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Contributing factors described in the literature: Reduced caloric intake Blood sugar fluctuations Sleep disruption from other side effects Metabolic adaptation to weight loss Community-reported management strategies: Community sources describe protein intake around 0.8-1g per lb body weight Consistent sleep schedule B-vitamin supplementation Monitoring for signs of dehydration Mitochondrial peptides for persistent fatigue

Most patients experience symptom improvement by weeks 8-12 as their digestive system acclimates to the new hormonal signaling

Diabetes Obes Metab 19(3):336347 Alpert CM, Smith MA, Hummel SL, Hummel EK (2017) Symptom burden in heart failure: assessment, impact on outcomes, and management

While the clinical trial was extensive enough to gain FDA approval for the treatment, the longest that some patients were observed for risks and side effects was six monthsand that was only a portion of the participants from the clinical study

Consider B-complex for energy, vitamin D if deficient, and omega-3 for heart health