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Weight Loss Medication Care

Semaglutide and Tirzepatide Side Effects in Your First Months

Last Updated

October 21, 2026

Estimated Time to Read

7 min

Author

Hillary Mitchell, APRN, FNP-C, PMHNP-BC, LSO

TABLE OF CONTENTS

Cold when no one else is, a headache the day after your shot, a mouth like cotton? Most of it is common, and most of it eases.

In the tirzepatide trials, most nausea, vomiting, and diarrhea came while the dose was going up, then eased. Most people who stopped because of side effects did so in the first few months.

Below are the five side effects people look up most, with label numbers. Feeling cold isn’t on any label.

If something’s bothering you, call us. That’s what we’re here for.

How Common Semaglutide and Tirzepatide Side Effects Are

Semaglutide is the medicine in Wegovy, FDA-approved for weight management, and Ozempic, approved for type 2 diabetes. Tirzepatide is the medicine in Zepbound, approved for weight management and for obstructive sleep apnea in adults with obesity, and Mounjaro, approved for type 2 diabetes.

Here’s how often each came up in the trials, per 100 adults, medicine against placebo:

Side effectSemaglutide (Wegovy label)Tirzepatide (Zepbound label)Worth telling us if…
Feeling coldNot on the labelNot on the labelit comes with tiredness or fast weight loss
Headache14 against 10Not among its common side effectsit bothers you or won’t go away
Dry mouthNot on the labelAbout 1 against about 0.1you can’t keep liquids down
Feeling tired11 against 55 to 7 against 3it’s more than you’d expect, or hangs on
Constipation24 against 1111 to 17 against 5it’s severe, lasts, or comes with belly pain or vomiting
Nausea44 against 1625 to 29 against 8it won’t stop or keeps you from drinking

One in ten people on placebo had headaches too, so not every headache is your medicine.

These figures come from the brand-name trials. Compounded semaglutide and tirzepatide aren’t FDA-approved.

Does Tirzepatide Make You Cold? Feeling Cold on Semaglutide or Tirzepatide

It’s one of the questions people ask most. Yet feeling cold isn’t listed on the Wegovy, Ozempic, Zepbound, or Mounjaro labels, and no study has measured body temperature in people taking these medicines.

So if you’ve searched “does Zepbound make you cold” or “does Ozempic make you cold”, the plain answer is that no one has shown whether these medicines cause it, or why. Plenty of articles offer reasons. None has been proven in people on these medicines, so we won’t guess.

One published case describes a woman on semaglutide who felt tired and newly sensitive to cold after losing weight fast. Her thyroid tests showed a pattern seen with rapid weight loss. She wasn’t given thyroid medicine, and her symptoms eased as her weight settled. That’s one person’s case, and the report’s authors suggest thyroid tests be considered for people with symptoms who are losing weight fast.

Feeling cold on tirzepatide or semaglutide? Tell us, especially if you’re also tired or losing weight quickly. Your provider looks at it alongside how you’re eating and your lab results over time, and decides whether anything needs checking.

Headaches on Tirzepatide or Semaglutide, and What Eases Them

A tirzepatide or semaglutide headache usually shows up early, tends to be mild, and usually passes.

Many GLP-1 headaches may not come from the medicine directly. When nausea or vomiting leaves you short on fluids, a headache often follows. Long stretches without food are the other common reason. A headache after about eight hours without eating, that eases once you eat, fits that pattern.

So keep sipping fluids through the day, and try not to go too long without a small meal.

If you also take insulin or a sulfonylurea for diabetes, a headache with shakiness, sweating, or confusion can be a sign of low blood sugar. Call us right away.

Dry Mouth on Tirzepatide

Does tirzepatide cause dry mouth? Sometimes, though it’s uncommon: about 1 in 100 people on Zepbound reported a dry mouth or throat, against about 1 in 1,000 on placebo. It isn’t on the Wegovy label.

Dry mouth often comes along with nausea, eating less, and slower digestion, when you’re also drinking less than usual.

Sip fluids through the day. If you can’t keep liquids down, or nausea, vomiting, or diarrhea won’t let up, call us. Losing fluids can cause kidney problems, so we’d rather hear from you early.

Feeling Tired on a GLP-1, and What Helps

GLP-1 fatigue often has an ordinary reason. People on these medicines eat a good deal less, and a cut that big can leave you short on vitamins and minerals. Tiredness beyond what you’d expect can be one sign of that.

If you’re wondering how to combat GLP-1 fatigue, start with how and when you eat:

  • Small, regular meals, even when you’re not hungry (a reminder on your phone helps)
  • Protein first on your plate
  • Enough fluids through the day

If tiredness hangs on, tell us. Your provider has your lab results over time to look at, which makes it easier to see what’s changed.

Tirzepatide Constipation and What Helps

Constipation is common on both semaglutide and tirzepatide, and it’s easiest to handle early. Fluids and fiber from food come first.

Search for a tirzepatide constipation treatment and you’ll find plenty of products. When food and fluids aren’t enough, there are other options, but ask us before you add any of them, including a fiber supplement or a probiotic. Your provider decides what fits your plan.

If constipation hangs on, tell us. Severe constipation, including blockage, has been reported since these medicines were approved. Constipation with belly pain that won’t go away, or with vomiting, is a call today.

What New You Does When You Call About a Side Effect

Here, a side effect isn’t something to push through on your own. When you call, our clinical team reviews your symptoms and gives you the next step. For anything severe, go straight to emergency care.

We don’t believe in one-size-fits-all care. Your plan is built around your symptoms, history, labs, and goals, then adjusted along the way based on how you’re feeling and responding. Regular visits are there to address concerns and make changes when you need them.

Our nurse practitioners see patients in Longview and Marshall, and by video Monday to Friday. You can get your weekly dose at the clinic or have it shipped. 

“They spend the time to make sure the medication is doing what your goals are and if not they adjust based on your needs.” (Dawn M., Google review)

“They answer every question you have and will even provide documentation on medication, techniques that work best, and symptom management that you can try.” (Jill E., Google review)

“They check up on me weekly (as I chose to get my dose at the clinic due to my squeamishness about needles) and do well to address any concerns I have.” (Tisvana A., Google review)

Read all our reviews on Google

When to Call About Side Effects, and When to Get Emergency Care

Most side effects ease with time. A few need attention sooner.

Call us today if you have:

  • Nausea, vomiting, or diarrhea that won’t stop, or keeps you from drinking
  • Stomach problems that are severe or won’t go away
  • Upper belly pain, yellow skin or eyes, fever, or pale stools, which can be signs of gallbladder trouble
  • A racing or pounding heartbeat at rest that lasts several minutes
  • A lump or swelling in your neck, hoarseness, or trouble swallowing
  • Any side effect that bothers you or won’t go away

Get emergency care right away for:

  • Severe belly pain that won’t go away, sometimes felt through to your back
  • Swelling of your face, lips, tongue, or throat, trouble breathing or swallowing, or fainting

Not sure which list it belongs on? Call our office today.

Weight Loss Medication Care With New You in Longview and Marshall, Texas

A side effect doesn’t mean you’re doing something wrong. It’s a reason to call, and a plan that changes with you is the whole point.

You don’t have to know exactly what to ask for. Tell us what you’re feeling, at our Longview or Marshall clinic or by video, and we’ll take it from there.

See our weight loss medication plans

Or call us at 903-212-0556.

New You · 905 Judson Rd, Longview, TX 75601 · 115 E Austin St, Marshall, TX 75670 · Virtual visits Monday to Friday · 903-212-0556

Your Goals. Your Health.
Your New You.

There is no single definition of what it means to feel your best. For one person, it may mean having more energy or finally making progress with weight management. For another, it may mean addressing hormonal changes, feeling more confident in their appearance, improving sexual wellness, or simply becoming more proactive about their health.

Wherever you are starting, New You Aesthetics & Wellness is here to help you understand your options and create a plan that feels right for you. Visit our Longview or Marshall location, call (903) 212-0556, or contact our team to schedule a consultation and take the next step toward feeling more like yourself.