kevin_tulsa said:The mechanism is slowed transit plus reduced intake, and that combination determines which interventions work.
Gastric emptying studies and constipation: semaglutide delays gastric emptying by ~40% at steady state, as measured by acetaminophen absorption testing and scintigraphy[1].
Clinically relevant implications:
- Explains early satiety and nausea
- Affects absorption of co-administered oral medications
- Creates aspiration risk for procedures under anesthesia
- Contributes to constipation via slowed GI transit
Importantly, the gastric emptying delay attenuates with continued use (tachyphylaxis), which correlates with the transient nature of GI side effects.
[1] Blundell J, et al. Diabetes Obes Metab. 2017;19(9):1242-1251.
PeptideChemSF said:Gastric emptying studies and constipation: semaglutide delays gastric emptying by ~40% at steady state, as measured by acetaminophen absorption…
Sulfur burps on constipation — the most underrated side effect nobody warned me about. 🤢 The smell is absolutely vile and comes on without warning.
What finally helped: eliminating eggs and cruciferous vegetables. Also, eating smaller portions and chewing thoroughly reduces the gas production.
If sulfur burps persist beyond 2-3 weeks, talk to your provider — it could indicate gastroparesis that needs medical attention.
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Update — the osmotic agent was the thing. I had been reaching for a stimulant, which was making the next day worse.
carl_compliance said:Sulfur burps on constipation — the most underrated side effect nobody warned me about.
Drug interaction alert relevant to constipation: if you take oral levothyroxine (Synthroid), GLP-1 agonists can reduce absorption due to delayed gastric emptying. My TSH drifted up after starting semaglutide.
Solution: take levothyroxine on an empty stomach, 60 minutes before any food, and have your TSH rechecked 6-8 weeks after starting or changing GLP-1 dose. My endo had to increase my Synthroid by 12.5mcg.