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Metabolic issues: Feeling constantly cold, chills, or a low body temperature (signs of metabolic acidosis) Severe gastrointestinal changes: Persistent diarrhea, vomiting, or a total loss of appetite Systemic changes: Unexplained tiredness, a fever or other signs of infection, unusual bleeding, bruising, or long-term concerns like osteoporosis In general, higher doses of topiramate are associated with an increased risk of adverse reactions

Evidencia citada Meta-anlisis de 3 ECA (878 sujetos): 14.33% de peso corporal vs placebo, con reduccin de IMC, cintura, glucosa en ayunas, HbA1c y presin arterial, sin diferencia significativa en eventos adversos

M., De Melo, A

Lysine, taken as a dietary supplement, can cause gastrointestinal side effects