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It explains both its ~14.9% peak weight loss in STEP 1 and its dose-limiting nausea profile, gastric-emptying delay is the same pathway that drives upper-GI side effects
P450 enzymes are also involved in the first step of the methylation pathway, where they convert methionine to S-adenosylmethionine (SAMe)
Meal Timing: Studies indicate that splitting daily food intake into 6-7 smaller portions rather than 2-3 large meals can reduce stomach discomfort [16]
Warm sitz baths at 104-108F for 10-15 minutes three times daily provide immediate relief by increasing blood flow, reducing swelling, and cleansing irritating secretions from the affected area
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