Symptoms3 min read
Dizziness and fatigue on GLP-1 treatment: the most common causes and what to do
Why dizziness and fatigue show up on GLP-1 treatment, what to do in the moment, how to handle low blood sugar and when to seek medical care.
The most common causes
With less appetite, meals get smaller, and food is also part of the day’s water; often there’s less drinking, too. Dizziness when standing up and unusual tiredness are among the signs of dehydration, along with a dry mouth, strong thirst and dark or scant urine.
Vomiting and diarrhea cause fluid loss, and that loss can affect the kidneys. Eating so little that weakness sets in is not the treatment “working better”: it’s a sign to adjust your eating with your care team.
If you take blood pressure medicine, dizziness on standing that keeps happening is worth bringing to your appointment: as weight comes down, blood pressure can drop, and the dose may need a review.
When dizziness hits
Safety first, then the cause.
- Sit or lie down until it passes.
- Get up slowly: sit on the edge of the bed for a moment before standing.
- If you use insulin, a sulfonylurea or a glinide, check your blood sugar before anything else.
- Then sip water, and eat something if it’s been a while since your last meal.
- Don’t drive while the dizziness lasts.
Low blood sugar, if you also take diabetes medicine
The risk is higher with insulin, sulfonylureas or glinides, but low blood sugar can also happen without diabetes: the prescribing information for tirzepatide reports cases like this. The signs are a cold sweat, shakiness, sudden hunger, a racing heart, confusion and blurred vision, with blood sugar below 70 mg/dL (3.9 mmol/L).
When it’s mild, and the person is conscious and able to swallow, the first step is fast-acting sugar: 15 g, which is 120 mL (4 oz) of juice or regular soda (not diet), or 1 tablespoon of sugar. With a glucose meter, check again in 15 minutes and repeat if it’s still below 70; without a meter, repeat if the signs continue. Then have a snack and let your care team know.
Severe confusion, fainting, a seizure, being unable to swallow, or mild low blood sugar that doesn’t improve with sugar is an emergency: call your local emergency number. Anyone nearby should give nothing by mouth to someone who can’t swallow, and should use the emergency medicine for low blood sugar, if one has been prescribed and someone knows how to use it.
Adjusting insulin or any other diabetes medicine is up to your prescriber, never something to do on your own.
When the tiredness lingers
Tiredness during treatment usually responds to the basics.
- Have a meal or a snack with protein, even without hunger.
- Sip water throughout the day.
- Get good sleep.
- On a low-energy day, rest or keep your workout light, and get back to normal when your energy returns.
When to get help
Seek urgent care if dizziness comes with fainting, chest pain, a pounding heart or shortness of breath; with weakness or numbness on one side of the body or slurred speech; if it doesn’t go away or comes with vomiting; or with signs of severe dehydration, like little or no urine and confusion. A racing heart at rest that lasts a few minutes or keeps coming back: contact your care team soon, without waiting for your appointment.
In Morphi
You log dizziness and tiredness as symptoms and keep track of your water goal through the day. If they keep happening, those logs go into the one-page summary you bring to your appointment.
