Suddenly having bad gastro side effects after months & no change in dose

[ShrillShill]

Title says it all. I've been doing a super slow up titration because I have very low tolerance for nausea, and I've been at 0.5mg for a couple months. This dose shuts off the food noise really well for me, so I've been pretty cozy on it. All of a sudden, about a month ago, I've had serious stomach cramps and subsequent frequent bathroom trips which make doing my job difficult. I went off for a week to enjoy the 4th, and dosed 0.10mg Tuesday hoping that it wasn't the Sema. No such luck, I've spent most of this morning doubled over in pain and on the toilet. Before this, my only real side effect was a little constipation which honestly wasn't even that bad.

The thing that's confusing me is that this is happening in the middle of a vial. Is it degradation? Contamination? Would you try a fresh vial from the same batch, or just give up on Sema altogether and try something else?

 

[latviantower]

So sorry to hear this setback after months of hard work! Yeah, if it was a new vial the answer would be clear, right? Had the vial been reconstituted for more than a month? Left out of the fridge (or experienced power outage) for more than an hour? Any ISR? My gut reaction would be to try another vial. Wishing you the best outcome!!

 

[zpped]

Title says it all. I've been doing a super slow up titration because I have very low tolerance for nausea, and I've been at 0.5mg for a couple months. This dose shuts off the food noise really well for me, so I've been pretty cozy on it. All of a sudden, about a month ago, I've had serious stomach cramps and subsequent frequent bathroom trips which make doing my job difficult. I went off for a week to enjoy the 4th, and dosed 0.10mg Tuesday hoping that it wasn't the Sema. No such luck, I've spent most of this morning doubled over in pain and on the toilet. Before this, my only real side effect was a little constipation which honestly wasn't even that bad.

The thing that's confusing me is that this is happening in the middle of a vial. Is it degradation? Contamination? Would you try a fresh vial from the same batch, or just give up on Sema altogether and try something else?

Highly unlikely it's specific to your vial. More people have side effects with Sema than any of the others.

 

[cldfront]

I flipped from having to manage constipation to having to manage the opposite with Tirz after about 7 months. No clue why, except I have increased dosing. I did try to stack Reta at one point, which may have been the trigger, as Reta disagreed with me to the point I was unable to sleep at night due to having to rush to the bathroom. Digestive sides are no fun - hang in there!

 

[adria37]

Do you think your vial might have been overfilled?

 

[Calm Logic]

My GI symptoms are different than when I started. It's not better or worse, just different. It's the main reason I look forward to switching from tirz to reta, since even 5 mg of tirz can sometimes make it hard to digest things, especially with so much tirz in my system already.

At the risk of sounding like a crazy addict, marijuana gummies have helped a lot with stomach pain and other issues. My stomach was feeling like a crampy disaster before my anniversary dinner, took a gummy, and was fine. Gabapentin has helped too, surprisingly.

On the positive side, I crave oatmeal with blueberries more than anything else, and one serving is now two. Even 8 ounces of yogurt is now up to four servings for me.

I also drink Kefir more now and eat more bananas. Both have pectin, which is good for the stomach.

 

[MsGizmo]

Title says it all. I've been doing a super slow up titration because I have very low tolerance for nausea, and I've been at 0.5mg for a couple months. This dose shuts off the food noise really well for me, so I've been pretty cozy on it. All of a sudden, about a month ago, I've had serious stomach cramps and subsequent frequent bathroom trips which make doing my job difficult. I went off for a week to enjoy the 4th, and dosed 0.10mg Tuesday hoping that it wasn't the Sema. No such luck, I've spent most of this morning doubled over in pain and on the toilet. Before this, my only real side effect was a little constipation which honestly wasn't even that bad.

The thing that's confusing me is that this is happening in the middle of a vial. Is it degradation? Contamination? Would you try a fresh vial from the same batch, or just give up on Sema altogether and try something else?

Maybe you need more water and fiber? I had some minor problems my first 2 weeks so I now start my day with a glass of off brand metamucil.

 

[Calm Logic]

Gemini agrees:

Yes, Metamucil (which contains psyllium fiber) can help with diarrhea. While it's commonly known for treating constipation, its unique properties allow it to address both:
* Absorbs excess water: Psyllium husk is a soluble fiber that forms a gel when mixed with water. In the case of diarrhea, this gel can absorb excess water in the intestines, which helps to firm up loose stools and add bulk.
* Slows down bowel movements: By adding bulk and absorbing water, Metamucil can help slow down the rapid transit of stool through the digestive system, which is a key issue in diarrhea.
Essentially, it acts like a sponge, bulking up the stool and making it more formed.
It's important to:
* Drink plenty of water: Even when using it for diarrhea, adequate fluid intake is crucial.
* Follow dosage instructions: Don't take more than recommended, as excessive amounts can actually lead to other issues.
* Consult a doctor: If diarrhea is severe, persistent, or accompanied by other concerning symptoms, it's always best to consult a healthcare professional.

And of course for acute episodes there is the BRAT diet (bread, rice, applesauce, toast) and immodium. White bread and white rice are ideal for BRAT since they are low in fiber.

Canned pears may be a mixed bag regarding diarrhea, but they do pair well with cottage cheese and other easy-to-digest dairy like yogurt:

The 5 Best Snacks If You’re Taking Weight-Loss Medications, According to Dietitians

Nutrition experts share the best snack combinations to help support balanced nutrition if you’re taking weight-loss medications.

www.eatingwell.com

“The pear-and-dairy combo is an underrated one, since pears not only pack fiber, but can also contribute to your daily hydration goals since they have a high water content.”

 

[Iamnew2this]

Title says it all. I've been doing a super slow up titration because I have very low tolerance for nausea, and I've been at 0.5mg for a couple months. This dose shuts off the food noise really well for me, so I've been pretty cozy on it. All of a sudden, about a month ago, I've had serious stomach cramps and subsequent frequent bathroom trips which make doing my job difficult. I went off for a week to enjoy the 4th, and dosed 0.10mg Tuesday hoping that it wasn't the Sema. No such luck, I've spent most of this morning doubled over in pain and on the toilet. Before this, my only real side effect was a little constipation which honestly wasn't even that bad.

The thing that's confusing me is that this is happening in the middle of a vial. Is it degradation? Contamination? Would you try a fresh vial from the same batch, or just give up on Sema altogether and try something else?

I'm sorry that you're going through this. You have received some great advice from others that you can try out first. I do hope with all the advice you received, that it will help you. Sema is known for worse sides for a lot of people. If all else fails and you still feel the same, maybe you can try tirz. Tirz might work out better for you as, it has less sides for a lot of people compared to, sema. Since you're on such a low dose of sema, if all else fails, tirz might work out for you. I do hope that these remedies work out for you before you consider switching. Give the remedies a go first and see if they help you. This is just my opinion. I'm in your corner. Good luck to you! 👍

 

[Calm Logic]

I am still finishing off my compounded tirz, but I have a kit of R50 in the freezer.

I would go straight to reta after sema:

1. Tirz fatigue is not fun, unless you have stimulants to help.

2. It seems very likely reta will be approved by the FDA.

3. All the cool kids like @zpped and @exploitedworkerbee are on reta, and you don't want FOMO, haha.

4. Incidence of diarrhea would probably be the same or less with reta compared to tirz.

5. Weight loss is greater with reta, according to studies so far.

Reta does cost more per mg, though the max dose of reta is 20 percent less at 12 mg vs 15 mg for tirz. But you can always start with kits of R10 or even R5. Or buy individual vials at Amino Annex. They sell a vial of R22 for $30.

 

[Iamnew2this]

Reta is a great alternative. I haven't tried because I have heart issues, but that's also something to consider.