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Most gastrointestinal effects are mild to moderate in severity and can be managed through slower dose titration and dietary modifications
National Institute of Diabetes and Digestive and Kidney Disease
Small levothyroxine adjustments (typically downward by 12.525 mcg) are sometimes needed, but changes are usually minor and made gradually based on lab results, not symptoms alone
Seek immediate medical attention (call 999 or attend A&E) if you develop : Signs of severe dehydration: dizziness, confusion, reduced urine output despite drinking fluids, rapid heartbeat Symptoms of diabetic ketoacidosis: excessive thirst, frequent urination, nausea, vomiting, abdominal pain, fruity-smelling breath, confusion (Note: GLP-1 medications do not cause DKA, but it can occur in type 1 diabetes or ketosis-prone type 2 diabetes, especially during illness) Severe flank pain with fever: may indicate pyelonephritis (kidney infection) If you experience persistent vomiting or diarrhoea from GLP-1 therapy and cannot maintain adequate fluid intake, seek urgent medical advice as there is a risk of dehydration and acute kidney injury
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