40–70%
develop GI side effects on a GLP‑1 in real-world studies
60-DAY MONEY-BACK GUARANTEE
UNDERSTORY
NUTRITION
FOR ADULTS ON A GLP‑1 MEDICATION
Your prescription came without its protocol.
Weight-loss surgery patients have had detailed nutrition guidelines since 2008. People on a GLP‑1 didn't get a nutrition advisory until 2025, and it was written for clinicians, not for you. Understory makes two protocols for that gap: one for digestive comfort and the nutrients smaller meals stop delivering, one for the fuel your gut lining runs on.
17
years between the first nutrition guidelines for weight-loss surgery patients and the first joint nutrition advisory for people on a GLP‑1.
FOR PEOPLE ON ANY GLP‑1
SemaglutideTirzepatideLiraglutideInjectableOral
Taken alongside your medication.
THE CHALLENGE
Your medication is working. That's exactly why this happens.
These drugs slow gastric emptying and cut appetite sharply — that's the mechanism doing its job. What follows isn't bad luck, isn't weakness, and isn't the price you agreed to pay. It's arithmetic, and it shows up in two places at once.
Constipation & bloating
Slowed motility means food moves through more slowly than it used to. When constipation shows up it typically runs a six-to-ten week window. Fiber alone often makes the bloating worse rather than better.
PROTOCOL ONELactoSpore · enzymes
Sulfur burps & nausea
When digestion slows, food sits longer — and that's measurable. Among 35,183 people having an endoscopy, those on a GLP‑1 were about four times as likely to still have food in their stomach (13.6% vs. 2.3%). Belching shows up in about 9 in 100 people in trials. Nausea hits 44 in 100 at the top semaglutide dose, and it's the most-cited reason people stop.
PROTOCOL ONEGinger · peppermint · enzymes
Fatigue & fog
Eat up to a third less, and you get up to a third less of the nutrients that used to ride along with that food. Nothing is broken — the arithmetic just stopped working. More than 60% of people on these medications fall below requirements for calcium and iron.
PROTOCOL ONEB12 · B6 · iron · folate
A gut lining running on less
The same drop in intake reaches tissue you never think about: the lining of your digestive tract. It rebuilds itself about every three and a half days, runs mainly on one fuel, and gets first pick of that fuel from the protein you eat. Less protein on the plate means less of it coming in.
PROTOCOL TWOComing soon
ONE CAUSE, TWO CONSEQUENCES
When you eat less, two things run short.
The first is the nutrients your blood carries around. The second is the fuel for the tissue lining your digestive tract, which is rebuilding itself right now, whether you notice or not.
CONSEQUENCE ONE
The digestive & nutrient gap
Across 461,382 GLP‑1 patients, 12.7% were newly diagnosed with a nutrient deficiency by month six — and 22.4%, nearly 1 in 4, by month twelve. More than 60% run below requirements for calcium and iron. The answer is repletion — replacing specific nutrients in forms chosen for how well they're tolerated — plus day-to-day digestive comfort.
See the Daily Micronutrient & Digestive Protocol →CONSEQUENCE TWO
The gut-lining fuel gap
The lining of your digestive tract is living tissue that rebuilds itself every few days, and it runs on fuel that comes from the protein you eat. Eat less protein, and less of that fuel gets through. Nothing here is broken; the raw material is just running shorter. We're finishing our second protocol for this exact gap.
Coming soon →THE PART NOBODY MENTIONS
You're eating up to a third less. Your needs didn't change.
What did you actually eat yesterday? Not what you meant to eat. What landed on a plate and got finished.
Tap whatever you actually managed. Nothing is stored or sent anywhere.
Rough guide only, not a nutritional assessment.
GLP‑1 medications cut energy intake by 16–39% compared with placebo, and measured protein intake averages 33.4g a day. Across 461,382 patients, 12.7% were newly diagnosed with a nutrient deficiency by month six, and 22.4% by month twelve.
GLP‑1 medications cut energy intake by 16–39% compared with placebo, and measured protein intake averages 33.4g a day. Across 461,382 patients, 12.7% were newly diagnosed with a nutrient deficiency by month six, and 22.4% by month twelve.
WHY NOBODY TOLD YOU
Two people lose the same eighty pounds. Only one gets handed a protocol.
Medicine learned the hard way what happens when you shrink someone's intake and don't replace what they've stopped eating. That lesson has been slow to reach the pharmacy counter — on both the nutrient side and the gut-lining side.
DOOR ONE
Bariatric surgery
Guidelines published 2008 · updated 2016
- Lifelong daily supplementation, recommended for every patient
- Specific doses — at least 12mg of thiamin a day, B12 for everyone
- Scheduled lab work and monitoring
- Structured follow-up
92 formal recommendations, 79 of them new in the 2016 update.
DOOR TWO
A GLP‑1 prescription
First joint nutrition advisory: 2025
- No set supplement protocol handed to patients
- An advisory written for clinicians, not patients
- By the advisory's own account, nutrition support alongside these drugs isn't widespread
- A randomized trial on multivitamin support for GLP‑1 users still underway
Seventeen years apart.
Your prescriber isn't hiding anything. 83% of physicians cite time as a barrier to nutrition counseling, and 62% say they lack the nutrition training for it. Being told these side effects are common is accurate. Common just doesn't mean there's nothing to do about what you're eating less of.
22.4%
diagnosed with a nutrient deficiency within 12 months (12.7% by month 6)
16–39%
less energy intake than placebo
33.4g
average measured daily protein intake
~2×
as many stop over side effects as over cost (26.8% vs. 14.4%)
83%
of physicians cite time as a barrier to nutrition counseling
BEFORE YOU GO ANY FURTHER
Your medication isn't the problem. It's doing exactly what it should.
Neither protocol below is a reason to question your medication, second-guess your decision to take it, or consider stopping. And neither is a "natural GLP‑1." The FTC has named fake supplements the single largest category of GLP‑1 fraud, and the FDA sent five warning letters to knockoff makers in a single day in December 2024. If you've scrolled past dozens of them, your pattern-matching is working correctly.
WHAT NEITHER PROTOCOL IS
- Not a replacement for your medication
- Not a suggestion your medication is hurting you
- Not a "natural alternative" or GLP‑1 activator
- Not a weight-loss product
- Not a reason to change your dose
WHAT THEY ARE
- Built for what eating less leaves short — not a fix for damage
- Named ingredient forms, with every single-nutrient dose on the label
- Third-party tested, with a Certificate of Analysis for every batch
- Taken alongside your prescription
- Something to raise with your prescriber, not hide from them
- Cancellable in two clicks
WHAT'S ACTUALLY AT STAKE
The top reason people stop isn't the price. It's how the medication feels.
Side effects are the largest documented reason people stop taking these medications. In one real-world analysis of 1,374 patients, 26.8% stopped because of adverse reactions, versus 14.4% over cost. Nausea is the number one stated reason. Up to 85% of patients are off them within two years.
And stopping doesn't just pause things. A meta-analysis of eight randomized trials found an average of 9.69 kg (about 21 lb) regained in the year after stopping. In the semaglutide trial that followed people after they stopped, about two thirds of the weight lost had come back within a year.
Nobody starts a GLP‑1 planning to quit. It usually happens one rough week at a time.
What we're not claiming: neither protocol treats side effects, and neither is proven to keep anyone on their medication. They're built to support digestion and nutrition during the months that tend to be hardest.
HOW IT TENDS TO GO
- FIRST 6 MONTHS31.7% stop within 180 days — and side effects account for nearly twice as many stops as cost.
- BY YEAR 2Up to 85% of patients are no longer taking the medication.
- 1 YEAR AFTER STOPPING9.69 kg (about 21 lb) regained on average across eight trials. In the semaglutide follow-up study, about two thirds of lost weight.
Two different studies behind the last row — see Sources.
THE PROTOCOLS
Two problems, two products.
PROTOCOL ONE — DIGESTIVE COMFORT & NUTRIENT REPLETION
DAILY PROTOCOL
Understory™ Daily Micronutrient & Digestive Protocol
Two capsules with dinner. Built for a slowed gut and a collapsed appetite — a different problem than the one a drugstore multivitamin was designed for.
- ✓ Iron as ferrous bisglycinate chelate, 18mg — not the ferrous sulfate in most multivitamins
- ✓ B12 as methylcobalamin 525mcg, folate as L‑5‑MTHF 400mcg DFE — active forms, no conversion step
- ✓ LactoSpore® probiotic, 6 billion CFU, plus a digestive comfort blend of ginger, peppermint, bromelain and DigeZyme®
- ✓ Zinc bisglycinate 20mg, D3 50mcg, magnesium 200mg, BioPerine® 5mg
- ✓ Every single-nutrient dose printed on the label
- ✓ Third-party tested, with a Certificate of Analysis for every batch
- ✓ Taken with your evening meal — timing guidance included, because you'll want it
$48.00/month, subscribe & save
≈ $1.60/day · one-time purchase $60.00 · 3-month supply $150.00 (free shipping) · cancel anytime, no phone call
You're already carrying the expensive line item. This is the cheapest one in the whole endeavour, and it's the one that supports the rest.
Start This Protocol →
PROTOCOL TWO
COMING SOON
Details on the second protocol land here once it's ready to launch.
COMING SOON
Our Second Protocol
We're finishing testing and paperwork on a second protocol for a different part of this same gap. Leave your email and we'll let you know the moment it's live — no spam, one email.
60-Day Money-Back Guarantee — a full titration cycle to judge either protocol, not a week that catches you mid dose-change.
THE SOLUTION
What's in each one, and what it's there to do.
Every ingredient, grouped by the job it does, explained in plain language.
PROTOCOL ONE — TWO CAPSULES, FOUR JOBS
01 — DIGESTIVE COMFORT
For a stomach that empties slower than it used to
When food sits in your stomach longer, it's more likely to feel heavy, gassy, or just off. This group helps digestion keep moving along comfortably.
- Ginger root extract — a traditional stomach-settler. The strongest ginger research uses more than a blend this size can hold, so we don't borrow those results.
- Peppermint leaf — a long-standing after-dinner herb for digestion.
- Bromelain & DigeZyme® — digestive enzymes that help break down protein, carbs and fats, so less of that work is left to a slower system.
Digestive Comfort & Soothing Blend 325mg
02 — THE PROBIOTIC
A probiotic built to survive the trip
Most probiotics are fragile. LactoSpore® is a spore-forming strain (Bacillus coagulans MTCC 5856), which means it survives stomach acid and doesn't need refrigerating.
- A studied strain — the same strain used in placebo-controlled digestive-comfort trials, which gave people 2 billion spores a day.
- A disclosed dose — 6 billion per serving, listed on its own line rather than tucked inside a blend.
LactoSpore® 166mg · 6 billion CFU
03 — ENERGY
For the kind of tired that creeps up slowly
B vitamins are how your body turns food into usable energy. Eat a lot less and you get a lot less of them, and the tiredness builds slowly enough that it's easy to blame on something else.
- B12 (methylcobalamin) — helps your body make red blood cells and keeps nerves working normally. It absorbs about the same as the common form; the difference is that more of it is kept rather than flushed out.
- B6 (P5P) — the active form of B6, which your body uses to turn protein and carbs into energy.
- Folate (L‑5‑MTHF) — between a third and a half of people carry a gene variant that slows how well they convert regular folic acid. This form skips that step.
- Ashwagandha — an herb traditionally used for everyday stress, part of the Energy & Vitality Complex. Not for use during pregnancy or nursing; check with your provider if you have a thyroid or liver condition.
B12 525mcg · B6 26mg · Folate 400mcg DFE · Energy & Vitality Complex 126mg
04 — REPLETION
Putting back what smaller meals stop delivering
These are nutrients that commonly run short when you're eating less overall, because they mostly come from the foods that get pushed off the plate first: meat, eggs, dairy.
- Iron (bisglycinate) — carries oxygen around your body. The form matters: in two randomized trials, black stools were reported by 8% of women taking bisglycinate, versus 31% on the ferrous sulfate found in most multivitamins.
- Zinc (bisglycinate) — supports immune function, taste, and normal skin and hair. In a small crossover study, this form was 43% more bioavailable than zinc gluconate.
- Vitamin D3 — supports bones, muscles and immune function. Vitamin D is the deficiency diagnosed most often in GLP‑1 patients.
- Magnesium — supports normal muscle and nerve function, and it's a mineral many adults already fall short on.
- BioPerine® — a black pepper extract that raises blood levels of some nutrients taken with it. In one study, peak vitamin B6 was 2.5× higher at two hours — and B6 is in this formula.
Iron 18mg (100% DV) · Zinc 20mg · D3 50mcg · Magnesium 200mg (48% DV) · Biotin 5mcg · BioPerine® 5mg
PROTOCOL TWO
COMING SOON
Our second protocol is in final testing. Details land here the moment it's ready.
WHAT YOU NEED, AND WHEN
Nobody hands you a calendar for this. So here's ours.
What's happening changes month to month, and so does what matters — for both protocols. Find where you are.
The first hit
Nausea, early satiety, and often the first stretch of constipation. A lot of people don't initially connect the symptoms to the medication at all — they assume they've caught something, or that it's stress.
This is also when you're told it's temporary. For some people it is. For a lot of people, the next dose increase resets the clock before it ever fully settles.
WHAT MATTERS NOW → Digestive comfort (Protocol One). Repletion and lining support aren't the pressing issue yet.
The climb, roughly every four weeks
Nausea tends to peak at each step up and settle around week six on a stable dose — which is often right about when the next increase arrives. It isn't a sign anything's going wrong. It's the predictable shape of titration.
WHAT MATTERS NOW → Consistency through the spike, not reaching for a fix once it's already bad.
The hardest stretch
Most people who discontinue do so within the first three months, and adverse reactions — not cost — are the largest documented reason. Staying comfortable enough to stay the course is the whole thing here.
This is also usually when the second, quieter worry opens underneath the first: is this actually good for me?
WHAT MATTERS NOW → Both halves. Comfort, repletion, and the gut-lining gap all start overlapping here.
When the deeper gaps surface
By six months, 12.7% of GLP‑1 patients — roughly 1 in every 8 — have been newly diagnosed with a nutritional deficiency, most commonly vitamin D. Fatigue and general depletion tend to become more noticeable than the digestive symptoms by this point. The gut-lining fuel gap has usually been running quietly the whole time, since it doesn't announce itself the way nausea does.
This is also when hair shedding shows up for some people. A 2026 systematic review ties it to rapid weight loss and shortfalls in protein, iron and zinc. It typically starts two to four months after the trigger, peaks around three to six, and is generally temporary.
This is the stage where "am I healthy, or just smaller?" becomes the real question.
WHAT MATTERS NOW → Repletion (Protocol One) and lining support (Protocol Two). Worth asking your prescriber about a panel.
Maintenance
Deficiency diagnoses keep climbing through the first year: 22.4% by twelve months, or nearly 1 in every 4, up from 12.7% at six. The rate nearly doubles inside a year. Requirements don't stop just because the dose is stable, and neither does the tissue turnover Protocol Two supports.
WHAT MATTERS NOW → Consistency on both protocols, and lab work if you can get it.
THE DIFFERENCE
Against what you've probably already tried
Some of what's below genuinely overlaps with what's already in your cabinet. We'd rather say that than have you notice.
PROTOCOL ONE VS. THE USUAL ALTERNATIVES
| PROTOCOL ONE | DRUGSTORE MULTIVITAMIN |
CUTTING SULFUR FOODS |
DOING NOTHING |
|
|---|---|---|---|---|
| Formulated for a GLP‑1‑slowed gut | ✓ | ✗ | ~ | ✗ |
| Gentler iron form (bisglycinate) | ✓ | ✗ typically ferrous sulfate | n/a | n/a |
| Supports digestive comfort directly | ✓ | ✗ | ~ burps only | ✗ |
| Addresses the nutrient gap too | ✓ | ~ often cheaper forms | ✗ cuts eggs & red meat | ✗ |
| Active B12 & folate forms | ✓ | ~ often cyanocobalamin & folic acid | n/a | n/a |
| Spore-forming probiotic at a disclosed dose | ✓ | ✗ | n/a | ✗ |
| Third-party tested, COA for every batch | ✓ | ~ varies | n/a | n/a |
| 60-day money-back guarantee | ✓ | varies | — | — |
REVIEWS
From people on GLP‑1 medications
Including the ones that weren't glowing.
★★★★★
Dinner doesn't sit like a brick anymore
I honestly didn't expect a supplement to do much. A few weeks in, my evenings are a lot more comfortable and I'm not dragging by mid-afternoon the way I was around month four. Two capsules with dinner is easy to remember.
Denise R.
★★★★★
Didn't expect a capsule to help this much
My wife found this after I complained for weeks about how uncomfortable dinner had gotten. About two weeks in, my stomach felt noticeably calmer, and I stopped dragging by mid-afternoon. Two capsules, easy to remember.
Marcus T.
★★★★★
Works for me, capsules are big
Stomach is calmer and bathroom stuff is more predictable. Taking a star off because the capsules are on the larger side and I have to take them one at a time with food.
Karen L.
★★★★★
Couldn't tell a difference
I wanted to love this. Took it every day for about six weeks and I genuinely can't say it did anything for me. No side effects either way, but I'm not reordering. The refund went through without any back and forth, which I appreciated.
Jen P.
★★★★★
My doctor was fine with both
I brought the bottle to my next appointment because I was nervous about mixing anything with my shot. She looked at the label and said go ahead. Four months in, I feel steadier day to day than I did before I started it.
Angela M.
FAQ
Questions from people on GLP‑1 medications
Honest answers. No hype. Grouped by protocol.
PROTOCOL ONE — DIGESTIVE COMFORT & NUTRIENT REPLETION
It's the right question, and the answer starts with your medication's own label. The prescribing information for semaglutide and tirzepatide says these drugs slow stomach emptying and can affect how other things taken by mouth are absorbed. In the drug-interaction studies on those labels, the effects measured weren't clinically meaningful for most medications tested.
There are exceptions worth knowing. For tirzepatide, the label warns that birth control pills may work less well after starting and after each dose increase. And medications where small absorption changes matter need closer watching. Those labels don't study supplements specifically, so that's why we give you timing: two capsules with your evening meal, well away from oral semaglutide, which is taken first thing in the morning on an empty stomach. If you take anything where timing matters, check with your prescriber.
Half of it genuinely is, and we'd rather concede that than have you spot it. The difference is the forms, and each one has a number behind it:
Iron: bisglycinate instead of ferrous sulfate. In two randomized trials, 8% of women on bisglycinate reported black stools, versus 31% on sulfate. Folate: L‑5‑MTHF, because between a third and a half of people carry a gene variant that slows folic acid conversion. Zinc: bisglycinate, 43% more bioavailable than gluconate in a small crossover study. Then there's the digestive-comfort half and a spore-forming probiotic, which no standard multivitamin attempts at all.
Two capsules, once a day, with your evening meal — not a drink, not a three-bottle system. That matters more than it sounds: in oral iron trials, up to 40% of people don't keep taking it, mostly because of stomach side effects. It's why the iron here is bisglycinate and why it goes down with food.
Fair — half of all GLP‑1 users say the medication itself is difficult to afford. On subscription this works out to about $1.60 a day. One-time purchase is available at $60.00, or $150.00 for a 3-month supply with free shipping and no subscription required — and the subscription itself cancels from your account in two clicks with no phone call.
Skip it if you're pregnant, nursing, or under 18. Check with your provider first if you have a thyroid or liver condition (the formula contains ashwagandha), or any medical condition that affects how you handle supplements.
At 18mg, this is a full day's iron. If you're a man, postmenopausal, or already taking iron separately, ask your provider before adding it — more iron isn't better, and your own bloodwork should decide.
Warning: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep this product out of reach of children. In case of accidental overdose, call a doctor or poison control center immediately.
FREE, NO PURCHASE
Questions to bring to your next appointment
A one-page printable covering both protocols: what to ask your prescriber about nutrient and gut-lining monitoring, which labs are worth requesting, and how to raise the symptoms most people don't bring up.
ONE EMAIL WITH THE PDF. UNSUBSCRIBE ANY TIME.
Eating less is the point.
Running short doesn't have to be.
Two protocols for the digestive, nutrient, and gut-lining side of GLP‑1 treatment, taken alongside the medication that's already doing its job.
See Both Protocols →Try either one for 60 days. If it isn't for you, you get your money back.