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Other contributing factors include medication interactions (certain psychiatric medications, corticosteroids, and reduced exposure to oral contraceptives during dose escalation), hormonal changes (thyroid dysfunction, menopause), inadequate sleep (less than 7 hours nightly), chronic stress with elevated cortisol, and reduced physical activity as patients become more comfortable at their current weight

However, some Trulicity patients claim they have experienced concerning gastrointestinal problems, including bowel obstructions, pancreatitis, and gastroparesis