Day 3 on sema and I feel like death warmed over — what worked for you?

Short answer first, then the reasoning. The practical protocol is dull and it works: smaller meals, stop eating at the first sign of fullness rather than at the end of the plate, drop the fat fraction of meals in the two days after dosing, and do not lie down straight after eating. Most of what people call unmanageable nausea is a meal-size and meal-composition problem interacting with a stomach that is emptying slowly.

VendorMark said:

The practical protocol is dull and it works: smaller meals, stop eating at the first sign of fullness rather than at the end of the plate, drop the…

VendorMark has the substance of this right. The condition it depends on is worth stating. The meal advice is right and incomplete without the hydration point. People stop drinking because drinking makes them feel full, then attribute dehydration symptoms to the drug.

DataDave said:

Nausea arrived on day two of each dose step, lasted about four days, and disappeared entirely by the second week — until the step where it did not.

Same position here, arrived at the long way round. Holding genuinely reduces total burden rather than redistributing it, because the gastric-emptying component adapts. Receptor-level tachyphylaxis to the delayed-emptying effect develops over weeks while the central appetite effect persists, so the same dose is materially more comfortable at week six than at week two. A slower ladder therefore reaches the same dose with less cumulative nausea, not the same nausea spread thinner.

Clinical perspective, offered as context rather than as advice. The version of this that has an answer is narrower than the version being asked. Narrow it and it becomes tractable; leave it broad and the thread will produce nine confident and incompatible replies.

Ask again with the specifics and you will get a better answer than this one.