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Neurologa europea, 1984,23(5):364-371.DOI:10.1159/000115715

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Primary carnitine deficiency and pivalic acid exposure causing encephalopathy and fatal cardiac events

These include: Severe headaches , particularly if sudden-onset or different from usual patterns Visual disturbances such as blurred vision or seeing spots Chest pain or pressure , which may indicate cardiovascular complications (call 911) Shortness of breath or difficulty breathing, especially with exertion (call 911 if severe) Neurological symptoms including facial drooping, arm weakness, speech difficulties (call 911) Severe dizziness or lightheadedness , particularly upon standing (suggesting hypotension) Nosebleeds that are difficult to control Confusion or difficulty concentrating Patients should also promptly report semaglutide-specific concerns that may require immediate evaluation: Severe, persistent abdominal pain (possible pancreatitis) Right upper quadrant pain, fever, or yellowing of skin/eyes (possible gallbladder disease) Signs of allergic reaction including rash, swelling, or difficulty breathing New or worsening vision problems (potential diabetic retinopathy complications) Persistent nausea, vomiting, or diarrhea can lead to dehydration, electrolyte imbalances, and secondary blood pressure changes

Additionally, physical activity such as walking, swimming, or pilates is encouraged to enhance gut motility and reduce constipation-related complications