around week 9, i stopped taking most supplements… wasn’t planned, just that when eating one meal a day, remembering vitamins feels dumb. saved ~$60/month… but now i’m flat and can’t tell if that’s the shot or if i’m slowly creating a deficiency i won’t notice till later. my OB said sema doesn’t directly deplete anything, but seemed confused i wasn’t eating more. anyone else on a GLP-1 still take full supplements? or did you scale back and feel fine?
“my OB said sema doesn’t directly deplete anything” is technically right and also doing too much work, because the deficiency risk on a GLP-1 isn’t a direct mechanism, it’s just that OMAD plus appetite suppression means your intake floor for B12, iron, magnesium, D, and protein drops below replacement and nobody flags it until labs catch it 6 months later. so the OB framing is correct on pharmacology and wrong on practical risk, and those are different claims. the steel-man for stopping the multi is fair, most generic multis are absorption-limited and a real meal beats them. but the ones i’d hold the line on are B12 (sema-specific GI motility changes + low intake stacks badly), D if you’re indoors a lot, and a protein floor target before you even think about micros. iron only if you’re still cycling and your ferritin was borderline going in.
“flat” at week 11 also tracks for under-eating protein more than micronutrients ime, the energy drop shows up days before the labs do. worth pulling a B12, ferritin, vit D, and a basic metabolic panel before you decide it’s the shot vs the intake gap. logging protein grams with a quick note on energy each day for two weeks would tell you more than another supplement guess.
eta: one more thing
the ‘energy drop days before labs catch it’ hits harder for me than it should, because I’ve been assuming the flatness is sema when it’s probably just that 40g of protein in one meal isn’t covering what I actually need on broken sleep. I haven’t tracked grams, just vaguely ‘ate protein’ and called it done, which works when you’re sleeping normal hours but doesn’t work when you’re already running on fumes. When you say protein floor, do you mean per meal or per day? I could probably commit to hitting a number more reliably than juggling five supplements.
per day, not per meal. for me it’s 130g across the 48hr post-injection window because that’s when the food noise drops hardest and intake tanks 15-20g without me noticing, and one meal a day on suppression peak isn’t the same nutrient load as one meal a day on a normal hunger cue. the case for swapping five supplements for one protein number is fair, it’s genuinely more trackable and you’ll actually hit it. but protein gram target answers the protein question, not the deficiency question, and on OMAD those are different curves. iron, b12, magnesium, d, those are the ones that show up as flatness weeks before a CBC catches it, and a protein floor doesn’t cover any of them. if you’re still cycling, iron especially, bc the monthly loss doesn’t pause for sema. i’d probably keep a basic multi + d + magnesium and drop the rest, that’s three pills not five, and use the saved $60 on whatever bloodwork your OB will actually run instead of guessing. quick-logging protein from the watch complication right after the meal is what made the gram target stick for me, the friction of opening an app at the table was where i kept losing the habit. ymmv on the specific pills, ask your doc, but “i hit my protein” and “i’m not running a deficit” aren’t the same sentence.
The OB is technically right that sema doesn’t directly deplete anything, but one meal a day for 11 weeks is doing the depletion work on its own. B12 and D3 aren’t synthesized internally at meaningful rates, and if food volume is that compressed, dietary contribution drops toward zero even if absorption stays normal. “Flat” is the symptom that shows up first for both of those, usually before any lab flags it. The confound worth separating is drug effect vs. restriction effect, and the only way to do that cleanly is baseline labs before you change anything. For what it’s worth, I track subjective energy and supplement timing together in CareClinic, and the monthly trend summary is what let me see that my own flat periods were clustering around weeks I’d been inconsistent with magnesium, not around dose days. That kinda correlation is invisible if you’re just eyeballing it week to week.