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If immediate discontinuation is medically necessary, careful monitoring and symptom management is warranted
Additionally, because topiramate increases the risk of metabolic acidosis, many providers recommend avoiding a strict ketogenic diet unless specifically directed otherwise
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The tradeoffs are equally real: weekly injection, $900+ per month without insurance, limited supply relative to demand, and side effects that affect a substantial portion of users nausea, vomiting, constipation, and GI disruption are among the most common, particularly during dose escalation
Practical high-fiber food choices for GLP-1 users include: Berries : Raspberries (8 grams per cup), blackberries (7.6 grams per cup), and strawberries (3 grams per cup) provide fiber with relatively low volume Chia and flax seeds : Two tablespoons of chia seeds deliver 10 grams of fiber and can be added to yogurt or smoothies Avocado : One medium avocado contains approximately 10 grams of fiber with healthy fats that support nutrient absorption Split peas and lentils : A half-cup cooked provides 89 grams of fiber with substantial protein Artichokes : One medium artichoke offers 7 grams of fiber Pears : One medium pear with skin contains about 6 grams of fiber Patients should prioritize whole food sources over fiber supplements when possible, as whole foods provide additional nutrients, phytochemicals, and varied fiber types
He agrees to give it a go - hurrah
