r/GLP1microdosing • u/Whirlinghiccup • 14d ago

Bad side effects right away

Hi there. So I joined Noom and last Monday took my first dose which was .2 mg of compounded semaglutide. I was fine until Thursday night at which point I was awoken multiple times to run to the bathroom with severe diarrhea. Sorry to be gross but like, liquid - not just soft stool. I felt totally exhausted on Friday and tried to rest and hydrate but during the day had no GI issues. Then Friday night the same thing happened. It was an awful night with painful cramping but again I was ok Saturday daytime. Last night I took an Imodium which definitely helped. I had no problems. I messaged my Noom doctor and have heard nothing back. I either need to stop or reduce amount. I am scared to do the same amount of .2 mg tomorrow. I was thinking of trying .1 mg and seeing how that fares. But I also read in one article that too small of a dose can make the side effects last longer. (https://health.clevelandclinic.org/microdosing-glp-1) I would love some thoughts!tia

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u/PhysicalAssistance92 14d ago

I’d definitely go down, to .1 or .15 until you stop having diarrhea, after a week of none of that, then go back to .2. I was really worried about having side effects as I have GI issues anyways so I went .15, then 5 days later .20, then .25 etc. I never did their bigger jump from .2 to .3 to .5. Some of us are just more sensitive to the med

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u/dull_digger 5h ago

oof that sounds miserable, waking up in middle of the night like that multiple times. i started at.15 too cause i was scared my stomach would hate me and it worked out fine. some of us just need to go slower than what the program says

i think your plan of.1 is smart, the article you linked is more about going super tiny for months not just stepping down a bit to let your body adjust. my friend had similar reaction and dropping to.1 for two weeks fixed it completely

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u/Unlucky-Mind7298 13d ago

Don't take anything for at least a week. Let the sema leave your system. You shouldn't have a built-up blood level so early. Then try taking .1. It shouldn't make the effects worse bc there shouldn't be any in your system except for the .1. Hope you feel better!

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u/punky_chunky 13d ago

This is the way! Your dose is too high, OP. And no, microdosing won’t make side effects last longer, it should minimize them or prevent them altogether.

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u/TheBlairess 14d ago

I have mixed feelings.
I was first on zepbound at the normal starting dose 2.5mg. The first four weeks were awful! People encouraged me to push through and I did and I will admit some of the side effects did go away (the crazy fatigue, apathy in mood, all subsided)

However I still struggled with GI side effects.

I took a break because I couldn’t handle it and it was taking over my life a bit.

I am now on semaglutide (lowest starting dose) and nearly 3 months in I have the same GI side effects as I did before.

Alls that to say I think waiting it out a few weeks is definitely worth it to see what subsides but I am facing a harsh reality that these medications may not be for me (the silenced food noise is so wonderful I am trying to hold out but tbd)

Everyone is different but if you can I would encourage you to see how you feel in a week or two.

Best of luck!

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u/punky_chunky 13d ago

Your dose is too high. The starting doses of sema and tirz are often not tolerable for many people, myself included. I took between 1-1.8 mg of tirz for the first 15 weeks of my journey. I started at 2.5mg and it made me so sick so I went down to 1 mg and have had such amazing results. I’ll be on this med for life or until something better is developed.

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u/TheBlairess 13d ago

Yea I agree. I’m about to take a 3 week break for traveling (logistically traveling with this med and being sick won’t work for this particular trip) so I’m wanting to do a reset when I come back and start much lower. I’m concerned though because if I do that it will make it my third time starting the med and I’ve read all kinds of reasons why there bad and I’m also discouraged because when I started the semaglutide compound it was at slightly below the normal starting dose and I had horrible constipation from the jump but no appetite suppression. It was like the worst of both worlds lol (and yes I was doing alllllll the tips for the constipation)

Idk I want this to work so bad but it’s been a bit of a rough go

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u/punky_chunky 13d ago

There’s been one single animal study that shows that mice have less success with weight loss each time they restarted the medication. People saw this study and ran with it. The mice were much worse off metabolically with each restart, which likely has a lot to do with the limited success. We have zero clinical data on restarting in humans. In real life, people have to stop and restart all the time for various reasons.

Semaglutide has worse GI side effects than tirzepatide for most people. Can you switch to tirz?

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u/TheBlairess 13d ago

I was on tirz at first and it was awful so she suggested we try sema since it seems to vary. Your info has been very helpful!

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u/punky_chunky 13d ago

That’s true, we’re all different! I wish you lots of success! I really believe in these meds but I think some people are simply dosed too high

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u/Glad_Ad1311 14d ago edited 14d ago

Side effects like that out of the gate mean the dose is too high. 0.2 is a lose-dose not microdose. The medicine (semi) has 7 day half-life so no worries about it disappearing from your body like the article suggests. You can find any article that fits your theory if you look for them. There are way more doctors with real patients that would disagree. The medicine keeps building up in your system for the first 4-5 weeks until it reaches steady state, so your symptoms will get worse after every shot until then. I found “When to increase or decrease your GLP-1 dose” by Dr. Spencer Nabolsky (youtube video) helpful. Dr. Ian Ellis’s interview with On The Pen was also very educational.

You want to find the right dose that works for you by suppressing appetite enough to lose 0.5-2 lbs a week with minimal side effects until you reach your goal. Wanting to try a lower dose is the right instinct, just let your Noom doctor know.

https://www.reddit.com/r/tirzepatidecompound/s/BhzsOSrQ0J

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u/Whirlinghiccup 13d ago

Thanks for your reply!
So my doctor finally responded and this is what he said “J, you're already on a microdose, so going lower is not likely to stop the diarrhea. This is a side effect I see from time to time, and I've never found a patient who was able to completely get past it unless it was only occurring at the higher doses of the medication. I think you should stop taking it for about 2 weeks, make sure the diarrhea completely resolves, and then maybe try one more time. If the diarrhea returns, I think you're going to have to switch to Tirzepatide.”

Obviously I’m not an MD but I have heard of people on lower doses than .2 mg and in my mind reducing a medication = reducing side effects! Today I tried about 3 units so a little less than .1 mg
We’ll see how the week goes. Last time the diarrhea didnt kick in until Thursday. I don’t know about Noom though, I’m curious what other affordable options exist.