Nausea affects 15-40% of patients who take GLP-1s, and in rare cases it can lead to vomiting. GLP-1s make the stomach empty more slowly, so food stays in the stomach longer and can leave you feeling overly full and queasy. They also send signals to the brain's nausea and vomiting centers, which adds to that sick-to-the-stomach feeling.
The good news is the nausea is usually mild and typically resolves over several weeks as your body adapts to the medication. It can, however, return with dose increases, so it’s important to reach out to the Calibrate Clinical Team via the Support Center in the app if your nausea persists so we can personalize your medication plan.
Importantly, if the nausea and vomiting are interfering with your daily life or if you’re unable to tolerate liquids or have minimal food intake, send the Clinical Team a message through the Support Center to discuss next steps, which may include a dose reduction of your GLP-1 or occasionally short term use of prescription anti-nausea medication. It is safe to abruptly stop your GLP-1 medication if needed if the side effects are too significant. Often, the below recommendations can help ease symptoms of nausea without having to resort to an anti-nausea prescription.
First Step: Check for Other Causes
Before treating nausea as a medication side effect, make sure something else isn't going on.
Contact the Calibrate Clinical Team first if:
- Your nausea started without a recent dose increase
- You've taken antibiotics recently
- You are concerned you may be pregnant
- Other members of your household or close contacts are having nausea and vomiting
Second Step: Diet and Lifestyle Changes
- If you are taking an injectable GLP-1, try changing the GLP-1 injection site, as some people report less nausea in different sites (thigh versus belly for example).
- Try adjusting the time of day you take your GLP-1 medication (not including oral Wegovy as this should be taken in the morning). For example first thing in the morning versus before bed or before a meal versus after a meal.
- Eat smaller portions, slowly, and stop eating when you are starting to get full. Often overeating will make the nausea worse.
- Avoid high-fat, fried, spicy and sugary foods and limit alcohol and carbonated drinks.
- Also, keep in mind that if you are having any issues with constipation, that can be a significant contributing factor to nausea as well. Let your Clinical Team know (and also refer to our constipation guide).
- Incorporate ginger. Ginger tea, lozenges, or fresh or powdered ginger added to meals can be particularly helpful. To make your own ginger tea, steep fresh ginger slices in boiling water for 15 minutes, then strain. For ready-to-use tea, we especially like Yogi and Traditional Medicinals. Sip slowly and, for best results, start taking the ginger before your nausea usually starts.
- Do acupressure. An acupressure technique commonly used for nausea is to apply pressure on your inner wrist about 2.5 inches from where your hand and wrist meet, between two large tendons. Holding pressure here for several minutes may help. Use a circular motion with firm but gentle pressure. You can also try a Sea-Band Anti-Nausea Acupressure Wristband.
- Nausea and vomiting can also be triggered by rapid changes in blood glucose while on GLP-1 medication. With this in mind, avoiding sugary or sweet foods can help prevent symptoms. Additionally, eating protein and fiber at the beginning of your meals can help blunt the glucose spike.
- Use some lemon. Add a squeeze of fresh lemon juice to a bottle of water along with a pinch of sea salt. The water should be room temperature or warmer (never cold!). Drink this throughout the day.
- Work on diaphragmatic or deep breathing. Long, slow exhales stimulate the parasympathetic nervous system to calm the nerves and put the body in “rest and digest” mode, which can alleviate nausea. To do this, breathe in through the nose, hold your breath for three seconds, and slowly exhale through the mouth. Try this for a couple minutes.
Third Step: Medication Adjustment
If these methods don’t provide relief, please reach out to the Calibrate Clinical Team via the Support Center in the app to discuss options, which include:
- Changing the dose of your GLP-1 medication to a dose that does not cause debilitating nausea
- Determining whether a short course of prescription anti-nausea medication is appropriate.
We want to tailor your GLP-1 dose so that you get the weight loss benefit without debilitating side effects!
When to Contact the Calibrate Clinical Team
Even without intervention, your mild nausea should start to improve after three to four weeks, so if it doesn’t, please reach out to the Medical Team. Also, always, if your symptoms get significantly worse, or if you’re worried about being dehydrated, please stop the medication; seek in-person medical care from your primary care doctor, urgent care, or the ER.
When to Seek Urgent Medical Care
Seek medical care right away if you have any of the following:
- Signs of dehydration (dizziness, dark urine, peeing much less than usual)
- Inability to keep fluids down
- Severe abdominal pain, bloating, or swelling
- Blood in your stool or rectal bleeding
- Fever, a fast heart rate, or feeling very weak
- Symptoms that feel urgent or severe
These symptoms may be signs of a more serious medical problem and should be evaluated as soon as possible.