When discussing gastrointestinal side effects, including heartburn, with your prescriber, it is helpful to: Keep a symptom diary noting when symptoms occur, their severity, duration, and any potential triggers Report all concurrent medications and supplements , as some including non-steroidal anti-inflammatory drugs (NSAIDs) and certain antibiotics can independently worsen reflux or interact with gastrointestinal function [8] [9] Ask about dose titration options if symptoms are significantly affecting your quality of life Discuss whether a formal GORD assessment is warranted , particularly if symptoms are persistent your GP may consider Helicobacter pylori testing or referral for endoscopy based on NICE CKS and NG12 criteria Your prescriber may refer you to a gastroenterologist if symptoms are complex or do not resolve with standard management
Common first-month side effects include mild nausea, constipation, reduced appetite, and possible fatigue as your body adjusts
Treatment typically involves vitamin B12 supplementation, either through oral supplements or injections, depending on the severity of the deficiency and underlying causes.
The results of these studies show that fasting increases hypothalamic AMPK activity in both areas in lean Zucker rats
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