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ForumsSide Effects & ManagementDay 3 on sema and I feel like death warmed over — need advice Page 4

Day 3 on sema and I feel like death warmed over — need advice

roxy_nash Sat, Aug 16, 2025 at 7:33 AM 50 replies 2,150 viewsPage 4 of 10
Dr.EndoIndy
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Oct 2024
Indianapolis, IN
Aug 16, 2025 at 1:13 PM#16

Just wanted to say — for anyone reading this Day 3 on sema and I thread who is feeling discouraged: it gets better. The first few weeks are the hardest. Hang in there. 💪

10 9mia_MS2, LeilaHI, marcus_mpls and 7 others
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InsuranceTom
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Mar 2024
Connecticut
Aug 16, 2025 at 1:30 PM#17

roxy_nash's experience with Day 3 on sema and I feel resonates deeply with mine. I went through almost the identical process — starting dose, titration timeline, side effects, everything.

The main difference: I titrated faster. But the overall trajectory has been remarkably similar. Down 40 lbs in 5 months.

One thing I would add that roxy_nash did not mention: the relationship with food fundamentally changed.

Last edited: Aug 16, 2025 at 6:30 PM
43 4lucas_SP_BR, lisa_labSD, adam_van and 40 others
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EndoResFellow
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Baltimore, MD
Aug 16, 2025 at 1:47 PM#18

Saving this for reference. Quality thread.

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chris_chi24
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Sep 2024
Chicago, IL
Aug 16, 2025 at 2:04 PM#19

As a healthcare provider, I want to add some clinical context to this discussion on Day 3 on sema and I feel like death.

Building on what roxy_nash said — the evidence base here is well-established. The key publications to reference are from the SUSTAIN program[1].

Key clinical points:

  1. Efficacy is dose-dependent and typically requires 4-5 weeks to reach steady state
  2. Side effect profile is predictable and usually manageable with standard protocols
  3. Monitoring should include baseline labs and follow-up at 3-month intervals
  4. Patient education significantly improves outcomes and adherence

Standard disclaimer: this is educational, not individualized medical advice.

References:
[1] See thread title for relevant study identification.
35 13PurityPaulOR, MaxMetOK, MounjBrad and 32 others
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JenMemphis
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Jan 2025
Memphis, TN
Aug 16, 2025 at 2:21 PM#20

Subscribing to this thread. Day 3 on sema and I feel is exactly what I've been researching. 🙏

50 21LarryQC_SD, wanda_boise, NurseAsh_DET and 47 others
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