My dad suffers on semaglutide

[timfa]

Okay, so some backstory before i ask for advice. My dad has been trying to lose weight for a while, he lost weight but the doctors still said he was overweight so they prescribed him semaglutide. hes been on it for about a month and a half and his dose is at 1mg right now. each time i see him he complains about how it makes him feel "disgusting", I hate seeing my dad like this and i dont know what to tell him. Should he lower the dose? should he stop and get back on it? I dont know much about sema so i wanted to get some advice from here, appreciate it.

 

[Calm Logic]

Whatever he does, he needs to talk to his provider who prescribed it.

"Disgusting" is very vague. Zepbound (tirz) may have less unwanted effects for him (or may not).

Lowering the dose (like you say) or simply staying at the same dose (not titrating up) may help with adjustment.

Typical dosing schedule for sema:

Standard Semaglutide Titration Schedule (Wegovy/Ozempic)

Phase Weeks Dose (Weekly) Goal Month 1 1–4 0.25 mg Initiation / Acclimation Month 2 5–8 0.5 mg First Step-up Month 3 9–12 1.0 mg First Therapeutic Dose Month 4 13–16 1.7 mg Escalation Month 5+ 17+ 2.4 mg Maintenance Dose

 

[RubbaDubba1]

Okay, so some backstory before i ask for advice. My dad has been trying to lose weight for a while, he lost weight but the doctors still said he was overweight so they prescribed him semaglutide. hes been on it for about a month and a half and his dose is at 1mg right now. each time i see him he complains about how it makes him feel "disgusting", I hate seeing my dad like this and i dont know what to tell him. Should he lower the dose? should he stop and get back on it? I dont know much about sema so i wanted to get some advice from here, appreciate it.

That really sounds like he progressed or got titrated to quickly by the Dr to 1 mg. The beginning dose is 0.25 mg once a week for the first 4 weeks. This will help give your body a chance to get used to the medicine. At Week 5, your health care professional will increase the dose to 0.5 mg once a week. Lowest effective dose, for as long as possible before moving up. Maybe go back down to 0.5mg for a while and try that. Tirzepatide is the better product by far, but if insurance is covering it, no harm in giving the Semaglutide a chance to do it's thing.

 

[Calm Logic]

Another potential issue is that the higher the motivation ("buy in"), sometimes the higher tolerance for mild-to-moderate GI sides. Conversely, the lower the motivation/desperation, possibly less tolerance for sides, which can be managed with OTCs, Rx medications, dietary changes, electrolytes, etc.

 

[Calm Logic]

should he stop and get back on it?

GI symptoms can disappear greatly/completely at lower doses, so usually no need to stop completely.

You can also type into an AI the exact symptoms, and it is pretty good for coming up with solutions, even dose suggestions and questions to ask the doc.

I asked Google Gemini about feeling "disgusting" on sema, and one thing (of many) it suggested is digestive enzymes, which is not mentioned often in forums. The problem I have with with dietary enzymes is remembering to use them. I do use probiotics, including the ones naturally in sauerkraut.

But the number-one dietary advice was to reduce fatty foods (which is more typical advice):

Emphasizing that these sides are manageable rather than just "part of the deal" could help. You could suggest a "Toolkit" approach:

OTC/Rx Support: Pepto-Bismol, ginger chews, or asking the doc for a Zofran (ondansetron) prescription for the first 48 hours post-shot.

Dietary Tweaks: Moving to smaller, more frequent meals. High-fat or high-sugar foods sit in the stomach much longer on GLP-1s, which is often what causes that "disgusting" or "heavy" feeling.

Hydration/Electrolytes: Standard advice, but vital. Dehydration on these meds often manifests as a vague, systemic "malaise" that people describe as feeling "gross."

A lot of us use daily protein shakes like the ones by Fairlife, Nurri, or Premier Protein. They can be easier to digest too.

My least favorite upper GI symptom (in the past, when titrating up) was bloating. Simethicone was somewhat helpful. My go-to for most GI sides is Alka-Seltzer.

 

[timfa]

Whatever he does, he needs to talk to his provider who prescribed it.

"Disgusting" is very vague. Zepbound (tirz) may have less unwanted effects for him (or may not).

Lowering the dose (like you say) or simply staying at the same dose (not titrating up) may help with adjustment.

Typical dosing schedule for sema:

yea I think they upped his dose too fast. He’s around week 6 and already on 1 mg

 

[Calm Logic]

The docs that do that can expect more calls/followups. My doc titrated me up weekly instead of monthly with tirz, like he did all of his patients ("as needed"). It was a rough ride for me regarding lower GI sympomts (diarrhea), but I didn't mind much because I am as crazy as he is, haha. Also, I already felt like shit before starting GLPs, including low-grade, non-stop heartburn that resolved with the weight loss (and sleeping in a recliner and buying generic Voquezna from India).

 

[timfa]

GI symptoms can disappear greatly/completely at lower doses, so usually no need to stop completely.

You can also type into an AI the exact symptoms, and it is pretty good for coming up with solutions, even dose suggestions and questions to ask the doc.

I asked Google Gemini about feeling "disgusting" on sema, and one thing (of many) it suggested is digestive enzymes, which is not mentioned often in forums. The problem I have with with dietary enzymes is remembering to use them. I do use probiotics, including the ones naturally in sauerkraut.

But the number-one dietary advice was to reduce fatty foods (which is more typical advice):

A lot of use daily protein shakes like the ones by Fairlife, Nurri, or Premier Protein. They can be easier to digest too.

My least favorite upper GI symptom (in the past, when titrating up) was bloating. Simethicone was somewhat helpful. My go-to for most GI sides is Alka-Seltzer.

I appreciate u taking time into this thank you so much

 

[Quailfeather]

is he getting good support on lifestyle changes? changing the composition of his meals or eating less and often will help.

tirz is specifically good at reducing the nausea caused by sema bc of the GIP and it's one of the main reasons why it's now more popular. however, you can still treat nausea with pepto-bismol, etc.

also, drinking water - glps can suppress thirst signals - i dont think people on sema need electrolytes but something to consider if he still feels bad

honestly i think the most important thing he needs is someone to advocate for him at the doctors, he might not realise this isn't normal/he doesn't have to feel this way, might not realise he can ask the doctor to titrate him slower, etc. If he is only overweight and was able to lose weight before, he doesn't need an aggressive dose at all.

 

[Calm Logic]

If it's not an insurance issue, definitely look into switching to tirz. I was never even offered sema, except told it wasn't as effective.

Even if it is an insurance info, tirz is relatively affordable from compounding pharmacies like Brello Health ($500 for three months), which is what I used before going grey. The cost of buying compounded can easily be a wash with food savings.

Some people will recon tirz or reta for their parent or other family member, even handing them the filled syringe. But obviously more caution, time, and research is required, if you are new to grey. There are also legal issues to consider (or ignore, haha). Like I would never inject my spouse. They need to inject themselves, if possible.

 

[lessthanhalf]

I agree that knowing what the side effects actually are would help. I do not think the jump in dose from 0.5 to 1 with semaglutide is that good an idea, and it is not slightly surprising it could cause unpleasant side effects. I did not even try , only going from 0.5 to 0.6mg, as I had mild side effects at 0.5, which were quite a bit worse at 0.6. It is possible to use in between doses with prescribed ozempic by counting clicks, there are charts on the internet showing how many clicks equal a given dose. But he needs to talk to the doctor about adjusting doses back down.

The alternative is tirzepatide, which is both more effective and has less side effects, I am not sure there are any good reasons to start with semaglutide instead of tirzepatide, other than familiarity or habit . The standard dose escalation plan for tirz also makes more sense.