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If constipation arises post-therapy, support with fluids, fiber, gentle activity, and perhaps a brief trial of over-the-counter fiber supplements during clinician consultation

There is a real physiological argument, though one that should be taken with appropriate skepticism until human data accumulates, about receptor downregulation and what hitting three pathways at maximum dose may do to the bodys endogenous signaling architecture over years of continuous use

This approach is reasonable for mild-to-moderate allodynia where the patient is receiving significant benefit from semaglutide and is willing to tolerate temporary discomfort

Med Ped Oncol 28:433-440, 1997

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