Dr.ObesityMed said:Fiber trials in this population are thin, and most of what gets quoted is extrapolated from idiopathic constipation in people eating normally.
That reframing is the part I needed.
Adding the clinical framing, because it changes how the question reads.
Acid reflux and constipation: I developed GERD symptoms around week 3 that I'd never had before. The delayed gastric emptying means food and acid sit in your stomach longer.
Management that works for me: elevate head of bed 6 inches, don't eat within 3 hours of lying down, avoid trigger foods (tomato, citrus, spicy, chocolate), and famotidine 20mg at bedtime. Much better now.
PharmacoVig_BOS said:Sulfur burps on constipation — the most underrated side effect nobody warned me about.
Gastric emptying studies and constipation: semaglutide delays gastric emptying by ~40% at steady state, as measured by acetaminophen absorption testing and scintigraphy[1].
Clinically relevant implications:
Importantly, the gastric emptying delay attenuates with continued use (tachyphylaxis), which correlates with the transient nature of GI side effects.
Community-driven peptide testing and vendor rating platform. Transparent results. Unbiased analysis. Trusted by thousands.
View ResultsRetaRick_CA said:The mechanism is slowed transit plus reduced intake, and that combination determines which interventions work.
Drug interaction alert relevant to constipation: if you take oral levothyroxine (Synthroid), GLP-1 agonists can reduce absorption due to delayed gastric emptying. My TSH drifted up after starting semaglutide.
Solution: take levothyroxine on an empty stomach, 60 minutes before any food, and have your TSH rechecked 6-8 weeks after starting or changing GLP-1 dose. My endo had to increase my Synthroid by 12.5mcg.
Moderator note: a post naming a supplier has been edited. Discuss suppliers in the review sections, not here. Tagging this one for the weekly digest.