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When to call your provider Routine check-in (schedule within 1-2 weeks): Nausea or vomiting that is bothersome but not preventing eating or drinking Constipation lasting more than 3 days Mild abdominal discomfort Questions about dose escalation timing Weight loss plateau lasting more than 4 weeks Same-day contact: Persistent vomiting (more than 12 hours, unable to keep fluids down) Severe abdominal pain, especially upper abdomen radiating to the back Signs of dehydration (dark urine, dizziness, decreased urination) Severe diarrhea (more than 6 episodes in 24 hours) New-onset vision changes Symptoms of gallbladder disease (right upper quadrant pain after fatty meals) Emergency care (call 911 or go to ER): Severe chest pain (rule out cardiac causes before assuming reflux) Difficulty breathing Vomiting blood or coffee-ground material Severe allergic reaction (facial swelling, difficulty swallowing, hives) Symptoms of pancreatitis (severe upper abdominal pain radiating to back, fever, rapid pulse) Altered mental status or confusion The line between "manageable side effect" and "medical emergency" is whether the symptom is interfering with hydration, nutrition, or indicates a serious complication

No supplement, sweat session, or extra drink can shortcut the process