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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

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