Microdosing GLP-1 Medications in Charleston
GLP-1 medications such as semaglutide and tirzepatide have skyrocketed in popularity in a relatively short time and are reshaping the treatment of obesity and metabolic disease. As with most new phenomena, there are some gray areas that have yet to be fully explored. Microdosing GLP-1s has quietly entered the medical conversation at a time when many patients want to use it for weight loss and to maintain the benefits they’ve achieved.
Why GLP-1 Medications Are Reshaping Weight Loss
These medications were originally developed for patients with type 2 diabetes, but their effects on appetite regulation, insulin sensitivity and inflammation quickly pushed them into the spotlight for weight loss. Microdosing refers to using doses lower than the FDA-approved starting amounts to achieve specific goals such as appetite control, metabolic stability or maintenance. Financially, many have used microdosing as a way to “stretch” the medication and still achieve results.
Microdosing as an Entry Point or Exit Strategy
Chris Michaelis, DO, owner of Luminus Aesthetics, said microdosing often serves as an entry point or an exit strategy, depending on the patient. “We like to start people low anyway to see how they respond,” he explained. “You’re increasing insulin sensitivity while slowing gastric emptying, which helps people understand portion control and put lifestyle changes in place.” Microdosing can help patients hoping to lose 10 to 20 pounds get over the initial hurdle; then they can gradually taper off once they establish healthy habits.
In other cases, higher doses are more appropriate. Patients who are borderline diabetic, have significant excess fat or carry increased cardiovascular risk may need standard-dose GLP-1 therapy. “Those are usually lifelong treatments,” Dr. Michaelis said. “Microdosing isn’t meant to replace that. It’s a different tool for a different situation.”
Medical Supervision and Dose Adjustments
At its core, microdosing is not a do-it-yourself concept. Dr. Michaelis typically starts patients at doses well below labeled recommendations, with weekly injections and frequent follow-ups. Doses are adjusted every couple of weeks based on response, goals and side effects. “We don’t have patients adjust anything on their own,” he stressed. “If there’s nausea or fatigue, they call us and we evaluate them in the office.”
Side Effects and Why Lower Doses Appeal
Side-effect mitigation is one reason the concept of microdosing has gained traction. At lower doses, patients often experience fewer gastrointestinal symptoms such as nausea or vomiting, which can occur when GLP-1s are escalated too quickly. The slower pace allows the body to adapt while still benefiting from appetite suppression and improved blood sugar regulation.
Metabolic Benefits Beyond Weight Loss
Those metabolic effects are not limited to weight loss. Edmund Rhett, MD, of Rhett Women’s Center pointed out that many benefits of GLP-1 medications stem from reduced insulin levels overall.
“When you decrease the intake of starchy carbohydrates and ultra-processed foods, insulin levels drop,” he said. “High insulin tells your body to store everything as fat and prevents access to stored energy. These drugs help reverse that process, and inflammation often improves as well.”
Some patients who are not primarily seeking weight loss still report better energy, more stable blood sugar levels and reduced cravings. Dr. Rhett noted that many of these improvements reflect better eating patterns rather than the medication alone. “A lot of what we’re treating is poor dietary habits,” he said. “GLP-1s help people change those habits.”
Is Microdosing FDA-Approved?
Microdosing, however, is not an FDA-approved strategy. While GLP-1 medications themselves are approved at specific doses for diabetes and obesity, using smaller, extended or maintenance doses has not been formally studied. “There are no long-term studies that say microdosing works,” Dr. Rhett explained. “People are experimenting clinically to see if spreading doses out or gradually tapering down can help maintain weight loss.”
That lack of FDA approval has not stopped interest from growing. As access improves and costs come down, more patients are asking whether a very low dose can preserve the appetite regulation and metabolic benefits they experienced at higher doses. “Everybody’s lost weight and wants to know what to do next,” Dr. Rhett said. “Can you go to a tiny dose and keep the advantages? That’s why this conversation is happening now.”
Protecting Muscle and Planning for Facial Volume Changes
One area physicians watch closely during weight loss is muscle mass. Rapid weight loss, particularly without adequate protein and resistance training, can lead to muscle loss, which becomes harder to reverse with age. Dr. Michaelis emphasized that GLP-1 therapy, even at low doses, must be paired with intentional nutrition and exercise. In some cases, his practice incorporates peptides such as sermorelin to help preserve lean muscle while patients lose fat.
Concerns about facial volume loss, often referred to as “Ozempic face,” also come up. Dr. Michaelis said those changes are not inevitable but require planning. “If someone’s skin gets loose, they’re not going to love the results,” he said. “That’s when we talk about skin tightening treatments or adjusting the pace of weight loss.”
Long-Term Perspective and Next Steps
Both doctors stressed that microdosing should only be done under medical supervision. Adjusting doses independently or stretching prescriptions without guidance can increase the risk of side effects, nutrient deficiencies or muscle loss.
In many ways, microdosing GLP-1s reflects a broader shift away from one-size-fits-all dosing and toward individualized care. While the science is still evolving, doctors are cautiously optimistic.
“This isn’t about chasing a trend,” Dr. Michaelis said. “It’s about helping people feel better, protect their health and maintain the progress they’ve worked hard to achieve. But they need to do it safely and with guidance.”
Anyone curious about microdosing should start with a conversation, not a syringe, and speak first with a medical provider because microdosing remains a strategy shaped by experience rather than by formal guidelines.
By Anne Toole
