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ForumsSide Effects & ManagementDizziness and orthostatic hypotension on GLP-1 — looking for input

Dizziness and orthostatic hypotension on GLP-1 — looking for input

paul_denver Mon, Dec 22, 2025 at 10:27 AM 14 replies 1,020 viewsPage 1 of 3
paul_denver
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Dec 22, 2025 at 10:27 AM#1

The nausea I get is not really nausea, it is an aversion. Food I want in the abstract becomes repellent in front of me, which no side-effect list describes.

Trial-level incidence runs roughly 20 to 25% for nausea at the higher dose tiers and 12 to 17% for diarrhoea, with most events mild to moderate and concentrated in the weeks after each escalation.

So the question, as narrowly as I can put it: what distinguishes the nausea you can titrate through from the nausea that means stop.

I have searched first, so if this is covered somewhere point me at it and I will read it.

50 20Dr.LeslieOBGYN, MikeNYC_runner and 47 others
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amsterdam_pete
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Dec 22, 2025 at 11:34 AM#2

Taking the question as asked, rather than the general version of it. The line between titrate-through and stop is not severity, it is trajectory and what else is present. Nausea that peaks and improves within a week is the expected pattern. Nausea that is escalating, or that comes with severe upper-abdominal pain radiating to the back, or that prevents fluids for more than a day, is a different conversation and belongs with a clinician the same day.

49 19ZaraB_AL, JakeSmashed95, NauseaFreeNow and 46 others
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pete_nash
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Dec 22, 2025 at 12:41 PM#3
amsterdam_pete said:
The line between titrate-through and stop is not severity, it is trajectory and what else is present.

Agreeing with amsterdam_pete, and the qualification matters more than the agreement. The meal advice is right and incomplete without the hydration point. People stop drinking because drinking makes them feel full, then attribute dehydration symptoms to the drug.

Last edited: Dec 22, 2025 at 6:41 PM
48 18mike_mod, SarahChen_PharmD, sarah.morrison and 45 others
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HealthEcon_DC
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Dec 22, 2025 at 1:48 PM#4
paul_denver said:
The nausea I get is not really nausea, it is an aversion.

Can confirm the pattern paul_denver describes. The practical protocol is dull and it works: smaller meals, stop eating at the first sign of fullness rather than at the end of the plate, drop the fat fraction of meals in the two days after dosing, and do not lie down straight after eating. Most of what people call unmanageable nausea is a meal-size and meal-composition problem interacting with a stomach that is emptying slowly.

47 17TirzTom, TrialTracker_MD, JennaRN and 44 others
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hans_munich
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Dec 22, 2025 at 8:13 PM#5

From the other side of the consultation, briefly. Worth answering the question that was asked rather than the one behind it. The narrow version usually has an answer; the broad version usually does not, and answering the broad one is how a thread stops being useful.

Last edited: Dec 23, 2025 at 2:13 AM
46 16emma_london, tammy_FL, Dr.LipidDallas and 43 others
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