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Side effects what to expect The most common side effects are gastrointestinal and worst in the first 48 weeks (full breakdown in our side-effects guide): Nausea (around 40% of patients in week one usually settles) Constipation or diarrhoea Reflux / burping / "sulphur burps" Reduced appetite (the desired effect) Tiredness and dizziness especially if dehydrated Less common but more serious risks include pancreatitis, gallbladder disease, severe dehydration leading to acute kidney injury, and very rarely thyroid C-cell tumours (seen in rodents human relevance unclear, but the medicines are contraindicated in MEN2 and personal/family history of medullary thyroid cancer)

Epithalon is a synthetic tetrapeptide a four amino acid sequence (Ala-Glu-Asp-Gly) originally derived from pineal gland peptide research

Some people also experience temporary gastrointestinal side effects, particularly when beginning treatment or increasing their dosage

The abdomen may feel hard to the touch or visibly distended

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