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In the JAMA paper: expression of the GLP-1 receptor in the human optic nerve and GLP-1 RAinduced enhanced sympathetic nervous system activity might influence optic nerve head perfusion. =Rapid lowering of blood glucose (and rapid change in metabolic state) in persons with pre-existing retinopathy may worsen ocular microvascular conditions (though this is more established with insulin rather than semaglutide specifically)

However, the extract produced a significant 15% reduction in TMAO response in female participants of premenopausal age and male participants ( n = 13), indicating potential sex-dependent cardiovascular benefits from polyphenol interventions targeting the gut microbiome-TMAO pathway

They can suggest other options to help you manage this side effect or look for other potential causes

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