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The choice of treatment should be individualised, considering the underlying cause, symptom severity, patient preference, and practical factors such as access to healthcare facilities for regular injections

Sikiric P, Seiwerth S, Rucman R, Turkovic B, Rokotov DS, Brcic L, Sever M

Laakso JT, Tervinen TL, Martelin E, Vaskonen T, Lapatto R

Dehydration makes nausea significantly worse For diarrhea: Increase fiber intake gradually, not suddenly Stay hydrated with electrolyte solutions, not just plain water Avoid sugar alcohols and artificial sweeteners, which can worsen GI symptoms For constipation: Increase water intake to at least 2-3 liters daily Add magnesium citrate if needed (a gentle, effective option) Include high-fiber vegetables and fruits in your diet When to slow the escalation If you experience side effects that significantly impact your daily function, extend the current dose phase by 2-4 additional weeks before escalating

If you think youre low on B12, talk with your doc.

Clinical data supports this