Ive been on Lanreotide every 3 weeks since last year and still struggle with diarrhea and fatigue. I just started taking Xermelo (telotristat) about a month ago and it does help with the additional diarrhea but to tell you the truth I don't think anything will get rid of it. Has anyone else notices any loss of muscle tone? And the 18 gauge needed that is used or the meds, it hurts every time and the site is sore for days sometime. I keep slowly loosing weight so there is no fat to cushion it. Anyone else having trouble with muscle tone?