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Serious Side Effects (Less Common but Severe) Pancreatitis (inflammation of the pancreas) Gallbladder problems (gallstones) Kidney injury (due to dehydration from severe vomiting or diarrhea) Thyroid tumors (found in animal studies but unclear risk in humans) Hypoglycemia (low blood sugar) Additional Risks with Compounded Semaglutide Since compounded semaglutide lacks FDA approval and its formulation can vary, it may carry extra risks, including: A dose may be stronger or weaker than expected Affecting blood sugar control and weight loss