Dr.RaviCardio said:

Sulfur burps on constipation — the most underrated side effect nobody warned me about.

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.

CanadaChris said:

Acid reflux and constipation: I developed GERD symptoms around week 4 that I'd never had before.

Bookmarking. The distinction being drawn above is the one nobody else makes.

Dr.RaviCardio said:

Sulfur burps on constipation — the most underrated side effect nobody warned me about.

Heartburn management on constipation: Tums as needed has been my savior. The delayed gastric emptying means stomach acid just sits there.

Don't ignore persistent heartburn — chronic acid exposure can damage your esophagus. If OTC remedies aren't cutting it after 2 weeks, see your doctor for something stronger. You shouldn't suffer through this.

One concrete data point for the thread. Practical: whatever you change, write down the date and the reason. In three months the reason is what you will have forgotten, and the reason is what makes the record worth having.

Moderator note: the sourcing question belongs in the vendor section and has been split out. Thread quality here is what the rules are for. Keep it up.