Can You Combine Ozempic and Testosterone?

In this article, we will take a close look at the potential interactions between Ozempic (semaglutide) and testosterone. We will understand the functions of these substances, their effects on the body, and the potential risks of combining them. This discussion is particularly relevant for individuals with type 2 diabetes or those considering testosterone supplementation (TRT).
Klara Hatinova

Klara Hatinova

Klara is postgraduate researcher in experimental psychology at the
University of Oxford.

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Can You Combine Ozempic and Testosterone?

Based on the available studies, there isn’t yet any direct evidence to suggest that Ozempic (semaglutide) and testosterone cannot be taken together. However, the two could interact and increase testosterone levels to unhealthy levels, so make sure to consult a medical professional.

What Is Ozempic?

Ozempic is a prescription drug marketed by Novo Nordisk, used to manage blood sugar levels in adults with type 2 diabetes if an individual does not respond to Metformin. It can also be used off-label as a weight loss drug, because it increases satiety [1].

Ozempic contains the active ingredient semaglutide. Semaglutide mimics the natural effect of Glucagon-Like Peptide (GLP-1), a peptide released by the small intestine that travels to the liver and hypothalamus to signal satiety and increase insulin release.

What Is Testosterone?

Testosterone is the primary male sex hormone produced by Leidig cells in the testicles. It performs a variety of functions, including modulating muscle mass, growth, sexual maturation, erectile function and sex drive.

Testosterone Supplementation

Testosterone supplementation is generally called testosterone replacement therapy (TRT) and is only advised in carefully monitored medical settings. Off-license testosterone supplements, such as those used in bodybuilding, have several possible side effects. In a medical setting, testosterone replacement therapy is commonly used in hypogonadism and, based on clinical trials, is considered effective and safe [2, 3].

This is linked to Ozempic, as obesity or type 2 diabetes increases the risk of hypogonadism [4]. Therefore, many men who are taking testosterone may be considering taking Ozempic. Due to this, studying the interaction between testosterone and Ozempic or semaglutide is critical for making an informed decision about taking these medications.

To date, no studies have examined the effect of Ozempic in conjunction with testosterone. Since Ozempic / semaglutide is a GLP-1 mimetic, we will examine the interaction between GLP-1 and testosterone.

GLP-1 and Testosterone

The effect of Glucagon-Like Peptide-1 (GLP-1) on testosterone levels depends on various factors such as baseline testosterone levels and the presence of conditions like type 2 diabetes.

In a study involving men with type 2 diabetes, GLP-1 receptor agonist therapy, similar to semaglutide, did not significantly change testosterone levels across the group. However, in subgroup analyses, men with lower baseline testosterone levels saw an increase in total and free testosterone, while those with higher baseline levels saw a decrease. Men with bigger improvements in long-term blood glucose also had increased testosterone [5].

In healthy men, the effects of GLP-1 are even less conclusive. One study found that GLP-1 administration reduced GLP-1 release [6], while others found that it did not affect testosterone release [7]. In contrast, a third study found a positive effect of GLP-1 on Leydig cells – the reproductive gland that produces testosterone [8].

Regarding metabolic effects, GLP-1 was found to increase the efficiency of glucose conversion to lactate in human Sertoli cells, which was interpreted as increased energy and ability to produce testosterone [9]. Together, stronger evidence indicates that GLP-1 activity can improve metabolism and boost testosterone production, which benefits individuals with type 2 diabetes and obesity.

Since Ozempic can increase testosterone levels, it is important to avoid having testosterone levels that are too high if you are concurrently taking testosterone supplements or hormone therapy.

Risks of Elevated Testosterone Levels

Having high levels of testosterone can lead to several health risks and possible side effects.

High testosterone levels can increase the risk of high cholesterol, which may, in turn, increase the risk of heart disease or similar cardiovascular difficulties. Other potential risks include elevated red blood cell count (erythrocytosis), high blood pressure (hypertension), type 2 diabetes, blood clots or increased risk of prostate cancer [10, 11].

In women, having testosterone levels that are too high can be a symptom of polycystic ovary syndrome [12].

What are your testosterone levels?

Testosterone levels can be easily measured from a blood sample.

Summary: Combining Ozempic and Testosterone

To summarise, combining Ozempic and Testosterone must only be done under close medical supervision. This is because both therapies have their individual risks and could interact to elevate testosterone levels above a healthy boundary. Consulting your healthcare providers will help you measure your testosterone profile.

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Klara Hatinova

Klara Hatinova

Klara is a postgraduate researcher in experimental psychology at the University of Oxford. She has worked across a spectrum of hot topics in neuroscience, including her current project measuring reinforcement learning strategies in Parkinson’s disease. Previously, she studied the efficacy of psilocybin as a therapy for critical mental health conditions and examined molecular circadian rhythms of migraine disorders. She completed her undergraduate degree in Neuroscience at the University of Glasgow and participated in a year abroad at the University of California, where she worked on a clinical trial for spinal cord injury.