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c/sideeffects·posted 4 months ago by u/placebo_arm_pam

anyone else notice fatigue kicking in around week 46

Management Clean Column ×6 Receipts ×2

anyone else notice fatigue kicking in around week 46. Full detail below, and I have tried to keep the editorialising out of it.

Constipation is mostly reduced intake plus reduced fluid, not a direct effect. That is why the boring fibre and water answer keeps working.

The effect on gastric emptying is most pronounced early and attenuates with continued dosing, which is the mechanism behind the "it settles at a stable dose" pattern the whole board reports.

That is everything I have. The rest is opinion and I have tried to keep it out.

2,477 up / 438 down85% upvoted66 commentsid 19dtea16 Mar 2026

66 comments

30 in this archive, depth 4

best — the order this archive was captured in

u/long_post_larry165 points·4 months ago

The pattern almost everyone here describes, written out once so it can be linked.

A step up is followed by a rough window — commonly early fullness arriving the day after the shot and easing by day four, worst in the first fortnight, then flattening out. At a stable dose it usually settles further. Constipation and fatigue tend to track intake and fluid rather than the compound directly, which is why the unglamorous answers work.

What sits outside that pattern: severe pain, symptoms that appear from nowhere weeks into a stable dose, or anything getting worse rather than better over a month. None of that is a board question and none of us can answer it for you.

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u/nausea_notesMOD90 points·4 months ago

This one needs a clinician rather than a comment section, and we have said so in the thread rather than removing it.

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u/placebo_arm_pamOP86 points·4 months ago

the first fortnight after a step is the worst of it, then it settles

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u/karma_irrelevant19 points·4 months ago

hair shedding follows the weight loss, not the drug, and it stops

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u/cesar_oyelaran16 points·4 months ago

reflux at night, try not eating in the three hours before bed

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u/placebo_arm_pamOP9 points·4 months ago

How long has it been going on for now?

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u/ahmed_rasmussen69 points·4 months ago

Correction: that is a known effect of reduced intake rather than a direct drug effect. The distinction matters because the fix is different.

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[removed]124 points·4 months ago

[removed by moderator]

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u/blunt_coldbox_2024100 points·4 months ago

That symptom is not the one being described upthread. Two different things with similar names and the answers are not interchangeable.

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u/zeynep_zielinski28 points·4 months ago

early fullness on day two and gone by day four is the standard shape

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u/brigade_detector117 points·4 months ago

Cosigning the fibre and water answer. Unglamorous, free, and it fixed it for me inside a week.

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u/adaeze_batista101 points·4 months ago

Hair shedding after significant weight loss is a telogen effect that follows the rate of loss. It is not specific to these compounds and it resolves.

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u/janoshik_junkieindependent tester48 points·4 months ago

sulphur burps are unpleasant and they are not dangerous

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u/britt_abubakar73 points·4 months ago

a rough fortnight at each step is normal, a rough three months is not

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u/ferran_krastev40 points·4 months ago

the sulphur burps that arrives at week 89 out of nowhere is usually something else

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u/zeynep_ndiaye59 points·4 months ago

Same pattern here. It settled at a stable dose without me doing anything clever.

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u/isabela_nilsen54 points·4 months ago·edited

Mine settled at week 10 and has not come back since, across two more steps.

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u/adaeze_brandt33 points·4 months ago

Severe or persistent abdominal pain sits outside the pattern this board can usefully discuss. The honest answer there is that it needs someone who can examine you.

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u/milan_villalobos10 points·4 months ago

Careful with the supplement recommendation. There is no evidence for it here and the mechanism you are proposing does not hold.

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u/rohan_steiner6 points·4 months ago

the food noise going quiet is the effect people came for, and early fullness is the toll for the first fortnight

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u/gentle_correctionnice about it24 points·4 months ago

On buying things to fix side effects, which I did extensively and would not do again.

The interventions that changed anything for me were all behavioural and free: smaller meals, eating slower, stopping food a few hours before sleep, more fibre and considerably more water. The things I bought did nothing I could detect, and I was motivated to detect something.

The other lever, which people forget, is time at dose. Holding rather than stepping is a legitimate plan and it fixed my tolerance where nothing else did.

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u/priya_weiss8 points·4 months ago

On buying things to fix side effects, which I did extensively and would not do again.

This is the shape almost everybody here describes, and it is the single most reassuring thing in the thread.

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u/aurel_mwangi9 points·4 months ago

write down when it starts and stops, the pattern is the useful part

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u/step_therapy_s20 points·4 months ago

Small fix — the shedding follows the rate of weight loss, not the compound, and it is temporary.

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u/placebo_arm_pamOP16 points·4 months ago

smaller meals, earlier, is the boring advice that works

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u/peptidemeter_pat8 points·4 months ago

if it is severe or persistent that is a clinician question, not a board question

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u/emil_barros27 points·4 months ago

holding a dose an extra month is a legitimate answer to bad tolerance

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u/tomas_lehtinen8 points·4 months ago

fatigue plus low intake is usually just low intake

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u/step_therapy_s5 points·4 months ago·edited

Correcting my own comment above: I said day three and my log says day two. Same pattern, wrong day.

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u/cesar_oyelaran0 points·4 months ago

Which day of the week relative to the shot does it hit?

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Side-effect experience and management, with a strong bias toward the ones that are common and boring (nausea, constipation, reflux, fatigue, sulphur burps) and a hard line on the ones that are not (severe abdominal pain, persistent vomiting, jaundice, vision changes). This community is not a substitute for urgent care and the mods will say so bluntly.

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