What is the cause of a slight sulfur odor with eructation while taking Glucagon-like peptide-1 (GLP-1) receptor agonists?

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Last updated: April 30, 2025View editorial policy

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From the Guidelines

A sulfur smell with burping while taking GLP-1 medications is likely related to changes in your digestive processes, and managing this side effect can be achieved by eating smaller meals, avoiding high-fat and high-fiber foods, and staying well-hydrated, as suggested by the most recent evidence 1. To manage this side effect, consider the following:

  • Eating smaller meals more slowly to reduce the burden on your digestive system
  • Avoiding high-fat and high-fiber foods that can worsen gas and slow down digestion
  • Staying well-hydrated to help prevent constipation and reduce symptoms of gas and bloating
  • Reducing consumption of sulfur-rich foods like eggs, dairy, garlic, onions, and cruciferous vegetables, which can contribute to the production of sulfur-containing gases While this symptom is usually not dangerous, if it becomes severe or is accompanied by persistent nausea, vomiting, or abdominal pain, it is essential to contact your healthcare provider, as cautioned in the study 1. Most digestive side effects of GLP-1 medications, including eructation, tend to improve after the first few weeks of treatment as your body adjusts to the medication, as noted in the study 1. It is crucial to weigh the benefits of GLP-1 medications, such as significant weight loss and improved glycemic control, against the potential side effects, and to discuss any concerns with your healthcare provider, as recommended in the guideline 1.

From the Research

Gastrointestinal Side Effects of GLP-1 Receptor Agonists

  • GLP-1 receptor agonists, such as semaglutide and exenatide, have been associated with gastrointestinal side effects, including nausea, vomiting, and delayed gastric emptying 2
  • These side effects may be related to the mechanism of action of GLP-1 receptor agonists, which slow down gastric emptying and reduce appetite 3, 4
  • Some studies have reported that semaglutide is linked to a higher odds of nausea, vomiting, and delayed gastric emptying compared to other GLP-1 receptor agonists 2

Sulfur Smell and Burping

  • There is no direct evidence in the provided studies that links GLP-1 receptor agonists to a sulfur smell with burping
  • However, the gastrointestinal side effects associated with GLP-1 receptor agonists, such as nausea, vomiting, and delayed gastric emptying, may contribute to burping and other gastrointestinal symptoms 2, 5
  • It is possible that the sulfur smell is related to other factors, such as diet or underlying medical conditions, rather than the GLP-1 receptor agonist itself

Management of Gastrointestinal Side Effects

  • Clinicians should be aware of the potential gastrointestinal side effects associated with GLP-1 receptor agonists and monitor patients accordingly 2, 5
  • Patients experiencing gastrointestinal side effects may need to adjust their diet or take medications to manage their symptoms
  • The choice of GLP-1 receptor agonist may depend on the patient's individual needs and preferences, as well as the potential for gastrointestinal side effects 4

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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