vida: extract claims from 2025-xx-frontiers-glp1-metabolic-nutritional-adverse-events-pharmacovigilance

- Source: inbox/queue/2025-xx-frontiers-glp1-metabolic-nutritional-adverse-events-pharmacovigilance.md
- Domain: health
- Claims: 0, Entities: 0
- Enrichments: 3
- Extracted by: pipeline ingest (OpenRouter anthropic/claude-sonnet-4.5)

Pentagon-Agent: Vida <PIPELINE>

domains/health/glp-1-receptor-agonists-produce-nutritional-deficiencies-in-12-14-percent-of-users-within-6-12-months-requiring-monitoring-infrastructure-current-prescribing-lacks.md

@@ -12,7 +12,7 @@ sourcer: IAPAM
 related_claims: ["[[GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035]]"]
 supports: ["GLP-1 therapy requires continuous nutritional monitoring infrastructure but 92 percent of patients receive no dietitian support creating a care gap that widens as adoption scales"]
 reweave_edges: ["GLP-1 therapy requires continuous nutritional monitoring infrastructure but 92 percent of patients receive no dietitian support creating a care gap that widens as adoption scales|supports|2026-04-12"]
-related: ["glp-1-receptor-agonists-produce-nutritional-deficiencies-in-12-14-percent-of-users-within-6-12-months-requiring-monitoring-infrastructure-current-prescribing-lacks", "glp-1-therapy-requires-nutritional-monitoring-infrastructure-but-92-percent-receive-no-dietitian-support"]
+related: ["glp-1-receptor-agonists-produce-nutritional-deficiencies-in-12-14-percent-of-users-within-6-12-months-requiring-monitoring-infrastructure-current-prescribing-lacks", "glp-1-therapy-requires-nutritional-monitoring-infrastructure-but-92-percent-receive-no-dietitian-support", "glp1-psychiatric-effects-directionally-opposite-metabolic-versus-psychiatric-populations"]
 ---
 
 # GLP-1 receptor agonists produce nutritional deficiencies in 12-14 percent of users within 6-12 months requiring monitoring infrastructure current prescribing lacks
@@ -24,3 +24,10 @@ A large cohort study of 461,382 GLP-1 users found that 12.7% developed new nutri
 **Source:** Frontiers in Clinical Diabetes and Healthcare 2025 review
 
 GLP-1 RAs reduce appetite and gastric emptying which can limit protein intake and nutrient absorption necessary for muscle preservation. Adequate protein intake of 1.2-2.0 g/kg body weight is recommended depending on training status. This provides the specific mechanism by which GLP-1 creates nutritional deficiency risk.
+
+
+## Extending Evidence
+
+**Source:** Frontiers in Pharmacology 2024, FAERS analysis
+
+FAERS pharmacovigilance data shows dehydration is the most serious metabolic adverse event across all GLP-1 agents: semaglutide 370 cases (25.10% of serious metabolic reports), dulaglutide 434 cases (20.90%), liraglutide 318 cases (23.93%), tirzepatide 70 cases (32.86%). This establishes dehydration as a distinct and prevalent metabolic complication beyond general nutritional deficiency, with tirzepatide showing the highest proportion despite lower absolute case counts.

domains/health/glp-1-therapy-requires-nutritional-monitoring-infrastructure-but-92-percent-receive-no-dietitian-support.md

@@ -10,16 +10,18 @@ agent: vida
 scope: structural
 sourcer: OMA/ASN/ACLM/Obesity Society
 related_claims: ["[[GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035]]", "[[SDOH interventions show strong ROI but adoption stalls because Z-code documentation remains below 3 percent and no operational infrastructure connects screening to action]]"]
-supports:
+supports: ["GLP-1 nutritional support advisory explicitly recommends SNAP enrollment support creating institutional contradiction with simultaneous 186 billion dollar SNAP cuts", "GLP-1 appetite suppression creates a protein deficiency pathway that causes muscle loss, making resistance training mechanistically necessary rather than complementary"]
-- GLP-1 nutritional support advisory explicitly recommends SNAP enrollment support creating institutional contradiction with simultaneous 186 billion dollar SNAP cuts
+reweave_edges: ["GLP-1 nutritional support advisory explicitly recommends SNAP enrollment support creating institutional contradiction with simultaneous 186 billion dollar SNAP cuts|supports|2026-04-12", "GLP-1 appetite suppression creates a protein deficiency pathway that causes muscle loss, making resistance training mechanistically necessary rather than complementary|supports|2026-04-24"]
-- GLP-1 appetite suppression creates a protein deficiency pathway that causes muscle loss, making resistance training mechanistically necessary rather than complementary
+sourced_from: ["inbox/archive/health/2025-05-31-oma-asn-aclm-obesity-society-glp1-nutritional-priorities-advisory.md"]
-reweave_edges:
+related: ["glp-1-therapy-requires-nutritional-monitoring-infrastructure-but-92-percent-receive-no-dietitian-support", "glp-1-receptor-agonists-produce-nutritional-deficiencies-in-12-14-percent-of-users-within-6-12-months-requiring-monitoring-infrastructure-current-prescribing-lacks", "glp-1-nutritional-support-advisory-recommends-snap-enrollment-creating-institutional-contradiction-with-snap-cuts", "glp1-hfpef-creates-competing-mechanisms-cardiac-benefit-versus-sarcopenic-malnutrition-risk", "glp1-appetite-suppression-creates-protein-deficiency-pathway-requiring-resistance-training-mitigation"]
-- GLP-1 nutritional support advisory explicitly recommends SNAP enrollment support creating institutional contradiction with simultaneous 186 billion dollar SNAP cuts|supports|2026-04-12
-- GLP-1 appetite suppression creates a protein deficiency pathway that causes muscle loss, making resistance training mechanistically necessary rather than complementary|supports|2026-04-24
-sourced_from:
-- inbox/archive/health/2025-05-31-oma-asn-aclm-obesity-society-glp1-nutritional-priorities-advisory.md
 ---
 
 # GLP-1 therapy requires continuous nutritional monitoring infrastructure but 92 percent of patients receive no dietitian support creating a care gap that widens as adoption scales
 
 GLP-1 receptor agonists suppress appetite as their primary mechanism, reducing caloric intake by 20-30%. This creates systematic micronutrient deficiency risk across iron, calcium, magnesium, zinc, and vitamins A, D, E, K, B1, B12, and C. The joint advisory from four major obesity/nutrition organizations identifies protein intake as 'difficult to achieve' during active weight loss, requiring 1.2-1.6 g/kg/day (versus 0.8 baseline) to preserve lean mass. However, implementation data shows 92% of GLP-1 patients had NO dietitian visit in the 6 months prior to prescription. Only 8.3% had dietitian contact in the 180 days before treatment initiation. This creates a structural care gap: the therapy's mechanism requires continuous nutritional monitoring, but the delivery infrastructure does not exist. As GLP-1 adoption scales from current millions to projected tens of millions of users, this gap widens arithmetically. The advisory recommends regular food logs, nutrient level lab testing (B12, 25(OH)D, iron, folic acid), and body composition monitoring (BIA, DXA) — none of which occur in standard primary care workflows. This is not a temporary implementation lag but a structural mismatch between the therapy's continuous-treatment model and the episodic-care delivery system.
+
+## Extending Evidence
+
+**Source:** Frontiers in Pharmacology 2024, FAERS
+
+Dehydration prevalence data (20-33% of serious metabolic adverse events across GLP-1 agents) strengthens the case for monitoring infrastructure by identifying a specific, measurable, and serious metabolic complication that current prescribing patterns miss. The GI side effects (nausea, vomiting, diarrhea) that drive GLP-1 discontinuation create a direct dehydration pathway requiring hydration and electrolyte monitoring.

inbox/archive/health/2025-xx-frontiers-glp1-metabolic-nutritional-adverse-events-pharmacovigilance.md

@@ -7,10 +7,13 @@ date: 2024-01-01
 domain: health
 secondary_domains: []
 format: paper
-status: unprocessed
+status: processed
+processed_by: vida
+processed_date: 2026-05-04
 priority: low
 tags: [glp1, pharmacovigilance, metabolic, nutritional, faers, adverse-events, dehydration]
 intake_tier: research-task
+extraction_model: "anthropic/claude-sonnet-4.5"
 ---
 
 ## Content