Key takeaways:
Sulfur burps have a rotten egg smell. They’re an unpleasant side effect of Zepbound and other glucagon-like peptide-1 (GLP-1) medications.
Sulfur burps happen because Zepbound slows digestion, which can allow sulfur-containing gas to build up.
Sulfur burps usually improve as your body adjusts to Zepbound. Eating smaller meals, limiting sulfur-rich foods, or slowing dose increases may help reduce symptoms.
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If you’ve started Zepbound (tirzepatide) and suddenly developed rotten egg-smelling burps, you’re not alone. Sulfur burps are an unpleasant and common side effect of GLP-1 medications. While they’re usually temporary, they can be embarrassing and frustrating.
The good news is that there are steps you can take to reduce your symptoms. Here's what causes Zepbound sulfur burps, how to get rid of them, and when they may be a sign of something more serious.
What are sulfur burps?
A sulfur burp is a burp that smells like rotten eggs. The smell comes from hydrogen sulfide (H₂S) gas. Hydrogen sulfide gas forms when gut bacteria break down sulfur-containing compounds in food during digestion.
Many foods contain sulfur, including:
Protein-rich foods, like meat and eggs
Wine and beer
Brassica vegetables, like broccoli and kale
Normally, the body gets rid of small amounts of this gas without any noticeable symptoms.
But if the gut produces too much hydrogen sulfide, the gas can build up in your intestines. And it can travel upward through your digestive tract and eventually come out as a burp. The gas can also travel downward through your digestive tract, where it gets released in farts.
Because hydrogen sulfide has a very strong odor, even tiny amounts can create the characteristic rotten egg smell.
Sulfur burps aren’t unique to Zepbound. People with conditions like irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and small intestinal bacterial overgrowth (SIBO) may also experience them. But sulfur burps are gaining more attention as the use of GLP-1 medications increases.
What causes Zepbound sulfur burps?
The source of Zepbound sulfur burps is the same as any other sulfur burp: too much hydrogen sulfide gas in the digestive tract. But Zepbound changes how food and gas move through your digestive system, which makes sulfur burps more likely.
On their own, these changes may have only a small effect. But together, they may create the right conditions for sulfur burps to develop. These include:
Food stays in your stomach longer. Zepbound slows how quickly your stomach empties. This gives gut bacteria more time to break down sulfur-containing foods and produce hydrogen sulfide gas.
More bacteria may grow in your small intestine. Slower digestion may allow bacteria to build up in parts of your small intestine where they normally aren’t found in large numbers. These bacteria may produce additional hydrogen sulfide.
Gas may travel upward more easily. Slower stomach emptying increases the likelihood of side effects like indigestion, heartburn, and gastroesophageal reflux disease (GERD). This also makes it easier for hydrogen sulfide gas to travel back up your esophagus and escape as a sulfur-smelling burp.
How can you stop Zepbound sulfur burps?
The good news is that sulfur burps usually get better over time as your body adjusts to Zepbound. In the meantime, here are some steps you can take help ease your symptoms:
Slow your dose increases. Talk to your healthcare team about staying at your current dose a little longer. This can give your body more time to adjust and give you a break from sulfur burps before your next dose increase.
Eat smaller, more frequent meals. Smaller meals empty from your stomach more easily than larger meals. This may help reduce sulfur burps by giving gut bacteria less time to create hydrogen sulfide.
Cut back on sulfur-rich foods. Foods high in sulfur provide more sulfur for gut bacteria to break down into hydrogen sulfide gas. Eating less of these foods can lower your chances of sulfur burps.
Eat more prebiotics. Certain types of fiber and prebiotics may keep gut bacteria from making hydrogen sulfide. Helpful foods include legumes (lentils, chickpeas, beans), whole oats, and barley.
Try bismuth subsalicylate (Pepto-Bismol). Bismuth binds directly to hydrogen sulfide gas and neutralizes it. Pepto-Bismol isn’t right for everyone. Talk with your healthcare team to make sure it’s safe for you.
When should you seek care for Zepbound sulfur burps?
For most people, sulfur burps improve as their body adjusts to Zepbound. You should seek care if your sulfur burps don’t go away within 2 months after you’ve reached a stable Zepbound dose.
Sulfur burps that don’t go away or continue to get worse may be a sign of another digestive condition, such as small intestinal bacterial overgrowth (SIBO) or stomach paralysis (gastroparesis).
Contact your healthcare team if you develop symptoms like:
Persistent bloating
Abdominal pain
Vomiting after eating
Trouble eating or drinking
Severe or worsening heartburn
Pain in the upper right side of your stomach
Yellowing of your skin or eyes
Frequently asked questions
Yes, other glucagon-like peptide-1 (GLP-1) medications can cause sulfur burps. Oral GLP-1 medications tend to cause more gut-related side effects, like nausea, bloating, and vomiting. While researchers haven’t looked at sulfur burps specifically, it’s likely that oral GLP-1s are more likely than injectable GLP-1s to cause this gut symptom.
Foods that naturally contain a lot of sulfur or cysteine, an amino acid, may make sulfur burps worse. These include all types of meat, dried fruits, and brassica vegetables. Wine and beer can also worsen sulfur burps. Some foods, like cured meats, also contain sulfite or sulfate additives that may also worsen sulfur burps.
It’s not clear how long Zepbound sulfur burps last. Most gut side effects improve within a few days to a few weeks. Research suggests that sulfur burps tend to be most common when starting Zepbound. Like most GLP-1 side effects, they may come back if you increase your dose.
Yes, other glucagon-like peptide-1 (GLP-1) medications can cause sulfur burps. Oral GLP-1 medications tend to cause more gut-related side effects, like nausea, bloating, and vomiting. While researchers haven’t looked at sulfur burps specifically, it’s likely that oral GLP-1s are more likely than injectable GLP-1s to cause this gut symptom.
Foods that naturally contain a lot of sulfur or cysteine, an amino acid, may make sulfur burps worse. These include all types of meat, dried fruits, and brassica vegetables. Wine and beer can also worsen sulfur burps. Some foods, like cured meats, also contain sulfite or sulfate additives that may also worsen sulfur burps.
It’s not clear how long Zepbound sulfur burps last. Most gut side effects improve within a few days to a few weeks. Research suggests that sulfur burps tend to be most common when starting Zepbound. Like most GLP-1 side effects, they may come back if you increase your dose.
The bottom line
Sulfur burps are an unpleasant but temporary side effect of Zepbound. Slowing dose increases may help ease this symptom by giving your body time to adjust to the medication. Avoiding foods that are naturally high in sulfur and eating prebiotic-rich foods can also help. Talk with your healthcare team if your symptoms don’t improve over time or if you develop other digestive symptoms.
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