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Studies on semaglutide tolerability have consistently shown that GI side effects are most common and most severe during the first few days after each dose increase, when drug levels are climbing toward a new peak

For someone worried about palpitations, this data provides important context

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A lower dose that still produces weight loss but allows adequate nutrition may be the right balance

According to NICE guidance, SGLT2 inhibitors are generally prioritised for patients with established cardiovascular disease, while GLP-1 receptor agonists like semaglutide are recommended based on glycaemic control and weight management criteria