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Common adverse effects include gastrointestinal symptoms, which affect the majority of patients to varying degrees: Nausea (20-44% of patients) usually most pronounced during dose escalation Diarrhea (20-30%) Constipation (15-24%) Vomiting (9-24%) Abdominal pain (6-10%) These symptoms typically diminish over time as physiological adaptation occurs

Age-related anabolic resistance and reduced baseline muscle reserve may increase susceptibility to lean mass loss during medically induced weight reduction [40]

Vitamin A is part of the natural tear film and as such is very well tolerated as a lubricant