Fishtown Medicine Library
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Amycretin: The Amylin/GLP-1 Drug That Comes as a Pill
Amycretin (zenagamtide) is Novo Nordisk's investigational amylin/GLP-1 co-agonist, in both an injection and an oral tablet. What the early-phase trials showed, why the pill matters, how it differs from CagriSema, and the early-stage caveats.
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Artificial Sweeteners and Erythritol: What the Evidence Says
Stevia, erythritol, aspartame, allulose - are they safe? A grounded look at the erythritol clotting scare, the aspartame cancer headlines, and what the best evidence shows, from Fishtown Medicine in Philadelphia.
CagriSema: The Amylin + GLP-1 Weight-Loss Combo
CagriSema (cagrilintide + semaglutide) is Novo's investigational amylin-plus- GLP-1 weight-loss combo. What the REDEFINE trials showed, how it compares with tirzepatide, and its regulatory status.
Compounded GLP-1 Drugs: Safe? Legal? What Changed in 2026
Compounded semaglutide and tirzepatide after the shortages ended: what compounding is, why the legal path narrowed in 2025 and 2026, the safety questions, the price gap, and what to ask your physician.
GLP-1 Drugs and Surgery: Do You Have to Stop Before a Procedure?
Most people can safely continue Ozempic, Wegovy, or Mounjaro before surgery. The 2024 multisociety guidance, why the old week-long hold is out of date, the aspiration risk, and how your care team decides.
Mazdutide: The Oxyntomodulin Drug Approved in China
Mazdutide is a GLP-1/glucagon dual agonist approved in China for weight and diabetes but not the US. What the GLORY-1 trial showed, its effects on uric acid and lipids, how it compares with survodutide and retatrutide, and its status.
The New Weight-Loss Drugs, Compared (2026)
Semaglutide, tirzepatide, orforglipron, retatrutide, and CagriSema compared: mechanism, weight loss, route, and approval status. Which is strongest, which is a pill, which has proven heart benefit, and how to choose.
Orforglipron (Foundayo): The GLP-1 Weight-Loss Pill
Orforglipron (Foundayo) is the first oral small-molecule GLP-1 pill, approved for weight loss in 2026. How it differs from Rybelsus and the injectables, what the ATTAIN and ACHIEVE trials showed, and the convenience-versus-potency trade-off.
Resmetirom (Rezdiffra): The First MASH Drug
Resmetirom (Rezdiffra) is the first FDA-approved drug for MASH (fatty liver with fibrosis). How the THR-beta agonist works, what the MAESTRO-NASH trial showed, who it is for, the lipid bonus, and the accelerated-approval caveat.
Retatrutide: The Triple-Agonist Weight-Loss Drug
Retatrutide is Eli Lilly's investigational triple agonist (GIP, GLP-1, glucagon). What the phase 2 and phase 3 trials show for weight, diabetes, and liver fat, the glucagon heart-rate trade-off, and its investigational status.
Can You Reverse Type 2 Diabetes? What Remission Really Means
Type 2 diabetes can go into remission for many people through substantial weight loss. What the DiRECT trial showed, why doctors say remission instead of cure, the GLP-1 nuance, who is most likely to succeed, and how durable it is.
Semaglutide (Ozempic) for Kidney Disease: What FLOW Showed
The FLOW trial showed semaglutide (Ozempic) cuts kidney-failure and related risk by 24% in diabetic kidney disease, earning an FDA kidney indication in 2025. How it works, how it fits with SGLT2 inhibitors and finerenone, and the limits.
Semaglutide (Wegovy) for MASH: What the ESSENCE Trial Showed
Semaglutide (Wegovy) is FDA-approved for MASH since 2025. What the ESSENCE trial showed for inflammation and fibrosis, how it compares with resmetirom, the weight and heart bonus, and the limits of the evidence.
Survodutide: The GLP-1/Glucagon Drug Built for the Liver
Survodutide is Boehringer Ingelheim's investigational GLP-1/glucagon dual agonist. What the phase 3 SYNCHRONIZE-1 weight result and the phase 2 MASH data show, the glucagon liver angle, the trade-offs, and its investigational status.
Tirzepatide (Zepbound, Mounjaro): The Dual Incretin Drug
Tirzepatide (Zepbound, Mounjaro) is the dual GIP/GLP-1 drug that outperformed semaglutide for weight loss. What the trials show for weight, diabetes, heart failure, and sleep apnea, and the limits of its heart evidence.
Acarbose: The Diabetes Drug With a Longevity Signal
Acarbose is an old diabetes drug with a striking mouse-longevity signal. What it does, why longevity researchers watch it, what it is proven to do in people (diabetes prevention rather than heart protection), and its side effects.
Fatty Liver (MASLD): How Serious It Is and How to Reverse It
Fatty liver (MASLD) is now the most common liver condition in the world, and in its early stages it is reversible. What the diagnosis means, how it is staged without a biopsy, and how Fishtown Medicine treats it in Philadelphia.
Finerenone (Kerendia): The Kidney-and-Heart Drug for Diabetes
Finerenone (Kerendia) protects the kidneys and heart in diabetic kidney disease, and now in heart failure. How it works, what the trials showed, the high-potassium caution, and how it fits with SGLT2 inhibitors.
GLP-1 Microdosing: What It Is and Whether It's Worth It
GLP-1 microdosing uses lower-than-standard doses for metabolic and longevity goals rather than maximum weight loss. What the evidence does and doesn't show, who it might fit, and how Fishtown Medicine approaches it in Philadelphia.
Losing Muscle on a GLP-1: How to Protect It
A meaningful share of the weight lost on semaglutide or tirzepatide is muscle. What the body-composition data shows, why it matters for the long run, and the protein and training plan that protects it.
GLP-1 Medications vs Bariatric Surgery: How to Choose
GLP-1 medications and bariatric surgery both drive major weight loss and can reverse diabetes, but they differ in size, durability, and trade-offs. How they compare, who fits which, and how Fishtown Medicine helps you decide.
SGLT2 Inhibitors: Heart, Kidney, and the Longevity Question
SGLT2 inhibitors (Jardiance, Farxiga) protect the heart and kidneys, even in people without diabetes, and carry a mouse-longevity signal. The trial evidence, the longevity question, dosing, and the safety points that matter.
Ultra-Processed Food: What It Does to Your Health
Ultra-processed foods make up most of the American diet and are tied to weight gain, diabetes, and heart disease. What counts as ultra-processed, why it overrides your appetite, and how Fishtown Medicine helps you cut it in Philadelphia.
High Uric Acid: More Than Just Gout
High uric acid causes gout, but it is also a marker of metabolic trouble tied to insulin resistance, high blood pressure, and fatty liver. What drives it, what the number means, and how Fishtown Medicine reads it in Philadelphia.
The GLP-1 Strategy
Why prescribing the shot is the easy part. Learn how we manage muscle preservation, protein intake, and the exit strategy for sustainable results.
Ozempic vs. Metformin: Which Strategy Wins?
Should you start with the foundation (Metformin) or the heavy hitter (GLP-1)? We break down signaling, metabolic impact, and sustainability.
Weight Loss That Works
A nuance-first approach to GLP-1s. We focus on body composition, not just the number on the scale, with HAES-aligned principles that prioritize health.
Metabolic Flexibility: The Holy Grail
Weight is a lagging indicator. Insulin is a leading indicator. We use fasting insulin, CGMs, and DEXA scans to find and fix metabolic dysfunction.
Metabolism: Getting Your Engine Working Right
A grounded clinical approach to metabolic health and GLP-1s. We focus on biological restoration and body composition, fixing the engine first.
The AIP Diet: Immune Reset
More than just clean eating. Discover how the Autoimmune Protocol (AIP) acts as a diagnostic tool to silence inflammation and identify your specific dietary...
Anxiety & The Gut-Brain Axis
Discover why your anxiety might be a microbial problem. Explore the Psychobiotic revolution and how the Vagus Nerve connects your gut to your brain.
Fasting Protocols: The Goldilocks Zone
Fasting is a tool you can learn to use with care. Here is how to run time-restricted eating, 24-hour fasts, and longer protocols safely while protecting your muscle.
IBS & SIBO: The Root Cause
Bloated after every meal? Up to 60% of IBS cases may actually be SIBO. Learn how we test, treat, and prevent recurrence.
Leaky Gut: The Science of Permeability
Pseudoscience or real biology? Learn the science of zonulin and how intestinal permeability drives autoimmune disease and chronic inflammation.