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Getting Relief from Semaglutide Nausea

Apr 9, 2024
Getting Relief from Semaglutide Nausea

Semaglutide and other glucagon-like peptide-1 (GLP-1) receptor agonists have shown promising results in long-term weight management and type 2 diabetes treatment. Semaglutide, marketed as Rybelsus, Wegovy, and Ozempic, is available in injectable and oral forms. The medication mimics GLP-1 hormone, a hormone produced in the gut that plays an important role in controlling appetite and blood sugar.

While semaglutide has many known benefits, it is not without its side effects, especially gastrointestinal side effects such as nausea. It is important to understand the mechanism of action that contributes to semaglutide nausea and how to get some relief from this common side effect.

Understanding semaglutide

Semaglutide is structurally very similar to naturally occurring GLP-1 hormone. It attaches to GLP-1 hormone receptors in the pancreas, stomach, intestines, and brain.

In the pancreas, semaglutide increases insulin release after eating and reduces glucagon production. Increasing insulin and reducing glucagon production lowers your blood sugar. People who have type 2 diabetes have higher than healthy blood sugar levels. Either their pancreas does not produce enough insulin, or their body cells have become resistant to insulin’s effects. Semaglutide helps with blood sugar control and is used to treat type 2 diabetes.

GLP-1 receptors are found throughout the stomach and intestines. When semaglutide binds to these receptors, it slows how fast food leaves the stomach and moves through the intestines. By slowing how fast the stomach empties, food is digested and absorbed more slowly. This leads to a more gradual increase in blood sugar after eating.

Semaglutide also binds to receptors in the brain, regulating appetite and reducing cravings.

Common causes of nausea with semaglutide

The combination of delayed stomach emptying and semaglutide actions in the brain may contribute to semaglutide nausea. By slowing down gastric emptying, you may have an uncomfortable sense of fullness or bloating, which can contribute to nausea, by stretching and stimulating nerves around the stomach. However, some people report semaglutide nausea between meals.1

Nausea with semaglutide is most common when you first start taking the medication and when you have a dosage increase. It may take time for your body to become accustomed to changes in gut motility, appetite, and blood sugar levels.

Higher semaglutide dosages are associated with an increase in the incidence and severity of nausea. People who may be prone to semaglutide nausea may need to escalate their semaglutide dosage more slowly than the typically recommended semaglutide dosage schedule.

Other common semaglutide side effects

Semaglutide side effects seen in clinical trials include:

  • Nausea (44%)
  • Diarrhea (30%)
  • Vomiting (24%)
  • Constipation (24%)
  • Stomach pain (20%)
  • Headache (14%)
  • Fatigue (11%)
  • Heartburn (9%)
  • Dizziness (8%)
  • Stomach bloating (7%)
  • Burping/flatulence (7%)
  • Low blood sugar in people with type 2 diabetes (6%)
  • Gas (6%)
  • Gastroenteritis (6%)
  • Acid reflux (5%)
  • Stomach irritation (4%)
  • Viral gastroenteritis (4%)
  • Hair loss (3%)

Most gastrointestinal side effects described in the clinical trials were considered to be of mild-to-moderate intensity. They were more common when semaglutide was first started or after dosage increases. If you experience semaglutide nausea or other side effects, contact your doctor. You and your doctor should work together to develop a weight-management treatment plan that meets your needs safely.

The science behind semaglutide and nausea

Researchers do not know exactly why semaglutide causes nausea, but it is likely due to its effects on the brain, pancreas, stomach, and intestines. In a 2022 research paper, Shu et al. identified 5,442 people with semaglutide-associated gastrointestinal (GI) side effects. The most common side effects reported were nausea, diarrhea, vomiting, and abdominal pain.

Here are some of their findings:2

  • GI side effects were more common in women (n = 3,064) than in men (n = 2,248)
  • Patients 18 to 65 were more likely to experience GI side effects than people over 65.
  • Nausea was the most common side effect (n = 2,369) reported, followed by vomiting, diarrhea, constipation, abdominal pain, and pancreatitis.

These results were consistent with the adverse (side) effects reported in all GLP-1 clinical trials. Nearly half (44%) of people taking the 2.4 mg dose of Wegovy reported nausea.3 About 10%  of people taking semaglutide discontinue treatment because of GI side effects, including semaglutide nausea.1

A patient talking to their doctor about semaglutide nausea.

Ways to manage nausea with semaglutide

Talk with your doctor about nausea with semaglutide. Since higher doses are associated with an increased risk of GI side effects, your doctor may advise that you stay at a lower dose for a longer period, lower your current semaglutide dose, or even change medication.

Strategies to reduce semaglutide nausea include the following:1

  • Eat smaller, more frequent meals. This can reduce stomach stretching and bloating, which can stimulate nerves that cause nausea.
  • Stop eating as soon as you feel satisfied.
  • Avoid high-fat meals. Try to avoid any fried or greasy foods. High-fat foods also slow stomach emptying, which can make nausea worse.
  • Avoid potential stomach irritants such as sugary, highly processed foods, refined carbohydrates, coffee, and alcohol. Consume high-protein foods and complex carbohydrates found in whole-grain breads and pasta.
  • Consume bland food high in water content when you feel nauseated. Try bananas, rice, toast, applesauce, and crackers. These foods are easy to digest but provide the energy your body needs.
  • Stay hydrated throughout the day. Drink cold liquids in small sips. Avoid using a straw, as it may increase stomach gas. Ginger- or mint-based drinks may help with nausea.
  • Avoid strong smells, as they can contribute to nausea.
  • Avoid lying down after you eat or eating before bedtime. Lying down after eating increases the risk that stomach contents will reflux into the esophagus, causing pain and burning.
  • Incorporate movement throughout your day. Exercise increases gut motility and can improve mood. This can help reduce nausea symptoms.
  • Wear loose-fitting, comfortable clothing. A belt or compressive garments can put pressure on the stomach and increase pressure and gastroesophageal reflux.
  • Try stress-management techniques such as meditation, yoga, or deep-breathing exercises.
  • Ask for a referral to a registered dietician for help in planning a diet that may reduce nausea.
  • Keep a symptom diary. Look for trends to see if your nausea is associated with certain foods or activities.
  • Talk to your doctor about changing your medication dosage or the time of day that you take your dosage. Your doctor may also recommend a prescription anti-nausea medication.

What should I do if nausea persists?

Despite your best efforts to manage nausea with semaglutide through lifestyle changes, dietary adjustments, and medical interventions, sometimes these symptoms persist. Talk to your doctor before discontinuing your medication. They can evaluate your semaglutide dosage, investigate potential causes of nausea, and explore possible alternative medications.

Semaglutide user reviews: semaglutide and nausea

Semaglutide user reviews on Drugs.com give semaglutide an average rating of 6.5 out of 10.

  • Dana said she had mild nausea and some dizziness for two weeks after starting Ozempic, but for the next two weeks, she had no symptoms. She said she could not eat what she used to eat before starting Ozempic, or she would feel sick.
  • Zell said her nausea occurred when her ozempic dose increased, but it resolved within two weeks.
  • Slow said their nausea was bad in the beginning. Slow said, “Try to drink 1/2 gallon of water a day and stay away from red meat, fried food, fast food, (most) dairy, and sugar. If you don’t, you will feel sick from eating that stuff. Also, only eating one cup of food every couple of hours has made a huge difference in the nausea. Stock up on SF (sugar-free) ice pops and SF Gatorade.”
  • KS  recommends drinking plenty of water and consuming small, high-protein meals to reduce nausea and other Wegovy-associated side effects.
  • MzGormo said they had bad nausea for a month, and it resolved when they switched to injecting semaglutide into their leg instead of their abdomen.

If you experience nausea with semaglutide and dietary and lifestyle modifications don’t help, contact your healthcare provider. While semaglutide nausea is common, most people taking it say that it improves after your body adjusts to the medication.

If you are interested in enrolling in an Invigor Medical weight loss program, start the process by completing your health forms. Semaglutide and other Invigor Medical weight loss programs include a doctor’s consultation, the medication, and any medical equipment you may need to administer the medication.  

Frequently Asked Questions

What causes nausea when taking semaglutide?

Semaglutide’s mechanism of action, which involves slowing stomach emptying and influencing appetite regulation in the brain, can lead to nausea.

How common is nausea as a semaglutide side effect?

Nausea is one of the most common side effects of semaglutide, with up to 44% of users experiencing it. Other gastrointestinal side effects include diarrhea, vomiting, and stomach pain.

What strategies can help manage semaglutide-induced nausea?

Eating smaller, more frequent meals, avoiding high-fat and irritating foods, staying hydrated, and exercising are some strategies to reduce semaglutide nausea. Prescription anti-nausea medication and dietary adjustments may also be recommended.

Is it common for nausea to persist despite dietary and lifestyle changes?

While most cases of semaglutide-induced nausea improve over time, some individuals may experience persistent symptoms. If nausea persists despite lifestyle modifications, consulting a healthcare provider is advised to evaluate the dosage and explore alternative medications.

Describe user experiences with semaglutide nausea.

Users have reported varying experiences with semaglutide-induced nausea, with some experiencing mild symptoms that resolved over time, while others required dietary changes and adjustments to their medication routine. It’s essential to share your experience with your healthcare provider for personalized guidance.

Disclaimer
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

Getting Relief from Semaglutide Nausea

Leann Poston, M.D.

Dr. Leann Poston is a licensed physician in the state of Ohio who holds an M.B.A. and an M. Ed. She is a full-time medical communications writer and educator who writes and researches for Invigor Medical. Dr. Poston lives in the Midwest with her family. She enjoys traveling and hiking. She is an avid technology aficionado and loves trying new things.

References

  • Smits MM, Van Raalte DH. Safety of Semaglutide. Front Endocrinol (Lausanne). 2021 Jul 7;12:645563. doi: 10.3389/fendo.2021.645563. Erratum in: Front Endocrinol (Lausanne). 2021 Nov 10;12:786732. PMID: 34305810; PMCID: PMC8294388.
  • Shu Y, He X, Wu P, Liu Y, Ding Y, Zhang Q. Gastrointestinal adverse events associated with semaglutide: A pharmacovigilance study based on FDA adverse event reporting system. Front Public Health. 2022 Oct 20;10:996179. doi: 10.3389/fpubh.2022.996179. PMID: 36339230; PMCID: PMC9631444.
  • Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., & Kushner, R. F. (2021). Once-weekly semaglutide in adults with overweight or obesity. The New England Journal of Medicine, 384(11), 989–1002. https://doi.org/10.1056/nejmoa2032183

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