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Community references organize stack-related symptoms into rough severity tiers: Discontinue immediately: Severe abdominal pain radiating to the back (possible pancreatitis) Right-upper-quadrant pain after meals (possible gallbladder) Persistent dysesthesia at any dose Cardiac symptoms (chest pain, palpitations) Acute jaundice or dark urine Pause and evaluate: Vomiting more than 5-7 days at the same dose without titration improvement New persistent fatigue beyond expected GLP-1 fatigue Unexpected lab changes (transaminases, lipase, glucose) Weight loss outside the expected curve (sudden acceleration may indicate inadequate caloric intake) Continue with monitoring: Mild injection-site reaction Standard titration nausea that resolves at each stable step Standard appetite suppression Mild constipation (manageable with hydration and fiber) This is a community-described framework, not a clinical guideline

These metabolites then must be conjugated and excreted by phase II enzymes such as GSTs and UGTs

Similarly, individuals who have undergone intestinal surgery, including weight loss surgery, are also at higher risk

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