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First, side effects are clearly dose-dependent, increasing as the dose goes up

Wang MTM, Bhatti MT, Danesh-Meyer HV

Lactate is the end-product of anaerobic glycolysis and the rate of lactate production when erythrocytes are incubated with autologous plasma, glucose or other potential substrates has been measured in a wide range of Australian native species

High glucose availability limits the ability of fatty acids to get inside the mitochondria, so fatty acid oxidation goes down and the mitochondria predominantly oxidize glucose for energy

That said, many people start to feel a real difference in their appetite within the first couple of weeks on semaglutide

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