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Constipation Prevention: Increase fiber intake gradually Stay well hydrated (80-100oz water daily) Regular physical activity Don't ignore urge to go Management: Magnesium citrate: 200-400mg before bed Psyllium husk or other fiber supplement Prunes or prune juice Miralax if needed Consider probiotic Fatigue and low energy Causes: Calorie deficit (especially if too aggressive) Reduced carb intake Rapid weight loss Dehydration Management: Ensure adequate protein (prevents muscle loss that worsens fatigue) Don't go too low calorie (minimum 1200 for women, 1500 for men) Strategic carbs around training Adequate sleep (even more important during weight loss) Consider B-complex vitamin Food aversions What happens: Foods you used to love become unappealing or even disgusting Management: This is actually helpful for weight loss (stops cravings) Embrace it - explore new healthy foods Focus on protein-rich foods you still enjoy If aversions are too severe (can't eat enough), dose may be too high Hair thinning Why it happens: Rapid weight loss (not the peptide itself) Nutritional deficiency Metabolic stress from deficit Prevention: Adequate protein (prevents this mostly) Biotin supplement: 5,000-10,000mcg daily Ensure sufficient calories (not too aggressive deficit) Multivitamin with iron, zinc, selenium Timeline: If occurs, starts 2-3 months into weight loss

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Compounded Semaglutide and Tirzepatide: Safety Concerns FDA enforcement discretion policies during drug shortages have allowed compounding pharmacies to prepare semaglutide and tirzepatide products when commercial supplies were insufficient