Ozempic (semaglutide) is a brand-name subcutaneous injection prescribed for managing type 2 diabetes, among other uses. Taking Ozempic can lower your appetite, which supports weight loss, but it can also increase the risk of missing important nutrients.

If you’re taking Ozempic to manage type 2 diabetes or support weight loss, you may question how it affects your nutrition. Many people taking glucagon-like peptide-1 (GLP-1) receptor agonist medications, such as Ozempic, experience a big drop in appetite, sometimes reducing calories by nearly 40%. Reducing calories can be helpful for weight loss, but it also means you might not get enough essential vitamins and minerals. When your daily calorie intake falls, the risk of nutrient gaps goes up.

Some people taking semaglutide drugs such as Ozempic and Wegovy might fall short on dietary nutrients, including essential vitamins and minerals. Here’s a closer look at what vitamins to take with Ozempic (with your doctor’s recommendation).

Note: The Food and Drug Administration (FDA) has not approved Ozempic for weight loss, but some healthcare professionals may prescribe it off-label. With off-label use, a drug approved by the FDA is prescribed for a purpose other than what it is approved for.

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Vitamin B12 is essential for forming red blood cells and keeping your nervous system working properly. It also helps your body make energy and supports DNA production. Most adults need 2.5 micrograms (mcg) of B12 each day.

You don’t always need a supplement if you eat enough B12-rich foods. But some factors raise the risk of B12 deficiency, such as:

  • older age (ages 65 years and older)
  • vegan and vegetarian diets
  • digestive tract disorders
  • history of gastrointestinal surgery, such as gastric bypass
  • certain medications, especially if you take them long term

If you take Ozempic along with metformin (a common diabetes medication), your risk of vitamin B12 deficiency is higher. Metformin can interfere with B12 absorption, which can lead to low levels of B12 over time. Sometimes, people develop anemia or nerve-related symptoms if B12 levels drop too much.

If you have one or more risk factors for vitamin B12 deficiency, it’s helpful to talk with your healthcare professional about checking your B12 levels regularly. If your levels are low, a daily B12 supplement can bring them back up. Your doctor can tell you how much vitamin B12 to take with Ozempic.

Vitamin D helps your body absorb calcium to build strong bones and teeth. It also plays a role in your immune system and nerve function. Most adults need about 15 mcg (600 IU) of vitamin D daily, according to the Office of Dietary Supplements (ODS). Older adults (ages 65 years and older) need 20 mcg (800 IU) daily.

You don’t always need a vitamin D supplement while taking Ozempic, but it can be hard to get enough vitamin D from food alone. Sunlight helps your skin produce vitamin D. But how much your body produces depends on several factors, including your age, skin color, sunscreen use, and geographic location.

Researchers have found that vitamin D deficiency is common among people with type 2 diabetes. (Ozempic is approved for managing blood sugar levels in people with type 2 diabetes.) People with obesity (body mass index of 30 or more) also may need higher vitamin D intake because the vitamin gets stored in body fat instead of circulating in the bloodstream. If you’ve had gastric bypass surgery, your risk of low vitamin D levels is even higher.

If you have diabetes or obesity or think you might not be getting enough vitamin D while taking Ozempic, talk with your healthcare professional. They can order a blood test to determine whether you should take a supplement. They can also recommend a dosage of vitamin D based on your blood levels and health needs.

Vitamin A supports healthy vision, skin, teeth, bones, and your immune system. Ozempic isn’t known to lower vitamin A levels directly, but if you’ve cut back on calories from fat, you might not be getting enough. Like vitamin D, vitamin A is fat soluble. So you need some fat in your meals for your body to properly absorb vitamin A. Most adults generally need about 700 to 900 mcg of vitamin A each day.

Most people in the United States get plenty of vitamin A from common foods like orange and yellow fruits and vegetables, eggs, and dark leafy greens. If you’re eating balanced meals with enough calories, you probably don’t need a vitamin A supplement. However, studies show people with obesity and type 2 diabetes are more likely to have low vitamin A levels.

Unlike water-soluble vitamins that leave your body through urine, your body stores extra vitamin A, and taking too much can be harmful. It’s best to check with your doctor before taking more than what you’d find in a standard daily multivitamin.

Many people taking Ozempic or other GLP-1 medications may not eat enough, and studies have found that their diets often lack important nutrients, including iron. Another small study suggests a possible connection between starting Ozempic treatment and reduced iron absorption.

Iron is necessary for making red blood cells and carrying oxygen throughout your body. According to the ODS, adult males generally need 8 mg per day, while adult females under age 50 years need about 18 mg. After the age of 50, women need 8 mg per day.

If you regularly eat meat, poultry, and seafood, you probably get enough iron. People who consume a vegetarian or vegan diet have an increased risk of low iron because plant-based iron isn’t absorbed as easily.

If you notice symptoms of low iron, such as feeling tired, talk with your doctor about starting an iron supplement. Working with a dietitian can also help make sure you’re meeting your iron needs.

Note: The use of binary terms such as “male” and “female” or “men” and “women” in this article reflects the language of the sources we’ve used. Unless otherwise noted, it’s unclear whether the research we reference included participants with expansive gender identities.

Constipation is a common side effect of Ozempic and of eating less overall. Fiber helps keep your digestion moving and supports gut health, so it’s important to get enough in your diet.

For most adults, the recommended daily fiber intake is about 22 to 34 grams (g), depending on their age and sex assigned at birth. Getting enough fiber can also help manage blood sugar levels.

That said, adding too much fiber at once can make you feel bloated. Try to gradually increase your fiber intake and drink plenty of water to avoid bloating.

If you still experience constipation despite increasing your fiber and water intake, talk with your doctor. They may recommend a fiber supplement suitable for you.

Ozempic changes your appetite, which can lead to a nutrient shortage. The best diet while taking a GLP-1 medication involves a balanced meal plan and plenty of fluids. If you’re unsure about your nutrient status, blood tests are the best way to check for deficiencies.

Taking too much of certain vitamins and other supplements can be harmful, so it’s best to work with a healthcare professional. Talk with your doctor or a dietitian to get personalized advice on the best foods to eat and which vitamins and supplements may be right for you during Ozempic treatment.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.