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Finally, some commonly used drugs (e.g., glucocorticoids and GLP-1RAs) can also affect intra-portal insulin levels that modulate the GH/IGF-I axis either by increasing or decreasing hepatic GH sensitivity, as reflected by the discordant GH and IGF-I levels
they represent your body finding a new equilibrium
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The features that should prompt assessment are: Severe, sudden pain in the upper right or upper central abdomen Pain radiating to the right shoulder or to the centre of the back Pain that comes in episodes lasting 30 minutes to several hours, particularly after meals Persistent nausea or vomiting beyond the expected GLP-1 side-effect window Fever, chills, or feeling systemically unwell Yellowing of the skin or eyes (jaundice) Dark urine or pale stools The last three suggest more serious complications and warrant urgent medical review
Despite the momentum, key challenges remain
The STEP 1 extension trial showed participants regained about two-thirds of lost weight within a year of stopping semaglutide (Wilding et al., 2022)
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