Wegovy and nausea

Not to worry at all, @jc76. Just wanted to be sure other members here understood what you meant.

I recall you said if you changed to tirzepatide (Zepbound) you'd have to wait a bit first. What are your thoughts right now about changing to tirzepatide (Zepbound), jc76?

@lisalucier
In my old age my remembering spelling is not part of mine better side.

WEGOVY offers programs to offset cost of their products except for federal insurance.

Yes I meant ZEPBOUND. My Mayo PCP wanted me to start on it to replace WEGOVY which did nothing on all the lower doses and then severe reactin on the highest does 2.4.

PCP stated Zepbound had to receptors to reduce appetite where Wegovy only had one.

I take a medication called Xhance and sometimes I find myself putting the X on Zepbound by mistake. Again, old man, terrible remembering and hoped spell check programs would help us old guys.

@jc76 - confirming you mean tirzepatide (Zepbound)?

@lisalucier
The short answer to the question is yes both nausea and stomachace with the 2.4 dosage.

I started per my Mayo PCP with lowest dose of Wegovy I think was .25 but those levels did not reduct my appetite. From .25 to before starting 2.4 I had very limited stomach upset. It was more bowel movement slow down that I noticed. I did not feel nausea. I did get a slight reduction at dinner in eating feeling a little full but only at that meal.

My wife got sick and I did not start the 2.4 level dose right away. When I did within 2 hours (was prior to bedtime) I could feel nausea and stomach discomfort.

When I woke up the next morning was quite frankly severe. I was really nauseated and had stomach pain. I vomited. I struggled and sent a message to my PCP about my symptoms. At lunch time I vomited again. I was given an acute visit to Mayo.

The doctor who saw me said no way to counter the drug it has to take is time to go through system and would take about 4-5 weeks to completely leave. I was told to eat very light and clear food. My doctor said I would normally prescribed a nausea pill for you but it would interfere with other medication you take.

Now what did I do to manage it. I tried eating mashed potatoes and let them dissolve in my mouth. This light and easy digetible food did not upset my stomach and I was able to keep it down. I chew a long time and ate very slow. I need to have protein but was not going to eat any meat. So I bought protein shakes. They were tasty and did not have an issue with them.

I drank gingerale. It seemed to quell stomach. I constantly felt nausea and was burping. I stayed with the mashed potatoes and protein drinks and did not vomit again. I watch not to lay down to soon after eating as would seem cause more nausea.

I don't want to put a negative on these medications. For some they have great success with them and minor side affects. For me none of the lower doses were working to reduce appetite and the highest one I got a severe reaction.

I wish it would have worked for me but I and others need to know once you stop them your appetite and stomach will eventually return to the way it was before. So you have to try to change you lifestyle and eating habits and not just count on being on a medication like Wegovy.

My PCP wanted me to consider Expound (spell?). He said it contained 2 recptors to lower appetite not just the one in Wegovy. But I have read on MCC others having issues with Expound as well. I was told we he would not even consider it for at least three months after I had the reaction to Wegovy.

Sorry about your problems. I had gastric bypass surgery 20 years ago. Even to this day, if I eat things I shouldn’t, I will dump. If I don’t chew my food completely, I’ll dump. Sugary foods will make me dump. Like I said, 20 years later. Sooner or later you need to realize that it’s what we put into our mouths we are responsible for. The doctors were certain that I understood the complications if I didn’t change my eating habits. Once you dump a couple of times, you know how to avoid it. I have kept off 100 pounds since then. Good luck.

@larry68
Go to their web site. Very helpful information there. They offer some cost savings for those with insurance and thos without but not federal ones like Medicare Part D and other federal programs.

My Mayo PCP was really up on Expound. He said had two receptor for appetite reduction where Wegovy only had one.

He also mentioned not so many side affects but I read on MCC posters having side affects to it.

WOW that is great you lost 45 lbs. You should be very proud of yourself!

I've had bariatric surgery, which led to severe nausea (called "dumping" if you decide to do a search for it); started tirzepatide last summer to get rid of the weight I had gained (to improve my knee arthritis), which led to a slew of GI side effects; and moved to semaglutide this year, largely to deal with the side effects.

One of the key reasons the weight went back on was that I eventually fell back on comfort food to assuage the dumping syndrome, so yeah, part of this is behavioral. However, I also devoted a lot of attention to figuring out my list of trigger foods, and that's what worked in the end.

This was a very useful experience when I started the GLP-1 RAs. I titrated up more slowly than they recommend, paused and stuck at a lower dosage than the maximum, and titrated down slowly. During this experience, I did make use of the controlled nausea as a tool to help manage my eating, but I also did a lot of tracking to figure out what made a difference, and also got a prescription for anti-nausea medication that I used sparingly. I found that the symptoms were worse with some foods than others, if I didn't stop eating immediately when I started to feel the first edge of nausea, and at meals later in the day (I used the medication to help me be able to go out to dinner for social occasions, since otherwise dinners were difficult for me). This may or may not be the same for you, but it's an example of sleuthing the issue out.

It's really important to prioritize protein and fiber when we eat so much less. Unfortunately, this has meant that I haven't been able to rely on plant proteins, where the protein requires eating more volume. In my case, vegetables are more triggering than fruit, especially cruciferous vegetables, so I'm skewing toward fruit.

My GI symptoms are only partially dose-related, meaning that dropping down to a lower dose helped a little but not a lot. That's why I switched to another drug in the family, which helped (as did the fact that I could get it as a multi-pen, which let me fine-tune dosages). Switching definitely helped, although it took a couple of months for my system to calm down.

This was not the only side effect I had, and I've systematically been going after each one. I don't think this is normal -- someone has to be a statistical outlier, and I guess I was elected -- and it really is normal for the nausea to be dose-dependent and to go away over time. But it does appear that the weight loss is not just a reaction to the nausea, and does not depend on that symptom. So if you can get the nausea under control, you may well see the weight loss still happen.

I wish i could find something about Expound.I might would do a trade off now that i lost 45 lbs.

I'd like to tag a few other Mayo Clinic Connect members who've talked about semaglutide (Wegovy) to see if they have had nausea and stomachache and if so, how to manage it @brianberchtold @jc76 @ami83 @isadora2021 @celia16. @predictable @neenagator64 @larry68 and @shiver may also have some input.

@wlb2, how have you felt in the last couple of days?

@lisalucier
The short answer to the question is yes both nausea and stomachace with the 2.4 dosage.

I started per my Mayo PCP with lowest dose of Wegovy I think was .25 but those levels did not reduct my appetite. From .25 to before starting 2.4 I had very limited stomach upset. It was more bowel movement slow down that I noticed. I did not feel nausea. I did get a slight reduction at dinner in eating feeling a little full but only at that meal.

My wife got sick and I did not start the 2.4 level dose right away. When I did within 2 hours (was prior to bedtime) I could feel nausea and stomach discomfort.

When I woke up the next morning was quite frankly severe. I was really nauseated and had stomach pain. I vomited. I struggled and sent a message to my PCP about my symptoms. At lunch time I vomited again. I was given an acute visit to Mayo.

The doctor who saw me said no way to counter the drug it has to take is time to go through system and would take about 4-5 weeks to completely leave. I was told to eat very light and clear food. My doctor said I would normally prescribed a nausea pill for you but it would interfere with other medication you take.

Now what did I do to manage it. I tried eating mashed potatoes and let them dissolve in my mouth. This light and easy digetible food did not upset my stomach and I was able to keep it down. I chew a long time and ate very slow. I need to have protein but was not going to eat any meat. So I bought protein shakes. They were tasty and did not have an issue with them.

I drank gingerale. It seemed to quell stomach. I constantly felt nausea and was burping. I stayed with the mashed potatoes and protein drinks and did not vomit again. I watch not to lay down to soon after eating as would seem cause more nausea.

I don't want to put a negative on these medications. For some they have great success with them and minor side affects. For me none of the lower doses were working to reduce appetite and the highest one I got a severe reaction.

I wish it would have worked for me but I and others need to know once you stop them your appetite and stomach will eventually return to the way it was before. So you have to try to change you lifestyle and eating habits and not just count on being on a medication like Wegovy.

My PCP wanted me to consider Expound (spell?). He said it contained 2 recptors to lower appetite not just the one in Wegovy. But I have read on MCC others having issues with Expound as well. I was told we he would not even consider it for at least three months after I had the reaction to Wegovy.