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GLP-1 medications also carry some serious (but rare) warnings: Potential risk of thyroid C-cell tumors (observed in rodent studies, unclear relevance in humans) Risk of gallbladder problems Pancreatitis (rare but documented) Hair loss (temporary, related to rapid weight loss rather than the drug itself) One notable advantage of GLP-1 medications: they do not cause cognitive dysfunction, do not carry teratogenicity warnings as severe as topiramate, and are not controlled substances

The biochemistry is sound

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The effect is most noticeable after eccentric exercise like downhill running or heavy resistance training

Topamax can also cause gastrointestinal disturbances, including nausea and abdominal discomfort

Helicobacter pylori infection and circulating ghrelin levels - a systematic review