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improves with slower dose escalation Vomiting, diarrhea, or constipation Bloating, heartburn, or stomach discomfort Reduced appetite and early fullness Fatigue or headache Less common side effects Injection-site reactions Fatigue or changes in taste Temporary mild hair thinning (limited evidence) Serious but rare risks Pancreatitis seek care immediately if you experience severe abdominal pain Gallbladder disease or gallstones Kidney complications, particularly from dehydration Thyroid C-cell tumor risk in patients with medullary thyroid cancer history or MEN2 Low blood sugar when combined with insulin or sulfonylureas Contact your provider immediately if you experience severe or persistent abdominal pain, constant vomiting, signs of dehydration, yellowing of the skin or eyes, or symptoms of low blood sugar

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Amodei, L., Ruggieri, A

This metabolic shift reduces 5-HT production, increases neurotoxin creation, and creates a self-perpetuating cycle where inflammation causes tryptophan metabolic imbalance, ultimately leading to neuronal damage that sustains inflammation (117)