Primary Care Voice With Kundlas M.D. is your dedicated space for delving into the intricate world of Primary Care. Hosted by the experienced and compassionate Primary Care Physician, Dr. Kulmeet Kundlas, this podcast sets out to bridge the gap between medical professionals and patients, unraveling the intricacies of healthcare.
In each episode, Dr. Kundlas and his expert guests dive deep into essential topics that encompass everything from preventive measures and chronic and acute disease management to cutting-edge telemedicine innovations, nurturing patient relationships, and staying updated on the latest medical trends
The Truth About GLP-1 Titration: What You Need to Know
Avoid GLP-1 Side Effects: Why Wegovy/Zepbound Titration Matters (Dr. Kulmeet Kundlas) Dr. Kulmeet Kundlas, a primary care physician of 30+ years, explains that many severe GLP-1 agonist side effects from Wegovy, Zepbound/Mounjaro (tirzepatide), and related medications are often due to titration errors, patient impatience, pharmacy/education gaps, or restarting at too high a dose after missed injections. He describes how GLP-1s disrupt GI motility, citing Wegovy trial rates of nausea (40%) and vomiting (26%), and outlines the rigid step-up schedules (Wegovy starting at 0.25 mg weekly for 4 weeks toward a 2.4 mg maintenance dose; tirzepatide starting at 2.5 mg with increases every 4 weeks). He warns against unsafe dose-jumping and using non–FDA-approved compounding sources, notes pancreatitis warning signs, and emphasizes physician/pharmacist training plus lifestyle measures like high-protein diet, exercise, sleep, and stress management. 00:00 GLP-1 Side Effects Explained 01:15 Why the First Dose Hits Hard 02:29 Real Results and Big Picture 03:30 Wegovy Titration and Stacking 05:35 Zepbound Dosing and Missed Shots 06:00 Pen Mistakes and Compounding Risks 07:31 Warning Signs and Safe Wrap-Up
6 Oct 2026
Hidden Causes and Solutions for Uncontrolled Diabetes 2
Can’t Control Blood Sugar on Multiple Meds? 24% May Not Be Type 2 Diabetes Hypercortisolism, LADA, Dawn vs Somogyi This episode explains that some people with persistently high blood sugar and A1C despite exercising, eating well, and taking two to three diabetes medications may have conditions that mimic type 2 diabetes, with an estimated 24% chance in difficult-to-control cases. It highlights hypercortisolism autonomous adrenal hormone production as a key cause, linking excess glucocorticoids to higher glucose and insulin resistance and mineralocorticoids to high blood pressure, and describes diagnosis with the overnight 1 mg dexamethasone suppression test checking dexamethasone level, cortisol greater 1.8, and ACTH and possible cure with treatment of adrenal adenoma/hyperplasia. It also reviews LADA diagnosed with C-peptide, dawn phenomenon vs Somogyi effect 2–3 AM glucose check, steroid/medication effects, lifestyle factors, and falsely elevated A1C from iron deficiency anemia or blood disorders.
29 Sept 2026
Understanding CGRP in Migraine Therapy KundlasMD
CGRP Migraine Medication Revolution (2026): Prevention, Abortive Options & Avoiding Medication Overuse Dr. Kulmeet Kundlas explains that migraine is a neurological event affecting 1.2 billion people and often leads to pain, disability, and medication overuse headache when treated repeatedly with NSAIDs, triptans, or opioids. He describes migraine biology involving the trigeminal nerve and CGRP release causing blood vessel dilation, brain sensitization, and inflammation, along with four migraine stages and the lack of a definitive diagnostic test. Treatment should include prevention and abortive strategies, emphasizing CGRP-targeted therapies: monoclonal antibodies that neutralize CGRP for prevention (monthly, quarterly, or IV options, including use from age six and up) and oral CGRP receptor antagonists (gepants like Ubrelvy and Nurtec) for acute attacks, which are not shown to cause medication overuse headache. He recommends tracking attacks with a migraine diary, aims for a 50% reduction in frequency/severity/duration, notes evolving guidelines and insurance support for CGRP drugs as first-line therapy, and highlights preventing progression to chronic migraine, especially when attacks exceed four.
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Dr Kulmeet Kundlas
Dr KK
Kulmeet Kundlas
Podcast Authority Score: 27 / 100
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