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[19] [2] Semaglutide is not recommended for patients with severe gastroparesis and may affect the absorption of oral medications due to delayed gastric emptying

Common side effects: - Injection site reactions (redness, mild swelling) - Water retention (usually mild and temporary) - Increased hunger (particularly with Ipamorelin, which activates ghrelin receptors) - Tingling or numbness in hands (sign of improved GH, usually temporary) - Vivid dreams or changes in sleep patterns When to contact your provider: - Persistent joint pain or swelling - Significant water retention - Carpal tunnel-like symptoms - Changes in blood sugar levels - Any unexpected or concerning symptoms Monitoring recommendations: - IGF-1 levels: check at baseline and every 3 months - Fasting glucose and HbA1c: GH can affect insulin sensitivity - Complete metabolic panel: standard health monitoring - Your provider will order appropriate labs based on your protocol Your can monitor your labs and adjust your protocol for safety and effectiveness