metabolism connection that most people are going to miss. Vitamin D is actually a hormone. And when your vitamin D is low, it directly impairs insulin sensitivity. So you're literally fighting your GLP-1 medication with one high hand tied behind your back. Now, for the optimal range for vitamin D, I want my patients between 50 to 100 ng per ml.

[00:05:30]Most labs call normal 30, which is sad because 30 is extremely deficient and it's way too low for your metabolic health. Now, if you're going to be supplementing at higher dosages of vitamin D, as with all of these tests, it is important to check your vitamin D, especially if you're going to be supplementing it, because it can be just as harmful for your vitamin D to be above 100 than it can be if it's at a 20. Number five is B complex. So, what is B complex? B1, B6, and folate. These are the cofactors that your mitochondria actually use to produce ATP, which is energy in the cells. No B vitamins equals no energy or poor cellular energetics. Low carb, low calorie diets, you tend to burn through your thiamine faster. And this is exactly what most GLP-1 patients are trying to run. High protein, low carb diet, usually thiamine's going to be in the gutter.

[00:06:20]Folate and vitamin B6 are critical for hair, skin, nails, and actually making your neurotransmitters. This impacts your mood, by the way. So, we need to use the methylated forms of B12 typically. This means methylfolate, P5P, and methylcobalamin within our B complex supplements. So, about 30 to 40% of people just genetically cannot convert or are not really great at converting these synthetic forms of B vitamins. So, we need to use the active forms when we're supplementing in order for them to be absorbed appropriately. I'll show you in the labs here in a second on what we need to check when it comes to B vitamins. Number six is actually electrolytes. This is probably my favorite. Save the best for last. When you eat less and you're told not to eat salt, God forbid, obviously you're taking in less sodium, less potassium, less magnesium. Your body cannot run without these. It impacts everything.

[00:07:12]Blood volume, blood pressure, how you feel is directly impacted by your electrolyte function. So, symptoms of low electrolytes are literally going to be complete brain fog, feeling like you're going to pass out when you stand up, mid-afternoon crash, dizziness, muscle cramps, heart palpitations, and blood pressure issues. I have to share this with you guys because it just happened to me like 3 days ago. I had a patient with hypertension, so the blood pressure was way too high on a daily basis, 30 to 40 points too high. And I I mean consistently. He told me he stopped taking his blood pressure medication cuz he didn't agree with it. He wasn't going to take it anymore. He was looking for alternative solutions. This is going to sound so silly, but all I had him do was just slightly increase his water intake and add electrolytes each and every day.

[00:07:54]3 weeks later, he came back in to see me and we had some blood work to review. I was excited to see him because I had all these ideas on how to reduce his blood pressure further. Turns out he didn't need it at all. He reported a 30-point drop on average daily blood pressure.

[00:08:08]Literally, his blood pressure was completely normal, 120 over 80. It fixed the problem. Turns out he was just severely electrolyte deficient and not drinking quite enough water. So, if you think over-the-counter supplements can't make a difference, think about this story. This is exactly why we have to be careful with over-the-counter supplements and treat them with a level of respect. They can be as significant as any medical treatment and they're just sitting right there in the grocery store. And this is exactly why on this video, like I can't tell you exactly what to take. That would be completely wrong. We don't want to guess. We want to test. So, how does this actually look in real blood work? Let me pull up a recent patient and I'll walk you through it. All right. So, we have a middle-aged female here who is on tirzepatide and has been plateaued for about a month or so. And we just ran these labs and these are some areas where we need to improve significantly. First and foremost, the lab that we just talked about, the iron or the iron storage, aka the ferritin, is right here. You can see that this patient's ferritin is quite low. This is definitely a case where you somebody needs to be supplementing with iron.

[00:09:09]This is going to be a full court press where we're focusing in and making sure that we're optimizing nutrition, optimizing digestion, having them supplement correctly in a way that they're not getting constipated from the iron. This patient we're working on all of those things and I believe I'm going to refer them out for iron IVs as well just because this has been so low and this has been a problem and we need to enhance results. So, if you run your ferritin and it looks like this and you're you're feeling well, you have poor exercise tolerance, you're exhausted, or your weight loss is stalled, then this could be a massive reason why. Next vitamin here that we want to take a look at, we got vitamin B12, and it's at 297. So, anything under 600 is deficient. We need to get this person up with using methylated B vitamins, sublingual methyl B vitamins, immediately. My goal is to push her all the way to 1,500. And you know, have make have her other doctors screaming at her to stop. But I'd be comfortable with this patient being around 1,500.

[00:10:06]Remember, your body's probably just going to pee out what it doesn't need.

[00:10:09]It's not going to hurt your kidneys.

[00:10:10]Unless you're somebody that's in kidney failure, then it shouldn't be a huge problem. Think back to the B complex part I was talking about. One of the things that we like to check for B complex is a homocysteine level. I'm trying to highlight it, it's highlighting everything else.

[00:10:22]So, you got your homocysteine level right here. It's at a nine. I want to see all my patients at a nine or below.

[00:10:27]So, she's she's just barely at the cut off here. If let's say that you're at like a 10, 11, 12, or even like I had a patient yesterday that was at an 18, that is pointing to a larger deficiency, and that can be a massive cause for fatigue, stall, and and then like I said, neurologic symptoms while on a GLP-1. So, we want to watch for this.

[00:10:46]This is a must. A lot of doctors don't check this for some reason. Lastly, the last test I'll go over here is vitamin D. She's at a 43 here, which isn't the end of the world. I want to see her higher. I would prefer her to be at around an 80. So, we're actually going to double her dosage, bring her up to 10,000 IUs per day, cuz I think she's taking 5,000 IUs currently. So, we're going to push on this. The important thing with vitamin D is that you retest.

[00:11:08]We don't want to drive her over 100 and cause any issues there. This is the type of stuff you cannot guess your way through. You either run the labs, or you just keep spinning your wheels. So, here's what I want you to do. If you want me to run this exact panel on you, build you a protocol, dial in your GLP-1, click the link down below to apply to work with us. We're doing this for patients all over the country. If this video helped you in any way, please smash the like button, give us a thumbs up, and subscribe. Drop a comment down there. I have another lab review video right here that you might find interesting where we take a patient from start to finish. I show why she was stuck with her weight loss, what we fixed, how we went about it to get her a good result. Otherwise, I will see you guys next week. Take care. God bless.