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ForumsSide Effects & ManagementDay 3 on sema and I feel like death warmed over — what worked for you?

Day 3 on sema and I feel like death warmed over — what worked for you?

DataDave Sun, Aug 4, 2024 at 7:31 AM 10 replies 1,883 viewsPage 1 of 2
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DataDave
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Aug 4, 2024 at 7:31 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.

What I actually want to know is whether holding at a lower dose for longer actually reduces total side-effect burden or just spreads it out.

Practical detail welcome, however dull — the duller the better.

15 10VendorMark, COA_Karl, MikeFit_NJ and 12 others
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PeptideChemSF
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Aug 4, 2024 at 9:12 AM#2

This one has a reasonably settled answer, so here it is. The line between titrate-through and stop is not severity, it is trajectory and what else is present. Nausea that peaks and improves within a week is the expected pattern. Nausea that is escalating, or that comes with severe upper-abdominal pain radiating to the back, or that prevents fluids for more than a day, is a different conversation and belongs with a clinician the same day.

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roxy_nash
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Aug 4, 2024 at 10:52 AM#3
PeptideChemSF said:
The line between titrate-through and stop is not severity, it is trajectory and what else is present.

Agreeing with PeptideChemSF, 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.

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nick_SD_fit
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Aug 4, 2024 at 12:32 PM#4
DataDave said:
The nausea I get is not really nausea, it is an aversion.

Same position here, arrived at the long way round. 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.

Last edited: Aug 4, 2024 at 2:32 PM
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Dr.BariatricHTX
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Aug 4, 2024 at 10:22 PM#5

Clinical perspective, offered as context rather than as advice. Start from the measurement rather than the conclusion. Almost every disagreement here turns out to be two people measuring different things and comparing the numbers anyway.

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