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Muscle cramps during GLP-1 therapy are typically caused by indirect factors including electrolyte depletion (especially magnesium and potassium) from gastrointestinal side effects, dehydration from reduced fluid intake or vomiting/diarrhea, rapid weight loss with some lean mass reduction, and increased physical activity exceeding current conditioning levels

GLP-1, secreted from the intestinal L cells postprandially, acts both centrally and peripherally to exert its anorectic and metabolic effects

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However, spontaneous reporting systems are subject to substantial limitations, including under-reporting, confounding by indication (e.g., diabetes-related xerostomia), channeling bias toward older or more comorbid patients, and polypharmacy involving xerostomia-inducing drugs such as antidepressants and anticholinergics

Serotonin mediates oxidative stress and mitochondrial toxicity in a murine model of nonalcoholic steatohepatitis