“The difference between the almost right word and the right word is really a large matter — ‘tis the difference between the lightning-bug and the lightning.” — Mark Twain, Letter to George Bainton
That quote captures the conversation around GLP-1 microdosing perfectly.
Microdosing GLP-1 medications such as Ozempic (semaglutide) and Zepbound (tirzepatide) has quickly become one of the most talked-about trends in the health and weight-loss space.
As many as 12% of adults in the U.S., over 30 million people, have used a GLP-1 agonist medication. Surveys suggest that up to 36% of these patients are microdosing their medications. That means roughly 10 million people may currently be following some form of microdosing strategy with tirzepatide or semaglutide.
The surge in popularity has created as much confusion as curiosity. It’s sparking questions, debates, and controversies across medicine, wellness, and online communities.
Is microdosing GLP-1 medications safe? Does it actually work? Why do respected institutions like the Cleveland Clinic and UCLA discourage it, and are they wrong? What’s the best way to microdose these medications? Can it improve longevity, gut health, or brain health?
This is your GLP-1 Microdosing Masterclass.
My goal here is to translate years of hands-on experience into clear, practical knowledge you can use on your own journey. These insights come from thousands of patient cases and real-world results across every kind of setting.
| 🔑 Key takeaways ➤ Microdosing GLP-1 drugs is trending but often misused as a marketing term. ➤ True microdosing is different from standard, custom, or maintenance dosing. ➤ The four dosing types are standard therapeutic, maintenance, fractional, and microdosing. ➤ There’s no clear medical definition or guideline for GLP-1 microdosing yet. ➤ The right approach depends on each person’s biology and goals. ➤ When done safely, microdosing may help maintain benefits with fewer side effects and lower cost. |
Why should you listen to me?
I’m licensed to practice medicine in all 50 states and board-certified in obesity medicine. I’ve prescribed nearly every GLP-1 agonist available, Ozempic, Wegovy, Zepbound, Mounjaro, Saxenda, Rybelsus, and various compounded formulations of semaglutide and tirzepatide.
I’ve worked for large, enterprise-level weight-loss companies running million-dollar ad campaigns, as well as for smaller, fast-moving startups that popped up during the FDA shortages. Many offered “coupon” or “Groupon” deals on custom compounds shipped through mail-order pharmacies.
I’ve seen the industry from every angle. I’ve prescribed brand-name auto-injector pens, single-use and multi-use vials, daily injections, oral drops, and pills. I’ve personally managed each of them, and even experimented with microdosing myself.
That’s why I have strong opinions about GLP-1 microdosing for tirzepatide and semaglutide. Some of what I’ll say might challenge what you’ve read online. But it’s based on clinical experience, not speculation.
What does “microdosing” GLP-1 drugs actually mean?
Before discussing whether microdosing works, we need to define it.
What does “microdosing” even mean in this context? And what are people trying to achieve when they take smaller doses of tirzepatide or semaglutide?
The truth is, no one really agrees.
Search online and you’ll find companies using “microdosing” as a marketing term. Many advertise “protocols” that still follow standard therapeutic doses, perhaps adjusting by half a milligram or so. Instead of starting at 2.5 mg, a company might recommend 2 mg.
That’s not true microdosing.
On the opposite end, you have influencers and self-proclaimed longevity experts recommending tiny doses, as low as 0.1 mg, claiming they improve gut function or extend lifespan.
Add in Reddit discussions, TikTok advice, and health influencers sharing personal “protocols,” and suddenly “microdosing” means everything from a small reduction to one-twentieth of a standard dose.
That’s a 20-fold difference in recommendations. Imagine if someone told you to take twenty doses of your blood pressure medication instead of one, or to cut your pill into twenty pieces and take just one fragment. That’s how inconsistent the advice has become.
With such a broad range, how can anyone know what’s safe or effective?
What do the experts say about microdosing GLP-1s?
At the time of this writing, the American Board of Obesity Medicine, The Obesity Society, and the American Diabetes Association have no official guidelines or position statements on microdosing GLP-1 medications like tirzepatide or semaglutide.
There’s no consensus definition. Everyone uses the word differently.
That’s why we need a new framework, a clear way to categorize how these medications are actually used.
How should we redefine GLP-1 microdosing?
After treating thousands of patients, I divide GLP-1 dosing into four categories. These categories give context to where microdosing fits and how it might benefit you.
Each category represents a different point on the spectrum of GLP-1 use. Patients may move between them depending on their goals and their response to treatment. There’s no “right” or “wrong” place to be, only what fits your biology and situation.
The four categories are:
- Standard and Custom Therapeutic Dosing
- Maintenance Dosing
- Fractional Dosing
- Microdosing
Let’s look closely at each one.
- Standard and custom therapeutic dosing
Semaglutide and tirzepatide each have their own standard dosing ladders recommended by the manufacturer. Before compounding pharmacies entered the scene, patients used fixed-dose auto-injector pens that only allowed preset increments.
You’d start at the lowest dose, increase monthly, and reach the maximum after several months.
This was effective for some but far too rigid for others. Medicine rarely works as a one-size-fits-all formula. So clinicians started finding ways to customize.
For example, with Wegovy pens, we could “click count”, adjusting doses by counting pen clicks to deliver smaller, more precise increments. That allowed semi-custom schedules long before compounding pharmacies began creating custom vials and formulations.
That was the start of personalized dosing.
But here’s where the confusion began. When compounding pharmacies entered the market, they began branding these small variations as “microdosing” programs. In reality, they were just offering standard or custom therapeutic dosing under a trendier name.
If a company tells you it’s “microdosing” but uses the same dose progression (starting low and titrating upward each month), it’s not microdosing. It’s simply standard dosing with marketing spin.
There’s nothing wrong with standard or custom therapeutic dosing. It’s how good medicine works, starting low, titrating up, and personalizing the plan. But it’s not true microdosing.
So if a clinic promotes a “microdosing protocol,” ask what doses they’re using. Compare those to the manufacturer’s titration schedule. If they match, you’re looking at standard dosing, maybe slightly adjusted, but not microdosing.
- Maintenance dosing
After a patient reaches their weight-loss goal, the next step is maintenance.
Here’s where confusion takes over again.
Many companies market “maintenance programs” as if they’re standardized regimens, but there is no established definition or industry standard.
Maintenance dosing isn’t a fixed number. It’s simply the dose that keeps you metabolically stable and weight steady.
That can look very different from one patient to another. For example, Zepbound’s maximum dose is 15 mg. I have patients who need that full dose to maintain their success. They don’t lose more weight, but they also don’t regain it. Their labs stay stable. Their appetite and cravings remain manageable. They feel normal, in control, like food no longer dominates their mental space.
Other patients do well stretching doses every 10 to 14 days instead of weekly. GLP-1 drugs remain active in your system for about a week, but everyone metabolizes medication differently. Some break it down slower, allowing for longer intervals between doses.
That’s the art of personalization.
Maintenance dosing should be based on your physiology, not a cookie-cutter chart. Some patients thrive on higher doses spaced further apart; others do best on smaller, more frequent injections.
My approach is to help patients discover what truly works for them. Because when you reach this phase, the right maintenance dose is the key to stability.
And it’s here, in this space between active treatment and long-term balance, that microdosing starts to shine.
What comes next?
Microdosing GLP-1 medications sits in that “sweet spot.” It’s where the medication’s benefits can be sustained while minimizing cost, side effects, and metabolic stress.
In my next deep dive, we’ll explore the remaining two categories, Fractional Dosing and True Microdosing, and break down what they mean, how they work, and whether they’re right for you.
Final thoughts
Between standard protocols, compounded formulas, and experimental “microdosing” trends, the space has become crowded, and often confusing.
But when you understand how dosing truly works, you gain control.
Each phase of GLP-1 use, from therapeutic to maintenance to microdosing, serves a purpose. The key is knowing which one fits your needs, metabolism, and long-term goals.
I’ve seen what works, what fails, and what genuinely transforms health. Microdosing can be part of that transformation, but it has to be done with science, precision, and supervision.
That’s how you move from lightning-bug to lightning.
References
- Harris, E. (2024). Poll: Roughly 12% of US adults have used a GLP-1 drug, even if unaffordable. JAMA, 332(1), 8. https://doi.org/10.1001/jama.2024.10333
- Lee, J. (n.d.). Microdosing GLP-1 medications: A new weight-loss trend? The Intake. Tebra. Reviewed by A. Curry. Retrieved from https://www.tebra.com/theintake/healthcare-reports/microdosing-glp-1
Author Bio: Dr. Adrian Blackwell is the founder and CEO of PonteVita Rx, a telehealth practice dedicated to making medication access simpler, more affordable, and less stressful. Licensed to practice medicine in all 50 states and DC, Dr. Blackwell is board certified in obesity medicine and emergency medicine. He combines clinical expertise with personal experience navigating the healthcare system as a patient and parent to children with chronic illnesses. His mission: ensure everyone has access to their necessary medications without unnecessary barriers.
Medical Disclaimer: All the information here, on these videos, YouTube, social media, or in any other format, is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult your personal physician or other qualified health provider with any questions you may have regarding a medical condition. Never replace professional medical advice given to you personally or delay in seeking it because of something you have read or heard on this website. This information is not meant to diagnose, treat, or cure any medical condition. No patient-physician relationship is formed. If you’re my patient, please text me before you make any changes to your medication. If you believe you are having a medical emergency please call 911.