I started out on 0.25 for 4 weeks. I had no side effects, lost a little weight. My first increase to 0.5 was fine, still no side effects and able to function as a normal person, at this point I was getting close to 30 pounds down. After 4 weeks, I was to increase my dose to 1mg. This is when the problems started...I've had bad reflux even with 40mg prescription Nexium, extremely painful stomach cramps, diarrhea (very bad, daily, about every 20-30 minutes, terribly disgusting sulfur burps, headache, weak/fatigue (likely from the inability to eat and barely drink liquids), if you do eat - you have to force yourself to eat because of the pain, dizzy spells (especially going from sitting to standing), stomach gurgles almost back to back all day, and did I mention how bad the diarrhea is? It's like giving yourself a virus that won't go away. I've taken the 1mg for 2 weeks now and can't tolerate this anymore. My doctor is putting me back down to the 0.5 dose as I had no side effects on that and took it for 4 weeks. However, the half life on this medication is very looooong, which means even though I have taken my 0.5 dose, it'll take a few weeks before anything balances out. My blood sugar levels have been so good it is unheard of. So far, I have lost 40 pounds but not without ridiculous amounts pain, did I mention the back to back diarrhea (don't leave home), and about 13 pounds of my weight loss came from the 1mg because you are so sick you don't want to eat or drink anything. Also, on the 1mg, you might want to just throw out your daily coffee or caffeine intake altogether as it makes it unbearable. Occasionally I will take ibuprofen for the stomach pain and does help (a little). I missed 2-3 days of work since going on the 1mg but thought I actually had a stomach bug until it was daily for the last 2 weeks. I am hopeful that going back to the 0.5 will stable me out. I love my BS numbers, and the weight loss is something I've never been able to accomplish (and haven not been this small since I was in my 20's (currently 38 years old). I'm actually able to fit into WAY smaller clothing and have even enjoyed shopping a little more. I have read in the comments about a lot of people feeling depressed after taking the medication. I have not noticed this, however, I have been on an antidepressant (Lexapro) for years. I could, however, see how this medication could make you depressed if you consistently experience the side effects that I have on the 1mg dose. Fingers crossed that going backwards will return me back to normal. Also, you may want to put 4-5 layers of underpants on when you go to sleep, trust me, to be on the safe side...did I mention diarrhea? If you can tolerate the smaller dose, stick to that, I personally do not recommend going to 1mg (the devil reared his head from the bowels of my stomach). Aside from wishing I never went to the 1mg (and perhaps being malnourished and dehydrated from upping the dose, I would recommend it but only to the level your body can tolerate it otherwise you will have zero quality of life. I functioned just fine with no side effects at 0.5 but still enjoyed the weight loss, 1mg will never happen again!Read More Read Less