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ForumsSide Effects & ManagementHeadaches on GLP-1 — looking for input

Headaches on GLP-1 — looking for input

robert_kc Wed, Feb 21, 2024 at 11:15 PM 19 replies 2,294 viewsPage 1 of 4
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robert_kc
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Feb 21, 2024 at 11:15 PM#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.

Tell me what I have not thought of.

44 14PurityPaulOR, MaxMetOK, MounjBrad and 41 others
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KevinCompounds
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Feb 21, 2024 at 11:25 PM#2

Taking the question as asked, rather than the general version of it. 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.

Ask again with the specifics and you will get a better answer than this one.

43 13Dr.RaviCardio, jennifer_SEA, tyler_CSCS and 40 others
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PharmD_Rodriguez
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Feb 21, 2024 at 11:35 PM#3
KevinCompounds said:
The line between titrate-through and stop is not severity, it is trajectory and what else is present.

Agreed on adaptation, with a caveat: adaptation applies to gastric emptying and not to everything. If your problem is the aversion rather than the fullness, waiting does less, because the aversion is central and it is the mechanism working as intended.

42 12robert_kc, dan_philly, MeganSA_TX and 39 others
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adam_van
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Feb 21, 2024 at 11:45 PM#4
robert_kc said:
The nausea I get is not really nausea, it is an aversion.

This matches mine closely enough to be worth saying so. 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: Feb 22, 2024 at 3:45 AM
41 11tommy_boulder, hyun_seoul, jim_asheville and 38 others
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LipidDoc_ATL
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Feb 22, 2024 at 12:36 AM#5

From the other side of the consultation, briefly. There is a difference between no evidence and evidence of no effect, and this subject is one where the two get swapped freely in both directions.

Last edited: Feb 22, 2024 at 5:36 AM
40 10KristenIndy, MarkLI_maint, Dr.PeteFamMed and 37 others
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