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This subset has distinct characteristics: Clinical pattern: Constipation begins in the first 4-8 weeks (typical) Symptoms plateau but don't improve after 12-16 weeks at stable dose Requires ongoing daily laxative use (usually polyethylene glycol) Worsens with dose escalation and improves with dose reduction Resolves within 2-4 weeks of discontinuing medication Why this happens: The current hypothesis is inadequate compensatory upregulation of non-GLP-1 motility pathways

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These usually resolve within 2448 hours without intervention

Early studies suggest that in people with high uric acid, treatment may improve insulin sensitivity and lower blood pressure

Treatment typically involves vitamin B12 supplementation, either through oral supplements or injections, depending on the severity of the deficiency and underlying causes.