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Amy Jenson began taking a compounded form of Ozempic, hoping to lose 10 pounds for her wedding. Then, the day after her ceremony, she was rushed to the ER and underwent emergency surgery for appendicitis. ozgurdonmaz/Getty Images
  • One woman shares her story of having appendicitis while taking a compounded version of semaglutide.
  • The FDA has raised concerns about compounded forms of semaglutide, which may not be safe or effective.
  • More research is needed to determine if there is a connection between taking any form of semaglutide and appendicitis.

[Amy Jenson’s name was changed in this story to protect her privacy.]

A year before her wedding, Amy Jenson was determined to lose 10 to 15 pounds to reach her target weight of 126 pounds and fit perfectly into her dress.

For 8 months, she tried the ketogenic diet, which had worked for her in the past.

Around the same time, she had a visit with her naturopathic doctor. Based on her A1C blood glucose test results, which showed Jenson was on the verge of prediabetes, the doctor recommended semaglutide to help control her blood sugar levels.

When Jenson learned that weight loss was a possible side effect of semaglutide, she decided to take the medication for both reasons.

Semaglutide is better known by the brand names Ozempic and Wegovy.

She got semaglutide + B12 from a compounding pharmacy and started at a low dose with slow increases each month.

“I got some side effects — two stomach issues over four months…that came and went [with] severe stomachache and lasted 8 hours,” said Jenson. “I felt full all the time, was constipated, and taking magnesium at night to have bowel movements.”

After three months on the medication, she lost 10 pounds and reached her goal weight. However, she kept taking it for another month until the week before her wedding for fear of gaining the weight back.

“The day after my wedding, I woke up at 3 a.m. with a really bad stomachache, sick out of both ends,” said Jenson.

Her wedding was out of the country, and she planned to fly back to the United States the next day.

“The pain got so severe, and I had to go to the emergency room, and they gave me a CT scan right away and told me my appendix was so swollen and impacted with fecal matter that [it] started an infection and…that I needed emergency surgery,” said Jenson.

She underwent an appendectomy to remove her appendix and was able to fly home 72 hours later.

While it’s not clear exactly what causes appendicitis, some possible causes include:

  • hardened stool or growths that can block the opening inside the appendix
  • enlarged tissue in the wall of the appendix that is caused by infection in the digestive tract or another area of the body
  • inflammatory bowel disease

Dr. Karl Nadolsky, endocrinologist and diplomate at the American Board of Obesity Medicine, said that any connection between semaglutide and appendicitis has not been noted in large randomized trials.

However, he pointed to one case that was reported in a person with end-stage kidney disease who took a glucagon-like peptide-1 receptor agonist (GLP-1RA) that is not semaglutide.

Additionally, a case report found that based on current trial results and adverse event reporting systems, there is an infrequent incidence of appendicitis in patients using GLP-1RAs.

“This does not seem like a clinical concern if using the real medicine that was studied and approved,” Nadolsky told Healthline.

While there is currently no data showing an increase in the risk of appendicitis from taking GLP-1 medications, Dr. David Renton, clinical associate professor of surgery specializing in minimally invasive abdominal surgery at The Ohio State University Wexner Medical Center and College of Medicine, told Healthline, “a dedicated study would help us show if there is a correlation between the two.”

He added that while appendicitis is rare, it can occur at any age. The most common symptoms are:

  • Nausea
  • Vomiting
  • Abdominal pain, usually starting around the belly button, then slowly centering in the right lower quadrant

“If you are having abdominal pain that lasts more than two days and is not relieved by medications or bowel movements, please seek medical attention,” said Renton. “Early appendicitis is easy to treat; late and perforated appendicitis usually has a longer hospital stay and can have weeks of treatment until it resolves completely.”

Nadolsky said that formulations of the brand Ozempic like compounded semaglutide + B-12 have been created and sold due to a loophole in legality.

For instance, when a drug is in shortage like Ozempic and Wegovy currently are, the FDA states that compounders are legally able to prepare a compounded version of the drug if they meet certain requirements in the Federal Food, Drug, and Cosmetic (FD&C) Act.

Nadolsky stressed that people should avoid compounded versions of medications.

“For any medicine, clinically anticipated benefits must far outweigh potential risks. These medications have now been inappropriately prescribed, or obtained from med spas or online ‘clinics’ in the form of compounded semaglutide +/- B12, in such a manner that the benefit-risk ratio may be discordant,” he said.

In January 2024, the Food and Drug Administration (FDA) posted a statement that said people should not use a compounded drug if an approved drug is available, noting that people and healthcare providers should know that the FDA does not review compounded versions of these drugs for safety, effectiveness, or quality.

The FDA also noted that it has received adverse reports from people who have used compounded semaglutide, and that some compounders may be using salt forms of semaglutide. It wrote:

“The salt forms are different active ingredients than is used the approved drugs, which contain the base form of semaglutide. The agency is not aware of any basis for compounding using the salt forms that would meet the FD&C requirements for types of active ingredients that can be compounded.”

Nadolsky added that any form of anti-obesity medication should only be prescribed for those who meet the requirements.

“Semaglutide and other GLP-1RAs should be reserved for those with obesity and severe clinical disease like type 2 diabetes or other complications or at very high risk of complications which will keep the benefit to risk ratio appropriate,” he said.

Looking back at her choice to take semaglutide, Jenson said she doesn’t regret taking the compounded version; however, she does regret taking it in any form.

In addition to appendicitis, she is also concerned that her blood glucose levels are erratic now that she hasn’t taken the medication for two months and wonders whether the medication affected her pancreas.

“I knew instinctively I shouldn’t be doing it, but I justified it because all these biohackers in health and wellness were touting peptides, and semaglutide is a peptide,” she said.

She hopes biohackers and influencers promoting health and wellness and ways to enhance longevity and brain function will also share more of the possible side effects of GLP-1s in the future.

“I’m responsible for myself at the end of the day,” said Jenson. “But this isn’t for everyone; it’s not without [risk of] adverse effects.”

To report adverse events or quality problems with a GLP-1 or any medication to the FDA’s MedWatch Adverse Event Reporting program, you can submit a report online or complete a form and fax it to 1-800-FDA-0178.