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10.3389/fpsyt.2023.1152435 Front

doi:10.1186/s12882-023-03149-7

Managing combined side effects Expect amplified GI effects: Both peptides slow gastric emptying Synergistic nausea (not just additive) Constipation very common Weeks 9-16 most challenging Nausea management protocol: Prevention from day 1 (ginger, small meals) Prescription anti-nausea (Zofran) essential Liquid nutrition if needed Slower titration if poorly tolerated Constipation prevention: 80-100 oz water daily Fiber 25-30g daily Magnesium citrate 300-500mg nightly MiraLAX as needed Nutrition maintenance: Protein shakes 2-3 daily (30-40g each) Target 60-80g protein minimum Multivitamin daily B12 supplementation When to reduce doses: Severe persistent nausea despite management Unable to maintain adequate nutrition Vomiting frequently Quality of life severely impacted See our common peptide mistakes beginners make to avoid errors

Current management paradigms for severe obesity include medical management or MBS

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By restoring systemic antioxidant status, L-glutathione helps to heal the endothelial lining, soothe vascular inflammation, and reduce the hyperactive clotting cascade, improving microcirculation and oxygen delivery throughout the body