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35 Nausea can be addressed in several of different ways: if receiving a titratable GLP-1RA, return to the previous dose or premeal interval that did not cause symptoms (maximal tolerated dose) give a nontitratable GLP-1RA on a full stomach consider antiemetics for intractable symptoms

Contact your GP or prescribing clinician if: You experience persistent, severe hunger despite reaching the maintenance dose of 2.4mg weekly for at least 812 weeks You have severe, persistent abdominal pain (with or without vomiting), especially if radiating to the back (possible pancreatitis) seek urgent medical care You develop right upper quadrant pain, fever, or yellowing of the skin/eyes (possible gallbladder disease) seek urgent medical care Hunger is accompanied by other concerning symptoms such as excessive thirst, frequent urination, unexplained weight gain, or fatigue (which may indicate inadequate diabetes control or other metabolic issues) You have gained weight or stopped losing weight despite adherence to dietary and lifestyle recommendations You experience symptoms of hypoglycaemia (low blood sugar), particularly if you have type 2 diabetes or take insulin or sulfonylureas (these medications may need dose adjustment) You experience severe gastrointestinal symptoms (persistent nausea, vomiting, or abdominal pain) that prevent adequate nutritional intake You suspect medication interactions with other prescribed treatments Psychological factors such as depression, anxiety, or disordered eating patterns are significantly impacting your relationship with food Your healthcare provider can assess whether dose adjustment is appropriate, review your overall treatment plan, and investigate potential underlying causes

Honored to have presented at the 12th International Conference in Lisbon: "Homeopathy in Clinical Practice: Managing Semaglutide-Related Side Effects." Article now published in French

doi:10.1002/jmv.25819 176

Serum bilirubin and risk of ischemic heart disease in middle-aged British men