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ForumsSide Effects & ManagementWhen to stop GLP-1 — what worked for you?

When to stop GLP-1 — what worked for you?

oliver_london Mon, Nov 11, 2024 at 10:08 PM 14 replies 1,866 viewsPage 1 of 3
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oliver_london
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Nov 11, 2024 at 10:08 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 am after is whether holding at a lower dose for longer actually reduces total side-effect burden or just spreads it out.

Happy to be told the question itself is wrong.

10 5Admin, Dr.Martinez, mike_mod and 7 others
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SarahChen_PharmD
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Nov 11, 2024 at 10:17 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.

That is the short version; the long version is somebody else's post.

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GenomicsKate
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Nov 11, 2024 at 10:26 PM#3
SarahChen_PharmD 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.

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hannah_MT
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Nov 11, 2024 at 10:35 PM#4
oliver_london said:
The nausea I get is not really nausea, it is an aversion.

Can confirm the pattern oliver_london describes. 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: Nov 12, 2024 at 1:35 AM
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Dr.PeteFamMed
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Nov 11, 2024 at 11:20 PM#5

Clinical perspective, offered as context rather than as advice. Order of operations matters more than any single choice here: establish a baseline, change one thing, wait long enough for it to express itself, then measure again under the same conditions.

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