GLP-1 medications—like semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound)—have changed the way we treat metabolic disorders, insulin resistance, PCOS, and even support hormonal balance through perimenopause and beyond. But while the standard dosing protocols are effective for many, they don’t work for everyone.
As a physician, I’ve seen a growing need for a more personalized, gentler approach: microdosing.
Microdosing GLP-1s means starting at significantly lower doses than standard guidelines—sometimes as low as 0.05 to 0.1 mg of semaglutide per week, compared to the usual starting dose of 0.25 mg.
The goal? To allow the body to adapt slowly, minimizing side effects like nausea, fatigue, or GI distress, while still gaining the benefits of appetite regulation, insulin sensitivity, and metabolic rebalancing.
Most patients are surprised to learn that more is not always better. Microdosing offers distinct advantages:
Many people stop GLP-1s early due to nausea, reflux, constipation, or fatigue. Starting at a microdose lets the body gently adjust to the medication, often eliminating the need for aggressive symptom management.
Microdosing avoids the intense appetite suppression or early aversion to food that some patients feel. Instead, it supports natural satiety and mindful eating—making it easier to build sustainable habits rather than relying solely on the medication to “do the work.”
When used at low doses, GLP-1s help correct blood sugar instability and insulin resistance even before any weight loss occurs. This is particularly powerful in women with PCOS, perimenopausal weight gain, or metabolic sluggishness—where balancing hormones and blood sugar is key.
Women going through hormonal transitions (perimenopause, menopause, PCOS, postpartum) often need a more nuanced approach. Microdosing helps stabilize metabolic and mood shifts without triggering overwhelming physical changes too quickly.
Here’s a simplified version of how I typically guide patients through microdosing:
| Week | Semaglutide Dose | Notes |
|---|---|---|
| 1–2 | 0.05 mg weekly | Observe for tolerance, hydration, appetite effects |
| 3–4 | 0.1 mg weekly | Gradual titration if tolerated |
| 5–6 | 0.15–0.2 mg weekly | Only if needed; many patients plateau here |
| 7+ | 0.25 mg or individualized | Adjust based on goals, labs, and response |
Note: Tirzepatide microdosing follows a similar philosophy but with slightly different increments.
This slow titration reduces the risk of unpleasant side effects and allows for more control. We monitor labs, hormonal markers, and clinical symptoms along the way to ensure we’re optimizing—not overwhelming—the body.
Women with PCOS, perimenopause, or insulin resistance
Patients with GI sensitivity or history of medication intolerance
Individuals seeking metabolic or hormonal balance without rapid weight loss
Patients who want to layer GLP-1s with lifestyle changes, not use them as a crutch
Not at all. In fact, for many patients, microdosing is more effective—because it allows them to stay on the medication longer, build foundational health habits, and avoid the “yo-yo” cycle of starting and stopping due to side effects.
The body responds to consistency, not intensity. Microdosing honors that principle.
GLP-1s are powerful. But power doesn’t need to mean aggression. By microdosing, we’re leveraging the benefits—insulin regulation, appetite reset, inflammation reduction—without shocking the system.
This approach aligns with my philosophy of medicine: root-cause healing, gentle rebalancing, and giving the body what it needs to restore itself.
If you’re curious whether GLP-1 microdosing is right for you, or if you’ve tried them before and felt overwhelmed, you’re not alone. There’s another way—and it starts small.
