Semaglutide, a medication used for type 2 diabetes and weight loss, may have unexpected side effects such as sarcopenia and age-related loss of muscle mass and strength. A 74-year-old male patient with type 2 diabetes and dyslipidemia presented with progressive fatigue over 2 years. He experienced a significant decline in walking endurance and speed despite the absence of joint pain or other obvious causes. He had a history of ocular myasthenia gravis and localized prostate cancer, both of which were well-managed. Further investigation revealed a weight loss of 8 kg after starting semaglutide treatment for diabetes. Physical examinations revealed reduced muscle bulk and strength. Extensive investigations, including blood tests, imaging, and cardiopulmonary exercise testing, have ruled out other potential causes of fatigue. The patient’s fatigue improved after reducing the semaglutide dose and implementing a tailored exercise program that focused on muscle strengthening. This case highlights the potential contribution of semaglutide to muscle mass loss and subsequent fatigue, particularly among older adults.
Citations
Citations to this article as recorded by
Semaglutide can only be responsible for exercise intolerance and muscle wasting after all other causes have been carefully excluded Josef Finsterer Korean Journal of Family Medicine.2026; 47(1): 93. CrossRef
Sarcopenia considerations when prescribing glucagon-like peptide-1 agonists to older adults Azwan Aziz Mohamad Korean Journal of Family Medicine.2026; 47(2): 184. CrossRef
GLP-1-derived therapies and risk of sarcopenia: myth or reality? André J. Scheen Expert Opinion on Drug Safety.2026; : 1. CrossRef
Semaglutide-Induced Sarcopenia via GLP-1R-mTOR-Satellite Cells Axis and Muscle-Glucose Feedback Loop Potentially Leading to Refractory Hyperglycemia in Type 2 Diabetes: A Case-Driven Hypothesis Amr Ahmed, Sharifa Rodini, Fahad Alrubyea, Maher Akl Problems of Endocrinology.2026; 72(3): 60. CrossRef
A multi-functional oral small molecule targeting energy and lipid metabolism to treat obesity and related metabolic disorders Justin Y. Lee, Chi Zhu, Melissa A. Boldridge, Rachelle L. Stark, Gracia Bonilla, Kosuke Watari, Christina Papa, Lei Xu, Federico Gonzalez, Xin Tang, Kaitlyn T. Dang, Kook Son, Kashish Chetal, Prabha Ibrahim, Ruslan I. Sadreyev, Bilal N. Sheikh, Michael Ka Science Advances.2026;[Epub] CrossRef
Mechanism of Semaglutide in MASLD Treatment: Where Is the Master Key? Devaraj Ezhilarasan Journal of Gastroenterology and Hepatology.2025; 40(9): 2163. CrossRef
A Multidisciplinary Perspective on Semaglutide Treatment and Medical Nutrition Therapy in Obesity Management Luigi Barrea, Giuseppe Annunziata, Ludovica Verde, Martina Galasso, Silvia Savastano, Annamaria Colao, Giovanna Muscogiuri Current Obesity Reports.2025;[Epub] CrossRef
We report a rare case of high-volume training-related myopericarditis. A male, 18 years old, elite road bicycle racing cyclist with high-volume training of 1,000 km per week for >7 years, presented with progressively worsening exertional breathlessness, reduced effort tolerance, and one episode of cardiac syncope. The symptoms were present prior to the coronavirus disease 2019 pandemic but made worse with the sudden increase in the volume of training after lockdown periods in preparation for competition. He exhibited multiple premature ventricular ectopic beats during his resting electrocardiogram, with a normal echocardiogram and non-elevated cardiac enzyme. The exercise stress test revealed similar multiple premature ventricular beats, warranting further investigation using cardiac magnetic resonance imaging (MRI). The findings of the cardiac MRI were suggestive of myopericarditis. He was instructed to refrain from training and initially started with a short course of colchicine. However, his symptoms deteriorated, and cardiac MRI revealed a decrease in the left ventricular ejection fraction from 59% to 50%. His treatment was escalated to a short course of tapered dose steroid, anti-failure medication and gradual, supervised, return to sports program. This case report highlights the discussion of return to play in athletes with myopericarditis.
First
Prev
