Relief from Side Effects of Semaglutide

Semaglutide has shown to be an incredible medication for weight loss when used responsibly. Are there side effects?  For some, absolutely! This is why I firmly believe you should take this medication with medical supervision. I like to be sure all of our patients on Semaglutide have a face-to-face meeting where we review the side effects, talk about ways to mitigate them, discuss a lifestyle diet, and review the physiology behind fat storage and fat breakdown. Luckily, we do not see very many side effects outside of mild nausea on our Semaglutide program. On rare occasions, I have seen some constipation, diarrhea, and a patient with gallstones. I also make sure all of my patients can reach me anytime if they need to. My motto is “first do no harm.”  Therefore, I would like to know if my patients are experiencing any issues and be there to work through it with my patients.  We are so happy with our Semaglutide program at The Natural Path.

Common and Rare Side Effects when Using Semaglutide

Most of the side effects seen with Semaglutide are gastrointestinal. Some experience mild nausea, vomiting, gas, and bloating from Semaglutide. Similar to other digestion-related side effects, dietary and lifestyle changes may help. Examples include eating smaller meals and avoiding fried foods and foods high in fat. I highly recommend all of my patients drink 2-4 liters of water daily with electrolytes; I recommend clean proteins, low-carb vegetables, and small amounts of healthy fats as the majority of your diet. I ask my patients to make sure their bowels move every day and to reach out to me if constipation happens. I remind my patients to chew food slowly.

Semaglutide mimics a hormone that we naturally make in our gut. This hormone, known as GLP-1  causes your pancreas to release insulin, blocks your liver from making glucose and slows down how quickly food leaves your stomach. It also works in the areas of the brain that regulate appetite and fullness. While these actions can be beneficial for Type 2 diabetes and weight loss, they can also cause some side effects.  It is important to have a medical professional at your fingertips to help you with these as on rare occasion they can be intense.

On rare occasions, some semaglutide side effects can be bothersome and make the medication challenging to tolerate. The good news is that gastro intestinal side effects usually subside over time.

1. Nausea and vomiting

Nausea is the most common semaglutide side effect. Up to 20% of the patients who are using it for Type 2 diabetes reported nausea in clinical trials. Nausea is even more common if you’re taking the higher-doses. Vomiting tends to be less common than nausea.  I see mild nausea in about 5-10% of my patient population. I rarely see vomiting.  Smelling rubbing alcohol can help nausea, and I prescribe Zofran for some, and many find these to be effective. Nausea can happen more commonly at the start and with dose increases.

You’re more likely to experience nausea and vomiting with higher doses of semaglutide. The dose is increased slowly over a few months to minimize these effects. For most people, side effects such as nausea should improve over time as your body adjusts to the medication.

Eating smaller meals, avoiding high-fat foods, and remaining upright after you eat can also help manage potential nausea and vomiting from semaglutide. But if these side effects are accompanied by severe upper and middle abdomen pain, get medical attention immediately.

2. Diarrhea

Diarrhea is another common semaglutide side effect. Around 9% of people taking it for Type 2 diabetes and a small percent of people taking it for weight loss reported diarrhea during clinical trials.  I have seen only a small handful of patients with diarrhea on our Semaglutide program. I recommend Immodium and Saccharomyces boulardii to help with that.

Similar to nausea and vomiting, you’re more likely to experience diarrhea with higher doses of semaglutide. As mentioned above, your healthcare provider will slowly raise your dose over time to minimize this side effect. Avoid foods that can make diarrhea worse, such as fatty or fried foods, dairy, alcohol, and caffeinated drinks.  I love treating it with Saccharomyces boulardii, which is a specific probiotic strain.

3. Constipation

Constipation can also happen with semaglutide, but it tends to be less common than diarrhea. Like other semaglutide side effects discussed above, constipation improves over time. If you’re feeling constipated, please drink 2-4 liters of water daily with electrolytes. I love the Noli breathing exercises for keeping intestinal movement strong. I also recommend OTC gentle laxatives if needed. I prefer things to move daily through the gastrointestinal tract. Mag07 is one of my very favorite colon cleansers. If bowels become sluggish, I may suggest my patients stop the medication.

Gas and bloating can also occur for some from semaglutide. Similar to other digestion-related side effects, dietary and lifestyle changes may help. This is usually a symptom of poor food combining in the stomach. Carbs, sugars, and high-fat foods can cause burping and bloating. Semaglutide can slow gastric emptying, so food tends to sit in the intestines longer.

Your healthcare provider may recommend an OTC anti-gas remedy, such as simethicone, to relieve bloating.

5. Stomach pain

Mild stomach pain is another common stomach-related side effect of semaglutide. This should subside over time, similar to nausea, vomiting, and diarrhea. Using the tips listed above can also help minimize this side effect.

Severe stomach pain can indicate other side effects. It is essential to go to your nearest ER or Urgent Care center if you have any severe abdominal pain to rule out a potentially more serious issue such as pancreatitis or gallbladder problems (like gallstones). Contact your healthcare provider right away if this develops.

6. Fatigue

Fatigue can happen to some patients when they begin the medication. Fatigue impacted 5-11% of people taking Semaglutide in clinical trials. Semaglutide works for weight loss by making you feel less hungry. If you eat fewer calories, the calories must come from nutrient-dense foods, not junk food.  Most of the fatigue that I have seen in my patient population happens at the start and improves over time.

7. Burping

Some people experience acid reflux symptoms while taking semaglutide, which can include burping. This has been called the “Ozempic burp” since it can have a distinct smell and taste. If you’re experiencing burps or other acid reflux symptoms from semaglutide, it may help avoid or minimize foods that can worsen them, such as greasy, spicy, and fried foods. Caffeine and alcohol can also be problematic. This is usually a symptom of poor food combining in the stomach. Carbs, sugars, and high-fat foods can cause burping and bloating. Semaglutide can slow gastric emptying, so food tends to sit in the stomach a bit longer.

8. Hair loss

Losing weight quickly can result in hair shedding or loss. In the clinical trials for the branded form Wegovy, this was seen in 3% of people. This type of hair loss, called telogen effluvium, is usually temporary. Hair loss you may be experiencing from Wegovy or Ozempic should subside as your body adjusts. Keep in mind this may take several months.

Since these medications can also affect your appetite, it’s essential to ensure you get enough vitamins, minerals, and protein. If you’re not, this can also contribute to hair loss. Your healthcare provider can help you ensure you’re getting adequate nutrition during treatment.  I highly recommend a very nutrient-dense diet to go along with using Semaglutide

9. Pancreatitis

Although extremely rare, pancreatitis has been reported with the use of Semaglutide. It’s unclear whether this is from Semaglutide or another causation. If it happens, it can be life-threatening. Seek immediate medical attention if you develop severe abdominal pain, nausea and vomiting, and/or jaundice (yellowing of skin and eyes). Again, this is extremely rare, and when it has occurred, it is most often in type 2 diabetics with other co-morbid conditions.

Let your healthcare provider know before starting semaglutide if you have a history of acute pancreatitis. They may recommend a different medication for you.

10. Gallbladder disease

Gallbladder issues, including gallstones, are possible with Semaglutide but very rare. They can happen with any low-fat diet as well.  It was reported in less than 2% of people taking it in clinical trials.  Symptoms of gallbladder problems include upper stomach pain, fever, and jaundice. You may also notice clay-colored stools. Let your healthcare provider know right away if these develop.

Talk to your healthcare provider about ways you can avoid gallbladder problems while taking semaglutide. This may include dietary changes and routine physical activity.

19. Stomach paralysis (gastroparesis)

One of the ways semaglutide works is by slowing down how quickly food leaves your stomach (called delayed gastric emptying), which appears to be a temporary effect. However, some people have reported severe stomach paralysis (gastroparesis) while taking the medication. It’s possible this was from Semaglutide or an underlying condition.

Gastroparesis symptoms, such as nausea, vomiting, and fullness after eating, are very similar to common Semaglutide side effects. If these symptoms occur, it doesn’t necessarily mean there’s a problem since they’re generally expected with treatment. But let your healthcare provider know if they’re severe, aren’t going away, or get worse.

Good to know: There have also been cases of intestinal paralysis (ileus) with semaglutide. Because of this, the FDA has added ileus to the list of potential side effects. In some cases, ileus can result in a bowel obstruction (blockage).

I like to be sure my patients eat nutrient-dense food, easy to digest, and move bowels daily.

Does semaglutide cause long-term side effects?

The pharmaceutically branded forms of Semaglutide – Ozempic, Rybelsus, and Wegovy have been on the market for years.  Researchers are still studying their potential long-term side effects, such as how they might affect the thyroid and gastrointestinal tract. The FDA also continues to review side effects that are reported with these medications while they’re on the market.

Currently, the longest Semaglutide trials have lasted 2 years. Two examples are the SUSTAIN-6 and STEP 5 trials. During these trials, those who received a placebo (an injection without medication) reported more serious side effects than those who received Semaglutide. No new safety concerns came up during these trials.

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