Many patients ask us why it is that at about two or three months, they start developing side effects of the medications, such as semaclutide or laraclutide.
The reason is it's at this time that the blood levels of the medication increases above a certain threshold where most patients are experiencing the benefits of the medication, but some patients are also experiencing side effects.
The most common side effects is that people will feel nauseous, but the nausea will subside.
Other people may become constipated. Now the constipation may stay in the long term. On the contrary, a small number of patients will also develop diarrhea. Now these side effects are all related to the dose of the medication.
And what you will find is that another number of patients will develop reflux when they are burping, and it has sort of a a very nasty sulfur smell, when they do burp.
That is also related to how the medication works. In the first instance, what the medication does is it works inside the brain to make you feel less hungry and more satisfied.
However, the same medication are also binding receptors that sit on the gut. For example, on the valve where the stomach empties into the small bowel, and this valve is slowed down, and that's why people are burping.
The second thing that happens is there's also receptors that sit on the small bowel, and that's why the small bowel turns slower and can cause the constipation.
The nausea, as well as the diarrhoea, may relate to how the medication works inside the brain.
The good news is that these side effects will subside as time goes on, and one way to manage them is by clearly just reducing the rate at which we increase the dose.
So say, for example, you're on taking a zero point five milligram dose on semaglutide and you don't have side effects, you increase to the one milligram and you do have side effects.
If they are mild, I think you should persist because the side effects will subside.
However, if the side effects are moderate or severe, what you can do is just reduce the dose back to zero point five again and allow the body to settle down.
The amount of weight loss is not related to the side effects. So people who have a lot of side effects do not lose more weight than those people that don't have any side effects.
So if you slow the dose titration down, you will lose exactly the same amount of weight than people where the dose titration is sped up.
It is important to say that if you do not have side effects, then there's no reason to slow the dose titration down. But know that this can be managed and reach out, to allow us to talk to you and explain what's happening.
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