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Nausea: While the medication itself causes nausea, low blood pressure can make it worse

Low energy is more common during the early stages of treatment or after dose increases, rather than as a persistent long-term effect

However, targeted microbiome support, particularly with strains that have been studied in the context of metabolic health (such as Akkermansia muciniphila and butyrate-producing bacteria like Clostridium butyricum), may offer benefits by supporting gut barrier function and helping the digestive system adapt