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ForumsSide Effects & ManagementDizziness and orthostatic hypotension on GLP-1 — March 2026

Dizziness and orthostatic hypotension on GLP-1 — March 2026

laura_annarbor Sat, Feb 22, 2025 at 11:09 AM 14 replies 1,814 viewsPage 1 of 3
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laura_annarbor
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Dec 2024
Ann Arbor, MI
Feb 22, 2025 at 11:09 AM#1

The nausea I get is not really nausea, it is an aversion. Food I want in the abstract becomes repellent in front of me, which no side-effect list describes.

Trial-level incidence runs roughly 20 to 25% for nausea at the higher dose tiers and 12 to 17% for diarrhoea, with most events mild to moderate and concentrated in the weeks after each escalation.

What I actually want to know is what distinguishes the nausea you can titrate through from the nausea that means stop.

Happy to be told the question itself is wrong.

8 3labquiet_amy, emily_PDX, Dr.SleepRoch and 5 others
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BenResearch_OR
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Dec 2023
Oregon
Feb 22, 2025 at 12:01 PM#2

Short answer first, then the reasoning. The practical protocol is dull and it works: smaller meals, stop eating at the first sign of fullness rather than at the end of the plate, drop the fat fraction of meals in the two days after dosing, and do not lie down straight after eating. Most of what people call unmanageable nausea is a meal-size and meal-composition problem interacting with a stomach that is emptying slowly.

7 2PharmD_Rodriguez, julia.endo, JessicaM_2024 and 4 others
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FranDenver
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Oct 2024
Denver, CO
Feb 22, 2025 at 12:53 PM#3
BenResearch_OR said:
The practical protocol is dull and it works: smaller meals, stop eating at the first sign of fullness rather than at the end of the plate, drop the…

Agreeing with BenResearch_OR, and the qualification matters more than the agreement. The meal advice is right and incomplete without the hydration point. People stop drinking because drinking makes them feel full, then attribute dehydration symptoms to the drug.

6 1BariatricNurseD, MASHdoc_SA, GenomicsKate and 3 others
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josh_phd_bmore
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Jul 2024
Baltimore, MD
Feb 22, 2025 at 1:46 PM#4
laura_annarbor said:
The nausea I get is not really nausea, it is an aversion.

Same position here, arrived at the long way round. Holding genuinely reduces total burden rather than redistributing it, because the gastric-emptying component adapts. Receptor-level tachyphylaxis to the delayed-emptying effect develops over weeks while the central appetite effect persists, so the same dose is materially more comfortable at week six than at week two. A slower ladder therefore reaches the same dose with less cumulative nausea, not the same nausea spread thinner.

5 0KarenAZ_mom, zoe_NC, Dr.ObesityLA and 2 others
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PharmacoVig_BOS
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Feb 2024
Boston, MA
Feb 22, 2025 at 6:44 PM#5

From the other side of the consultation, briefly. It helps to ask what evidence would change your mind before you look at any. If nothing would, the discussion is not about evidence, and it is better to say so early than to spend nine posts discovering it.

4 24LabKate, kate.chem, DataDave and 1 other
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