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This results in a lack of energy production from fatty acids, which causes symptoms ranging from tiredness and hypoglycemia (glucose being used extensively as an energy source) to accumulation of fat in the liver and other organs, and damage to heart and muscle tissues

Acid reflux (GERD), nausea, or vomiting frequently result, particularly in the early weeks of treatment or after dose increases

Additionally, Zumpano says, this gel can bind with the bile in your gut, which is composed of cholesterol, and remove it with the body's waste, thus reducing the amount of cholesterol in your body

It can also lead to diabetic macular edema (DME)