Ozempic and neuropathy: do GLP-1 drugs affect the nerves in your feet?

This week, a new FDA warning on GLP-1 drugs sent many people to search for “Ozempic neuropathy.” If you take one of these medicines and your feet tingle, burn or feel weak, you want to know if the two are linked. Here is what the research says, and when a Foot and Ankle Surgeon who treats nerves can help.

Why GLP-1 drugs are in the news

On November 9, 2026, the FDA said it found a potential increased risk of a rare but serious eye condition called NAION (non-arteritic anterior ischemic optic neuropathy) with GLP-1 drugs. It now requires a warning on the labels of all of them, including Ozempic, Wegovy, Mounjaro and Zepbound.^[5]

NAION affects the optic nerve, the nerve that carries sight from the eye to the brain. It is rare. In a pooled look at 126 trials, it happened 6.4 times per 100,000 person-years on GLP-1 drugs, versus 3.8 on other treatments or placebo. Warning signs include sudden vision loss in one eye that does not hurt, sometimes noticed on waking.^[5]

This warning is about the eye. It does not tell us anything about the nerves in your feet. The FDA asks patients with symptoms to contact their health care professional right away. It does not tell patients to stop the medicine on their own.^[5]

Ozempic neuropathy: what has been reported?

Reports of foot and leg nerve problems after GLP-1 weight loss are new and growing.

• A 2026 review of every reported case. Researchers found 19 studies with 31 individual cases plus one group of 103 people. All but one were published from 2024 on. Semaglutide or tirzepatide was involved in 83% of the cases, and 67% of people had prediabetes or diabetes.^[2]
• Fast, large weight loss was common. The typical person lost about 20 kg (44 pounds), or 22% of their body weight, at about 3.7 kg (8 pounds) a month. Symptoms began around five months in.^[2]
• Which nerves? Fibular neuropathy at the knee was most common (10 cases), then lumbosacral radiculoplexus neuropathy, which affects the nerve roots and nerve networks that supply the leg (9), then the usual stocking-pattern neuropathy of both feet (7).^[2]

A 2025 study in the journal Neurology compared people with these problems to matched people without them. GLP-1 users were about 30% more likely to develop common fibular neuropathy and about 51% more likely to develop lumbosacral radiculoplexus neuropathy. The fibular cases looked like nerve compression and were tied more to weight loss. The radiculoplexus cases were tied more to big drops in A1C, a blood test of average sugar.^[3]

Lowering blood sugar very fast can also affect nerves. This was studied with fast sugar improvement in general, not with GLP-1 drugs in particular. In a neuropathy clinic, 10.9% of 954 people had sudden nerve pain or other nerve symptoms after a big A1C drop. When A1C fell 2 to 3 points in three months, the risk was 20%. When it fell more than 4 points, the risk was over 80%.^[6]

The review’s authors suggest good nutrition and avoiding very fast drops in A1C and weight.^[2] How fast to go is a question for your prescriber.

Where surgery fits: a nerve squeezed after weight loss

This is where a nerve surgeon can help most. The common fibular nerve (also called the common peroneal nerve) wraps around the outside of the knee. When it is squeezed, the top of the foot can go numb and the foot can weaken or drag. Learn more about common peroneal nerve compression and foot drop.

The Neurology study authors found that fibular neuropathy after GLP-1 use had the features of a compression problem.^[3] A compressed nerve can often be freed. In 51 common peroneal nerve decompressions, 83% of people with weakness got stronger, 84% of those with pain had less pain, and 49% of those with numbness had better feeling.^[4]

Diabetes also makes trapped nerves at the ankle more common. Signs of a trapped tibial nerve were found in 44.9% of people with diabetes, versus 26.5% of people without diabetes.^[7]

So if foot numbness, burning or weakness persists while you take a GLP-1 drug, or after you have lost a lot of weight, see a nerve specialist. Dr. Efe Ozturk, a double board certified Foot and Ankle Surgeon and podiatrist, checks each nerve along its path for a squeeze point. For the right patients, freeing the nerve with nerve decompression is an option. Nerve studies and imaging, when needed, are arranged with another specialist.

Could GLP-1 drugs help the nerves in your feet?

Maybe, but the studies disagree.

• Fewer foot ulcers, more Charcot. In a large US records study of people with diabetic neuropathy, GLP-1 users had fewer foot ulcers at one year than people on another diabetes drug class (2.2% versus 2.7%). They also had more Charcot foot (0.3% versus 0.2%).^[8]
• Fewer pinched nerves in the hand. People with diabetes on GLP-1 drugs had about half the odds of a new carpal tunnel diagnosis over two years.^[9]
• More neuropathy than another drug class. In Denmark, people starting a different class (SGLT-2 inhibitors) had a lower risk of neuropathy than people starting GLP-1 drugs.^[10]

These are records studies, so they show links, not cause.

Better sugar control can make surgery safer

If you need nerve surgery, the gains from your diabetes care help. In 21,854 people with diabetes having planned foot or ankle surgery, each 1-point rise in A1C raised the odds of a complication by 5%. Neuropathy itself raised the odds 1.78 times.^[11] Our main practice explains diabetic foot care (external site).

Tell your surgeon and anesthesia team that you take a GLP-1 drug. Surgical, anesthesia and digestive health societies have issued joint guidance on these drugs around surgery.^[12] Any change to your medicine is for your prescriber and surgical team to decide together.

What are the limits?

Most reports of nerve problems on GLP-1 drugs are single cases and look-back studies. They cannot prove the drug caused the problem.^[2,3] The FDA calls the eye risk potential, and its review of animal studies did not find how the drugs would cause it.^[5] The decompression results come from one surgical series that was not limited to GLP-1 users.^[4] And trials so far have not shown a clear effect of GLP-1 drugs on diabetic neuropathy.^[1]

Common questions

Can Ozempic cause peripheral neuropathy?

Cases have been reported, mostly after fast, large weight loss, and most often at the fibular nerve near the knee.^[2] A link has been found, but not proof of cause.^[3]

Does Ozempic help diabetic neuropathy?

Not clearly. Trials have not shown a significant effect.^[1] Read can peripheral neuropathy be reversed?

Is the GLP-1 eye warning about the nerves in my feet?

No. NAION affects the optic nerve of the eye.^[5] Foot symptoms need their own exam.

When to see a specialist

Book a visit if your feet tingle, burn or feel numb for more than a few weeks, if one foot feels weak, or if numbness started after big weight loss. Finding a squeezed nerve early keeps surgery that frees it on the table. We see patients in Lyndhurst, Paramus and Millburn. Please call our office at 908-215-5953 to inquire about your insurance.