Straight Shot with Dr. Clete Barrick

Dr. Clete Barrick
  • 5.0 (1)
  • Medicine

Straight Shot is the GLP-1 podcast for patients who want the real information, not the watered-down version. Dr. Clete Barrick is dual board-certified in internal medicine and obesity medicine, has treated more than 5,000 patients on GLP-1s, and has personally lost 100 lbs on tirzepatide. Each week he breaks down one focused topic: how these medications work, how to optimize your results, what your doctor isn't telling you, and what the science actually says. No guests. No fluff. No corporate script. Just the straight shot, from a doctor who lives it. New episodes weekly. Visit barrickhealth.com for physician-led weight loss care.

  1. 23h ago

    GLP-1s & the Skin and Hair

    Let Dr. Barrick know what you think of the episode and send any questions his way too! Is your GLP-1 making your hair fall out? This episode covers hair loss and what to do about it, burning skin on high doses, injection-site reactions, Ozempic face, loose skin and body contouring surgery, psoriasis, hidradenitis and skin cancer. Ending with a verdict, built from a full literature review. Dr. Clete Barrick is board-certified in internal medicine and obesity medicine. Straight Shot Season 2 goes through the body one system at a time. In this episode: - Hair loss is real, mostly in women, and mostly comes from rapid weight loss; it usually grows back - Protein, iron and patience come first; topical minoxidil if shedding is heavy - Burning skin hit about 1 in 5 patients on semaglutide 7.2 mg and usually settles with a lower dose - Ozempic face is weight loss revealing aging, not the drug aging you - Adding tirzepatide to a biologic increased complete psoriasis clearance; no rise in melanoma The GLP-1 Bible, my book, is out now as an ebook (EPUB, $12.99), with the print copy coming soon: https://payhip.com/b/I6zhx Your first visit at Barrick Health is free: https://barrickhealth.com Chapters 0:00 Is Ozempic making your hair fall out? 1:48 Hair loss: how common and why 4:47 What to do about hair loss 7:26 Burning or painful skin 9:31 Injection sites and rashes 11:08 Ozempic face 12:44 Loose skin and body contouring 14:01 Psoriasis 14:52 Hidradenitis and other skin conditions 16:01 Skin cancer 16:46 Where I land Sources Hair loss Wegovy label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b Zepbound label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b Hair loss meta-analysis: https://pubmed.ncbi.nlm.nih.gov/42155605/ Survey by weight lost: https://pubmed.ncbi.nlm.nih.gov/42579223/ BMJ alopecia cohort: https://pubmed.ncbi.nlm.nih.gov/42486607/ Hair loss after bariatric surgery: https://pubmed.ncbi.nlm.nih.gov/33675022/ What to do about it Minoxidil expert consensus: https://pubmed.ncbi.nlm.nih.gov/39565602/ Burning skin STEP UP: https://pubmed.ncbi.nlm.nih.gov/40961952/ STEP UP T2D: https://pubmed.ncbi.nlm.nih.gov/40961953/ TRIUMPH-2: https://pubmed.ncbi.nlm.nih.gov/42810372/ Injection sites Injection-site meta-analysis: https://pubmed.ncbi.nlm.nih.gov/41395692/ Tirzepatide antibodies: https://pubmed.ncbi.nlm.nih.gov/37700637/ Ozempic face and loose skin Midface imaging: https://pubmed.ncbi.nlm.nih.gov/40407186/ Perceived age after surgery: https://pubmed.ncbi.nlm.nih.gov/30252813/ Body contouring complications: https://pubmed.ncbi.nlm.nih.gov/41364427/ Contouring vs bariatric patients: https://pubmed.ncbi.nlm.nih.gov/41729134/ Weight plateau meta-analysis: https://pubmed.ncbi.nlm.nih.gov/40835770/ Psoriasis TOGETHER-PsO: https://pubmed.ncbi.nlm.nih.gov/42139049/ Weight loss and psoriasis: https://pubmed.ncbi.nlm.nih.gov/41416383/ Hidradenitis Danish HS cohort: https://pubmed.ncbi.nlm.nih.gov/42828450/ Skin cancer Skin cancer target trial: https://pubmed.ncbi.nlm.nih.gov/42521622/ UK cohort: https://pubmed.ncbi.nlm.nih.gov/37876318/ Everything in this episode is for educational purposes. It is not medical advice. #GLP1 #HairLoss #OzempicFace #StraightShot

    GLP-1s & the Skin and Hair

  2. Nov 2

    GLP-1s & the Immune System

    Let Dr. Barrick know what you think of the episode and send any questions his way too! Does a GLP-1 weaken your immune system? This episode covers infections, COVID, sepsis, shingles, surgery, inflammation, autoimmune disease, allergic reactions, transplant medicines, HIV and vaccines. Ending with a verdict, built from a full literature review. Dr. Clete Barrick is board-certified in internal medicine and obesity medicine. Straight Shot Season 2 goes through the body one system at a time. In this episode: - Across 136 randomized trials, serious infections were slightly less common on a GLP-1, not more - One database study found a little more shingles; get Shingrix at 50 or older - CRP falls 35 to 55%, partly before much weight comes off - No credible evidence GLP-1s cause autoimmune disease; tirzepatide helped psoriatic arthritis in a trial - Transplant and HIV medicines are compatible with the shots; the Foundayo pill has real drug interactions The GLP-1 Bible, my book, is out now as an ebook (EPUB, $12.99), with the print copy coming soon: https://payhip.com/b/I6zhx Your first visit at Barrick Health is free: https://barrickhealth.com Chapters 0:00 Does a GLP-1 weaken your immune system? 1:43 Infections overall 3:38 COVID and pneumonia 4:36 Sepsis 5:12 Shingles and cold sores 6:38 Urinary infections and surgery 7:35 Inflammation and CRP 8:47 Autoimmune disease risk 10:00 Living with autoimmune disease 11:10 Allergic reactions and antibodies 12:53 Organ transplant 14:36 HIV 15:32 Vaccines 16:18 Where I land Sources Infections overall 136-trial meta-analysis: https://pubmed.ncbi.nlm.nih.gov/41173399/ Network meta-analysis: https://pubmed.ncbi.nlm.nih.gov/41610949/ FLOW infection analysis: https://pubmed.ncbi.nlm.nih.gov/41728915/ SELECT safety: https://pubmed.ncbi.nlm.nih.gov/39948761/ COVID and pneumonia SELECT non-CV deaths: https://pubmed.ncbi.nlm.nih.gov/39217559/ Pneumonia in outcome trials: https://pubmed.ncbi.nlm.nih.gov/33825329/ Sepsis Sepsis and pneumonia cohort: https://pubmed.ncbi.nlm.nih.gov/39645259/ Shingles Herpes target trial: https://pubmed.ncbi.nlm.nih.gov/41469686/ UTIs and surgery Danish UTI study: https://pubmed.ncbi.nlm.nih.gov/40173095/ Arthroplasty meta-analysis: https://pubmed.ncbi.nlm.nih.gov/42538001/ Major surgery: https://pubmed.ncbi.nlm.nih.gov/39788883/ Inflammation STEP CRP: https://pubmed.ncbi.nlm.nih.gov/36467859/ SURMOUNT-1 biomarkers: https://pubmed.ncbi.nlm.nih.gov/42233927/ SELECT hsCRP: https://pubmed.ncbi.nlm.nih.gov/42610271/ SELECT mediation: https://pubmed.ncbi.nlm.nih.gov/42777687/ Autoimmune disease Canadian cohort: https://pubmed.ncbi.nlm.nih.gov/41466578/ TriNetX cohort: https://pubmed.ncbi.nlm.nih.gov/40544585/ TOGETHER-PsA: https://pubmed.ncbi.nlm.nih.gov/41903163/ NYU lupus cohort: https://pubmed.ncbi.nlm.nih.gov/39388251/ Allergy and antibodies Anaphylaxis cohort: https://pubmed.ncbi.nlm.nih.gov/38363873/ Zepbound label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b Wegovy label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b Transplant Kidney transplant meta-analysis: https://pubmed.ncbi.nlm.nih.gov/42017027/ Kidney transplant registry: https://pubmed.ncbi.nlm.nih.gov/40056927/ Orforglipron interactions: https://pubmed.ncbi.nlm.nih.gov/42399716/ Foundayo label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8ac446c5-feba-474f-a103-23facb9b5c62 HIV Semaglutide in HIV: https://pubmed.ncbi.nlm.nih.gov/38964353/ Immune markers in HIV: https://pubmed.ncbi.nlm.nih.gov/40160348/ Vaccines Vaccine hypothesis: https://pubmed.ncbi.nlm.nih.gov/39025754/ Weight loss and vaccine response: https://pubmed.ncbi.nlm.nih.gov/35062740/ Everything in this episode is for educational purposes. It is not medical advice. #GLP1 #ImmuneSystem #Inflammation #StraightShot

    GLP-1s & the Immune System

  3. Oct 26

    GLP-1s & the Endocrine System

    Let Dr. Barrick know what you think of the episode and send any questions his way too! Every GLP-1 carries a black box warning about thyroid cancer. Should it worry you? This episode covers the thyroid cancer data, why screening ultrasounds backfire, your thyroid pill, prediabetes, low blood sugar on insulin and other diabetes medicines, type 1 diabetes, ketoacidosis, bariatric surgery, your adrenal glands and genetic causes of obesity. Ending with a verdict, built from a full literature review. Dr. Clete Barrick is board-certified in internal medicine and obesity medicine. Straight Shot Season 2 goes through the body one system at a time. In this episode: - The thyroid cancer warning comes from rodents; the human risk is very low and unproven - Routine calcitonin tests and thyroid ultrasounds lead to biopsies and surgery without proven benefit - Levothyroxine doses often need to come down as weight comes off - Prediabetes reverses while you take a GLP-1, and much of that fades after stopping - Sulfonylureas and insulin need adjusting at the start, carefully, to avoid both lows and ketoacidosis The GLP-1 Bible, my book, is out now as an ebook (EPUB, $12.99), with the print copy coming soon: https://payhip.com/b/I6zhx Your first visit at Barrick Health is free: https://barrickhealth.com Chapters 0:00 The thyroid cancer warning 2:05 Where the black box warning comes from 4:04 The common thyroid cancers 6:08 Why you shouldn't get screened 7:39 Your thyroid pill 9:16 Prediabetes, on and off the shot 10:49 Low blood sugar on other diabetes medicines 12:52 Type 1 diabetes 14:16 When type 2 isn't really type 2 15:23 Ketoacidosis without diabetes 16:13 After bariatric surgery 17:19 Adrenals and pituitary 18:32 Brain and genetic causes of obesity 19:51 Where I land Sources The black box warning Rodent and monkey C-cell studies: https://pubmed.ncbi.nlm.nih.gov/20203154/ LEADER calcitonin: https://pubmed.ncbi.nlm.nih.gov/29279300/ Scandinavian cohort: https://pubmed.ncbi.nlm.nih.gov/38683947/ French case-control: https://pubmed.ncbi.nlm.nih.gov/36356111/ Common thyroid cancers Annals meta-analysis, Ko: https://pubmed.ncbi.nlm.nih.gov/41359966/ Trial meta-analysis, Silverii: https://pubmed.ncbi.nlm.nih.gov/38018310/ Multinational cohort, Baxter: https://pubmed.ncbi.nlm.nih.gov/39772758/ Screening Overscreening study: https://pubmed.ncbi.nlm.nih.gov/41371825/ Your thyroid pill Oral semaglutide and levothyroxine: https://pubmed.ncbi.nlm.nih.gov/34289755/ Levothyroxine after bariatric surgery: https://pubmed.ncbi.nlm.nih.gov/26895690/ Prediabetes STEP 10: https://pubmed.ncbi.nlm.nih.gov/39089293/ SURMOUNT-1 three-year: https://pubmed.ncbi.nlm.nih.gov/39536238/ STEP 1 extension: https://pubmed.ncbi.nlm.nih.gov/35441470/ Remission definition: https://pubmed.ncbi.nlm.nih.gov/34462270/ Low blood sugar GRADE hypoglycemia: https://pubmed.ncbi.nlm.nih.gov/39546502/ Zepbound label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b Type 1 diabetes and LADA ADJUST-T1D, semaglutide: https://pubmed.ncbi.nlm.nih.gov/40550013/ Tirzepatide in type 1: https://pubmed.ncbi.nlm.nih.gov/41264593/ C-peptide and response: https://pubmed.ncbi.nlm.nih.gov/26242184/ Ketoacidosis Ketoacidosis without diabetes: https://pubmed.ncbi.nlm.nih.gov/39686534/ After bariatric surgery GLP-1 in post-bypass lows: https://pubmed.ncbi.nlm.nih.gov/27975209/ Adrenals and pituitary Hydrocortisone absorption case: https://pubmed.ncbi.nlm.nih.gov/23264309/ Craniopharyngioma cohort: https://pubmed.ncbi.nlm.nih.gov/41153084/ Brain and genetic obesity Exenatide in hypothalamic obesity: https://pubmed.ncbi.nlm.nih.gov/33026160/ TRANSCEND, setmelanotide: https://pubmed.ncbi.nlm.nih.gov/42418774/ MC4R carriers on tirzepatide: https://pubmed.ncbi.nlm.nih.gov/40858971/ Everything in this episode is for educational purposes. It is not medical advice. #GLP1 #Thyroid #Prediabetes #StraightShot

    GLP-1s & the Endocrine System

  4. Oct 19

    GLP-1s & the Respiratory System

    Let Dr. Barrick know what you think of the episode and send any questions his way too! Zepbound is now FDA-approved for sleep apnea. Can you finally put the CPAP away? This episode covers what GLP-1s do for sleep apnea, why the sleep study should come before the shot, what happens if you stop, and the evidence on asthma, COPD, lung function, lung cancer and breathing side effects. Ending with a verdict, built from a full literature review. Dr. Clete Barrick is board-certified in internal medicine and obesity medicine. Straight Shot Season 2 goes through the body one system at a time. In this episode: - Tirzepatide cut breathing interruptions in sleep apnea roughly in half, and about half of patients reached remission or mild sleep apnea - Nobody has tested stopping CPAP on a GLP-1, and sleep apnea will likely return if the weight does - Get the sleep study before the medication starts working - Asthma and COPD flare-ups look lower in database studies, with no randomized proof yet - No sign of more lung cancer; a reflux cough is the most common chest side effect The GLP-1 Bible, my book, is out now as an ebook (EPUB, $12.99), with the print copy coming soon: https://payhip.com/b/I6zhx Your first visit at Barrick Health is free: https://barrickhealth.com Chapters 0:00 Can you ditch the CPAP? 2:02 The sleep apnea trials 4:10 What it means for how you feel 6:49 Can you stop your CPAP? 8:52 Semaglutide, retatrutide and the rest 11:02 Get tested before you start 13:18 Obesity hypoventilation 14:26 Asthma and COPD 16:36 Lung function and rarer lung disease 17:40 Lung cancer 18:25 Cough, reflux and other side effects 20:08 Where I land Sources Sleep apnea trials SURMOUNT-OSA (NEJM 2024): https://pubmed.ncbi.nlm.nih.gov/38912654/ Zepbound label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b How you feel SURMOUNT-OSA patient-reported outcomes: https://pubmed.ncbi.nlm.nih.gov/40774158/ Time course and weight: https://pubmed.ncbi.nlm.nih.gov/41135142/ SAVE CPAP trial: https://pubmed.ncbi.nlm.nih.gov/27571048/ Stopping CPAP and stopping the shot SURMOUNT-4: https://pubmed.ncbi.nlm.nih.gov/38078870/ Diet-cured sleep apnea follow-up: https://pubmed.ncbi.nlm.nih.gov/9864013/ The other GLP-1s TRIUMPH-1 retatrutide: https://pubmed.ncbi.nlm.nih.gov/42814954/ SCALE Sleep Apnea, liraglutide: https://pubmed.ncbi.nlm.nih.gov/27005405/ UK active-comparator cohort: https://pubmed.ncbi.nlm.nih.gov/42745463/ Getting tested AASM diagnostic testing guideline: https://pubmed.ncbi.nlm.nih.gov/28162150/ Obesity hypoventilation ATS guideline: https://pubmed.ncbi.nlm.nih.gov/31368798/ Bicarbonate on GLP-1s and SGLT2s: https://pubmed.ncbi.nlm.nih.gov/41014194/ Asthma and COPD Asthma exacerbations, Wang: https://pubmed.ncbi.nlm.nih.gov/39012183/ GLP-1s in obese asthma, McCraw: https://pubmed.ncbi.nlm.nih.gov/42733229/ Weight loss and asthma control: https://pubmed.ncbi.nlm.nih.gov/39940116/ COPD target trial emulation, Ray: https://pubmed.ncbi.nlm.nih.gov/39928303/ Lung function and rarer disease LIRALUNG: https://pubmed.ncbi.nlm.nih.gov/34737187/ Liraglutide in COPD: https://pubmed.ncbi.nlm.nih.gov/35237033/ GLP-1 before lung transplant (case): https://pubmed.ncbi.nlm.nih.gov/38594196/ Lung cancer TriNetX respiratory outcomes, Ho: https://pubmed.ncbi.nlm.nih.gov/41083699/ Medicare cancer cohort, Lu: https://pubmed.ncbi.nlm.nih.gov/40841345/ Side effects Infections meta-analysis, Han: https://pubmed.ncbi.nlm.nih.gov/41173399/ Chronic cough, Gallagher: https://pubmed.ncbi.nlm.nih.gov/41296333/ Silent aspiration case: https://pubmed.ncbi.nlm.nih.gov/40625884/ Wegovy label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b Everything in this episode is for educational purposes. It is not medical advice. #GLP1 #SleepApnea #Zepbound #StraightShot

    GLP-1s & the Respiratory System

  5. Oct 12

    GLP-1s & the Musculoskeletal System

    Let Dr. Barrick know what you think of the episode and send any questions his way too! What do GLP-1s do to your bones, muscles and joints? Today we cover muscle loss, bone density, fractures, knee arthritis, joint replacement, gout and tendons, plus a verdict, built from a full literature review. Dr. Clete Barrick, board-certified in internal medicine and obesity medicine, continues Season 2 of Straight Shot: every organ, one episode at a time. This one is your musculoskeletal system. The GLP-1 Bible, my book, is out now as an ebook (EPUB, $12.99), with the print copy coming soon: https://payhip.com/b/I6zhx Free first visit with Dr. Barrick: https://barrickhealth.com Chapters 0:00 Do GLP-1s melt muscle and thin bones? 2:17 Muscle: how much is really lean mass 5:53 Bone density: what happens at the hip 8:23 Fractures, the Wegovy label and falls 11:16 What protects you: lifting, protein, calcium, the bone scan 15:35 Knee and hip arthritis: the good news 17:56 Joint replacement and orthopedic surgery 20:13 Gout and uric acid 21:24 Shoulders, tendons and back pain 22:44 Teenagers and the growing skeleton 23:21 Where I land: the musculoskeletal verdict Sources Muscle Eisa 2026, lean mass in 20 trials: https://pubmed.ncbi.nlm.nih.gov/41877354/ SURMOUNT-1 body composition: https://pubmed.ncbi.nlm.nih.gov/39996356/ SURPASS-3 MRI: https://pubmed.ncbi.nlm.nih.gov/40318682/ Batsis 2026, Annals review: https://pubmed.ncbi.nlm.nih.gov/41996180/ SEMALEAN: https://pubmed.ncbi.nlm.nih.gov/41068996/ Copenhagen fitness: https://pubmed.ncbi.nlm.nih.gov/41579235/ BELIEVE, bimagrumab: https://pubmed.ncbi.nlm.nih.gov/41772149/ Bone density Hansen 2024, osteopenia: https://pubmed.ncbi.nlm.nih.gov/38737002/ Copenhagen bone: https://pubmed.ncbi.nlm.nih.gov/38916894/ Mesinovic 2021, diet and bone: https://pubmed.ncbi.nlm.nih.gov/34004388/ Fractures Zhang 2025, 44 trials: https://pubmed.ncbi.nlm.nih.gov/39603373/ Hamad 2026: https://pubmed.ncbi.nlm.nih.gov/42496972/ Kasher Meron 2026: https://pubmed.ncbi.nlm.nih.gov/41665888/ SELECT: https://pubmed.ncbi.nlm.nih.gov/37952131/ Wegovy label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b Constantine 2026: https://pubmed.ncbi.nlm.nih.gov/41429015/ Protection LITOE, older adults: https://pubmed.ncbi.nlm.nih.gov/28514618/ Beavers 2025, weighted vest: https://pubmed.ncbi.nlm.nih.gov/40540267/ Nutrition advisory 2025: https://pubmed.ncbi.nlm.nih.gov/40445127/ Weaver 2026, protein: https://pubmed.ncbi.nlm.nih.gov/41553490/ Calcium case report: https://pubmed.ncbi.nlm.nih.gov/42226819/ Preventive Services Task Force screening: https://pubmed.ncbi.nlm.nih.gov/39808425/ Knees STEP 9: https://pubmed.ncbi.nlm.nih.gov/39476339/ TRIUMPH-1: https://pubmed.ncbi.nlm.nih.gov/42814954/ LOSEIT: https://pubmed.ncbi.nlm.nih.gov/33471039/ Qin 2026, cartilage: https://pubmed.ncbi.nlm.nih.gov/41666927/ Surgery Badhe 2026, waiting list: https://pubmed.ncbi.nlm.nih.gov/42558015/ Lee 2026, arthroplasty: https://pubmed.ncbi.nlm.nih.gov/41072556/ Pereira 2025, fracture fixation: https://pubmed.ncbi.nlm.nih.gov/40915058/ Yu 2026, neck fusion: https://pubmed.ncbi.nlm.nih.gov/42635669/ Preoperative pilot trial: https://clinicaltrials.gov/study/NCT07755085 Gout SURMOUNT-1 uric acid: https://pubmed.ncbi.nlm.nih.gov/41198460/ Wang 2024, gout: https://pubmed.ncbi.nlm.nih.gov/38796335/ Shoulders, tendons, back Bergstein 2025, frozen shoulder: https://pubmed.ncbi.nlm.nih.gov/39855332/ Stump 2026, carpal tunnel: https://pubmed.ncbi.nlm.nih.gov/41719026/ Benedict 2026, back pain: https://pubmed.ncbi.nlm.nih.gov/42238413/ Teenagers Mitra 2024, teen surgery: https://pubmed.ncbi.nlm.nih.gov/38333369/ Bone study, ages 12 to 21: https://clinicaltrials.gov/study/NCT06903923 Also cited: Lilly's TRIUMPH-4 release (Dec 2025) and the 2026 American College of Rheumatology guideline coverage. Educational content, not medical advice. Talk with your clinician before changing any medication. #GLP1 #Ozempic #Wegovy #BoneHealth #StraightShot

    GLP-1s & the Musculoskeletal System

  6. Oct 6

    GLP-1s & the Reproductive System

    Let Dr. Barrick know what you think of the episode and send any questions his way too! What do GLP-1s do to your reproductive health? Today we cover birth control, pregnancy, polycystic ovary syndrome (PCOS), menopause and testosterone, plus a verdict, built from a full literature review. Dr. Clete Barrick MD, board-certified in internal medicine and obesity medicine, continues Season 2 of Straight Shot: every organ, one episode at a time. This one is reproductive health, for women and men. The GLP-1 Bible, my book, is out now as an ebook (EPUB, $12.99), with the print copy coming soon: https://payhip.com/b/I6zhx Free first visit with Dr. Barrick: barrickhealth.com Chapters 0:00 Ozempic babies, and what's behind them 2:28 Birth control on tirzepatide, and why fertility comes back 5:42 Planning a pregnancy: the washout and the weight rebound 9:01 A positive test while you're on your shot 12:04 Breastfeeding on a GLP-1 13:06 Polycystic ovary syndrome (PCOS) and fertility 15:26 Menopause and hormone therapy 17:39 Breast and endometrial cancer 19:15 Men: testosterone, sperm and erections 22:48 Where I land: the reproductive verdict Sources Birth control Zhou 2023 https://pubmed.ncbi.nlm.nih.gov/37940910/ Kapitza 2015 https://pubmed.ncbi.nlm.nih.gov/25475122/ Jordy 2021 https://pubmed.ncbi.nlm.nih.gov/33782832/ UK contraception guidance 2025 https://pubmed.ncbi.nlm.nih.gov/41136186/ Zepbound label https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b Foundayo label https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8ac446c5-feba-474f-a103-23facb9b5c62 UK regulator 2025 https://gov.uk/government/publications/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know Australian regulator 2025 https://www.tga.gov.au/news/safety-updates/updated-contraception-advice-mounjaro-tirzepatide Planning a pregnancy Wegovy label https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b Wyckoff 2025 https://pubmed.ncbi.nlm.nih.gov/40652453/ Maya 2025 https://pubmed.ncbi.nlm.nih.gov/41284263/ Yu 2026 https://pubmed.ncbi.nlm.nih.gov/42208070/ Imbroane 2025 https://pubmed.ncbi.nlm.nih.gov/39848396/ Hattler 2026 https://pubmed.ncbi.nlm.nih.gov/42391628/ Banerjee 2026 https://pubmed.ncbi.nlm.nih.gov/42098901/ A positive test Cesta 2024 https://pubmed.ncbi.nlm.nih.gov/38079178/ Dao 2024 https://pubmed.ncbi.nlm.nih.gov/38663923/ Brown 2026 https://pubmed.ncbi.nlm.nih.gov/42258827/ Breastfeeding Diab 2024 https://pubmed.ncbi.nlm.nih.gov/39275201/ PCOS and fertility Lin 2026 https://pubmed.ncbi.nlm.nih.gov/41862977/ Chen 2025 https://pubmed.ncbi.nlm.nih.gov/40713699/ Legro 2022 https://pubmed.ncbi.nlm.nih.gov/35041662/ Wu 2026 https://pubmed.ncbi.nlm.nih.gov/42001071/ Jensterle 2026 https://pubmed.ncbi.nlm.nih.gov/42106472/ Ongoing trial https://clinicaltrials.gov/study/NCT06742710 Menopause Bozick 2025 https://www.rand.org/pubs/research_reports/RRA4153-1.html Tchang 2025 https://pubmed.ncbi.nlm.nih.gov/40074721/ Castaneda 2026 https://pubmed.ncbi.nlm.nih.gov/42290037/ Marassi 2025 https://pubmed.ncbi.nlm.nih.gov/40706779/ Hurtado 2024 https://pubmed.ncbi.nlm.nih.gov/38446869/ Viana 2026 https://pubmed.ncbi.nlm.nih.gov/42721915/ Cancer Piccoli 2021 https://pubmed.ncbi.nlm.nih.gov/33248445/ Ko 2026 https://pubmed.ncbi.nlm.nih.gov/41359966/ Yen 2026 https://pubmed.ncbi.nlm.nih.gov/41665904/ Hsieh 2026 https://pubmed.ncbi.nlm.nih.gov/42000371/ Men Salvio 2025 https://pubmed.ncbi.nlm.nih.gov/40105090/ Deameh 2026 https://pubmed.ncbi.nlm.nih.gov/41498523/ Orra 2025 https://pubmed.ncbi.nlm.nih.gov/41291666/ Jensterle 2019 https://pubmed.ncbi.nlm.nih.gov/30707677/ Gregorič 2025 https://pubmed.ncbi.nlm.nih.gov/39511836/ Able 2025 https://pubmed.ncbi.nlm.nih.gov/38778151/ Bajaj 2021 https://pubmed.ncbi.nlm.nih.gov/34153269/ Tang 2026 https://pubmed.ncbi.nlm.nih.gov/42005929/ Cowart 2025 https://pubmed.ncbi.nlm.nih.gov/40614622/ Educational content, not medical advice. Talk with your clinician before changing any medication. #GLP1 #Ozempic #Wegovy #Fertility #StraightShot

    GLP-1s & the Reproductive System

  7. Sep 28

    GLP-1s & the Gut

    Let Dr. Barrick know what you think of the episode and send any questions his way too! What do GLP-1s do to your gut? Today we cover the everyday side effects, the rare ones, what helps, and a verdict, built from a full literature review. Dr. Clete Barrick MD, board-certified in internal medicine and obesity medicine, continues Season 2 of Straight Shot: every organ, one episode at a time. This one is the gut. In this episode: - The everyday side effects: nausea in 44% at 2.4 mg of Wegovy, vomiting or constipation in about 1 in 4, almost all mild and tied to dose increases - The nausea is not the weight loss: under 1 percentage point of semaglutide's weight loss traces to GI side effects - Tirzepatide against semaglutide: small day-to-day differences, and the same rate of serious GI events - What helps: going slower is the only thing with randomized support, and the schedule on the box is a ceiling, not a requirement - Emergency visits: about 24,500 for semaglutide in 2022 and 2023, almost 70% of them GI, 1 in 11 a medication error - Stomach paralysis: a solid meal half-empties about 36 minutes slower, and a gastroparesis diagnosis is uncommon, up 60% from a low base - Surgery, endoscopy and colonoscopy: retained food four to six times more likely, no rise in aspiration, and why the one-week hold was walked back - Pancreatitis: 18 cases on liraglutide against 23 on placebo, no difference across 31 trials, about 1,300 British reports - Bowel obstruction: up 70% in one British study, no increase in 300,000 Scandinavian patients - Reflux roughly doubled across 55 trials, about 4 extra cases per 1,000 patients - IBD: relapse 7.9% with or without a GLP-1. Colon cancer: no reduction across 90 randomized trials - Birth control on tirzepatide needs 4 weeks of backup after every dose increase, and liraglutide beat colesevelam for bile acid diarrhea The GLP-1 Bible, my book, is out now as an ebook (EPUB, $12.99), with the print copy coming soon: https://payhip.com/b/I6zhx Free first visit with Dr. Barrick: barrickhealth.com Chapters 0:00 The side effects everyone gets, and the four fears 3:19 How common and how mild 5:04 The nausea is not the weight loss 7:08 What helps 10:38 The emergency room 12:34 Stomach paralysis 15:04 Before surgery, endoscopy or a colonoscopy 18:31 Pancreatitis 21:42 Bowel obstruction 23:16 Reflux and the burps 24:52 Crohn's and colitis 26:05 Colon cancer 27:02 Your other pills 28:18 Where I land: the gut verdict Sources Everyday side effects Wharton 2022 https://pubmed.ncbi.nlm.nih.gov/34514682/ Kushner 2025 https://pubmed.ncbi.nlm.nih.gov/39948761/ Wharton 2025 https://pubmed.ncbi.nlm.nih.gov/40961952/ Nausea and weight loss Rubino 2025 https://pubmed.ncbi.nlm.nih.gov/39789843/ Crisafulli 2026 https://pubmed.ncbi.nlm.nih.gov/41183330/ What helps Jastreboff 2023 https://pubmed.ncbi.nlm.nih.gov/37366315/ Wegovy label https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b Emergency visits Lovegrove 2025 https://pubmed.ncbi.nlm.nih.gov/40194288/ Lambson 2023 https://pubmed.ncbi.nlm.nih.gov/37392810/ Stomach paralysis Hiramoto 2024 https://pubmed.ncbi.nlm.nih.gov/38634551/ Jensterle 2023 https://pubmed.ncbi.nlm.nih.gov/36511825/ Niu 2026 https://pubmed.ncbi.nlm.nih.gov/40900093/ Sodhi 2023 https://pubmed.ncbi.nlm.nih.gov/37796527/ Procedures Baig 2025 https://pubmed.ncbi.nlm.nih.gov/39694296/ Sen 2024 https://pubmed.ncbi.nlm.nih.gov/38446466/ Alkabbani 2024 https://pubmed.ncbi.nlm.nih.gov/39438043/ ASA 2023 https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative Kindel 2025 https://pubmed.ncbi.nlm.nih.gov/39480373/ Yao 2024 https://pubmed.ncbi.nlm.nih.gov/37856247/ Pancreas Steinberg 2017 https://pubmed.ncbi.nlm.nih.gov/28476871/ Bakker 2026, preprint https://www.medrxiv.org/content/10.64898/2026.03.19.26348844v1 Wen 2025 https://pubmed.ncbi.nlm.nih.gov/40988099/ Azoulay 2016 https://pubmed.ncbi.nlm.nih.gov/27479930/ MHRA 2026 https://www.gov.uk/drug-safety-update/glp-1-receptor-agonists-and-dual-glp-1-slash-gip-receptor-agonists-strengthened-warnings-on-acute-pancreatitis-including-necrotising-and-fatal-cases Ko 2026 https://pubmed.ncbi.nlm.nih.gov/41359966/ Bowel obstruction Faillie 2022 https://pubmed.ncbi.nlm.nih.gov/34587280/ Ueda 2024 https://pubmed.ncbi.nlm.nih.gov/37716613/ Reflux Chiang 2025 https://pubmed.ncbi.nlm.nih.gov/40499738/ Liu 2024 https://pubmed.ncbi.nlm.nih.gov/37739778/ IBD and colon cancer Yeh 2026 https://pubmed.ncbi.nlm.nih.gov/42309434/ Wang 2024 https://pubmed.ncbi.nlm.nih.gov/38060218/ Figlioli 2024 https://pubmed.ncbi.nlm.nih.gov/39251099/ Other pills Calvarysky 2024 https://pubmed.ncbi.nlm.nih.gov/38273155/ Zepbound label https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b Kårhus 2022 https://pubmed.ncbi.nlm.nih.gov/35868334/ Educational content, not medical advice. Talk with your clinician before changing any medication. #GLP1 #Ozempic #Wegovy #GutHealth #StraightShot

    GLP-1s & the Gut

  8. Sep 21

    GLP-1s & the Brain

    Let Dr. Barrick know what you think of the episode and send any questions his way too! What do GLP-1s do to your brain? Today we cover brain benefits, harms, and a verdict, built from a full literature review. Dr. Clete Barrick MD, board-certified in internal medicine and obesity medicine, continues Season 2 of Straight Shot: every organ, one episode at a time. This one is the brain. In this episode: - How a GLP-1 reaches your brain: semaglutide does not cross the blood-brain barrier, so its strongest effects are on appetite and reward and its weakest are on memory - Stroke: 16% fewer across 13 randomized trials in type 2 diabetes, and why obesity without diabetes is less settled - Dementia prevention: about 45% lower odds of a diagnosis in the randomized GLP-1 trials, on thin data, and database studies that disagree once the comparison is fair - Alzheimer's treatment: in evoke and evoke+, two Phase 3 trials with just over 3,800 patients, oral semaglutide did not slow the disease - Parkinson's: the exenatide benefit disappeared in its Phase 3 trial - Alcohol: in 108 patients with alcohol use disorder and obesity, semaglutide cut heavy drinking days by about four a month more than placebo, with no data past six months - Other substances and smoking: what the veterans data can and can't show, and why Trulicity did not change quit rates - Depression and suicide: the FDA pooled 91 trials, reviewed more than 2.2 million patients, found no increase, and had the warning removed from the Wegovy and Zepbound labels - The one real harm: semaglutide roughly doubles a rare optic nerve stroke, nonarteritic anterior ischemic optic neuropathy (NAION), about 1 extra case per 7,000 patients a year. Sudden painless vision loss in one eye means same-day care - Brain pressure, seizures, brain fog, and what carries over to tirzepatide and retatrutide The GLP-1 Bible, my book, is out now as an ebook (EPUB, $12.99), with the print copy coming soon: https://payhip.com/b/I6zhx Free first visit with Dr. Barrick: barrickhealth.com Chapters 0:00 Saving your brain or wrecking it? Four headlines checked 3:08 How a GLP-1 reaches your brain 4:37 Stroke: the benefit with the strongest proof 6:40 Can a GLP-1 prevent dementia? 9:36 Alzheimer's treatment: the evoke trials 10:58 Parkinson's: why the early promise faded 12:01 Drinking less on a GLP-1: the alcohol trials 14:06 Other addictions and smoking 15:22 Depression and suicide: why the FDA removed the warning 18:14 Your eyesight: the rare optic nerve risk and the symptom to know 21:21 Brain pressure, seizures and brain fog 23:12 Tirzepatide and retatrutide: what carries over 24:10 Where I land: the brain verdict Sources (author, year, PubMed identifier) Reaching the brain: Gabery 2020, 32213703. Stroke: Stefanou 2024, 38400569; Gerstein 2020, 31924562; Lincoff 2023, 37952131. Dementia prevention: Seminer 2025, 40193122; Tang 2025, 40193118; Zhou 2026, 41424236; Wang 2025, 40552638; Younis 2026, 41544899. Alzheimer's treatment: Cummings 2026, 41865758. Parkinson's: Athauda 2017, 28781108; Vijiaratnam 2025, 39919773; Meissner 2024, 38598572. Alcohol: Klausen 2026, 42070571; Hendershot 2025, 39937469; Schacht 2026, 42522065; Klausen 2022, 36066977; ClinicalTrials.gov NCT07218354. Other substances and smoking: Cai 2026, 41781010; Lengsfeld 2023, 36874396. Depression and suicide: the FDA Drug Safety Communication, January 13 2026; Pierret 2025, 40366681; Kornelius 2024, 39424950; Ueda 2024, 39226030. Optic nerve: Hathaway 2024, 38958939; Grauslund 2024, 39696569; Simonsen 2025, 40098249; Cai 2025, 39976940; Chrzanowski 2026, 42166479; Dhivagaran 2026, 42060879; Liu 2026, 41475544; regulators in Safi 2026, 42078635. Pressure, seizures, brain fog: Mitchell 2023, 36907221; Sioutas 2025, 40658395; Eun 2026, 42308439; Cheng 2026, 41370744; Badulescu 2026, 41218611. Tirzepatide and retatrutide: Chen 2026, 42420795; ClinicalTrials.gov NCT06383390. Educational content, not medical advice. Talk with your clinician before changing any medication. #GLP1 #Ozempic #Wegovy #BrainHealth #StraightShot

    GLP-1s & the Brain
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About

Straight Shot is the GLP-1 podcast for patients who want the real information, not the watered-down version. Dr. Clete Barrick is dual board-certified in internal medicine and obesity medicine, has treated more than 5,000 patients on GLP-1s, and has personally lost 100 lbs on tirzepatide. Each week he breaks down one focused topic: how these medications work, how to optimize your results, what your doctor isn't telling you, and what the science actually says. No guests. No fluff. No corporate script. Just the straight shot, from a doctor who lives it. New episodes weekly. Visit barrickhealth.com for physician-led weight loss care.

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