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Some studies indicate a 40 to 50 percent reduction in cortisol levels with DSIP use, though these figures should be viewed as preliminary rather than definitive

Selvaraj V, Manne NDPK, Arvapalli R, Rice KM, Nandyala G, Fankenhanel E et al (2015) Effect of cerium oxide nanoparticles on sepsis induced mortality and NF-B signaling in cultured macrophages

When to call your provider Within 3-5 days: No bowel movement for 5+ days despite using Miralax or other osmotic laxative Severe abdominal pain or distension Inability to pass gas Vomiting, especially if it tastes or smells fecal Within 1-2 weeks: Constipation not improving after 2 weeks of consistent dietary changes plus Miralax Blood in stool (bright red or dark/tarry) Severe pain during bowel movements Unintended weight loss beyond expected from the medication At your next scheduled visit: Mild persistent constipation that's manageable but bothersome Questions about whether to escalate dose given current constipation Interest in prescription motility agents The threshold for calling is lower if you have a history of bowel obstruction, diverticulitis, inflammatory bowel disease, or prior abdominal surgery

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People who should be more cautious include those with: a history of certain thyroid cancers past serious pancreas problems serious stomach emptying disorders some rare genetic conditions People who are pregnant, trying to become pregnant, or breastfeeding should also talk with their providers about the risks and benefits of staying on or starting GLP-1 treatment