"Four Stone Down, Dreading Day Six": A UK Vein Health Doctor Finally Names the Weight-Loss Jab's Hidden Side Effect (and Why Kiwis, Prunes and Laxatives Were Never Going to Fix It)
The pen works. The jeans prove it. But five or six days after every injection comes the day nobody put in the welcome email. And before anyone gives up the best decision they ever made, it helps to picture the one thing every remedy in the kitchen has in common, the 50-year-old French answer most UK surgeries have never been offered, and the 21-day test that shows, on anyone's own calendar, when jab week becomes just a week.
Read this while it's still up. Pages that talk honestly about what the weight-loss injections do at the other end of the week tend to get reported and pulled, and we can't say how long this one will stay public in its current form. If any of it sounds like your jab week, read it to the end now.
She has spent years listening to patients who tell their doctor everything, except this.
Nadia De Licht
Sunday night, 10.42pm.
I don't know which part of this scene will sound most like yours. I only know that one of them will.
A woman stands at the fridge with the pen in her hand. Two minutes, done. Four stone down since last year. A few pounds from goal. Jeans two sizes smaller hanging on the wardrobe door like a trophy.
And she's thinking about stopping.
Not because of the nausea: that faded months ago. Not because of the money, though it's serious money. Because of the other day. The one that comes five or six days after every injection, the one her provider never mentioned, the one she can't say out loud even to the people who cheer her weight loss every single week.
Days one to three: nothing moves. Day four, day five: still nothing. Day six: the big push. And this week, it hurt.
There was a sting that stayed for an hour. There was a moment, before she flushed, when she looked.
I'm Dr Nadia De Licht, and I work in digestive and vein health. I have heard the Sunday-night story, in one form or another, more times than I can count. The names change. The sentence underneath never does.
"The jab is the best thing I've ever done. So why am I thinking about giving it up over this?"
This page is my answer. The people who say that sentence have all been handed the same three remedies, and all three are half right. The first is harmless. The second wastes money. The third is the trap, and it's the reason day six keeps coming back long after the kitchen cupboard has filled up with prunes, sachets and creams.
Before we go any further, though, a check. Because this page is not for everyone.
Who this page is for (and who it isn't)
As a person who has already done the hard part (started the injections, stuck with them, watched the numbers fall), I'd ask you to read the next lines slowly. Everything has slowed down since you started. And the end of your jab week now comes with soreness, swelling, or the sting of piles you thought you'd left behind years ago. Then this page is for you.
It is not a substitute for a check-up. If you've noticed new or changed bleeding, a change in bowel habit that doesn't settle, or nobody has ever actually looked: see a GP first. Always. These things have boring causes far more often than frightening ones, but that is a judgement for a doctor with their eyes on the problem, not for a page on the internet.
Checked, reassured, told it's "just piles, watch the constipation", and still living the same week on repeat? Then stay, and let's find out together why.
"I tried every remedy going"? You're not the only one. Not even close.
For a while I thought this was my clinic's problem. Then I started reading the forums where British people on the injections actually talk (Mumsnet, the Mounjaro and Wegovy subreddits, the Facebook groups), and what I found is worth reading word for word, typos included:
"I have had constipation from week 1 and I am now 9 months in. I tried every remedy going from prunes, ispaghula husk, kiwis, bran etc but nothing helped."
"Me too. I need to take Movicol twice a week minimum which sorts it out. Prunes, prune juice, everything else etc just don't work enough."
"5mg has acted like concrete in my bowels 😬 Drinking loads of water and started Laxido yesterday. Up in the night with abdo pain. Daytime sore arse from a tear whilst expelling some concrete (tmi sorry)."
"The gift that keeps on giving: I am now the proud owner of a bunch of painful heammaroids."
Real public posts, quoted verbatim. They describe the problem. None of them mention any product.
And then one woman wrote the sentence that made me sit back, because it's the exact moment this page exists for:
"I've also been very constipated (even got hemorrhoids) … I'm thinking of stopping this week"
Read that again. She isn't thinking of stopping because the jab isn't working. It's working brilliantly. She's thinking of throwing away the thing that changed her life because of what the end of each week does to her bottom.
Hold that thought. Underneath every one of those posts there is one thing none of them can see, and every remedy they list has the same blind spot. We'll get there together in a minute. And as you read the next list, you may wonder how many of the lines could have been written in your own kitchen.
How many of these are yours?
- You know your jab day. And your body knows the other day: the one that comes five or six days later.
- Days one to three, nothing moves. Then the "big push".
- Kiwis, prunes, psyllium or a laxative sachet are somewhere in your kitchen right now.
- You're more or less "regular" again, and it still flares anyway.
- By 11am in a long meeting, you shift in your seat. You've started noticing chairs.
- You've thought, at least once: maybe I should just stop the injections.
Four or more? What follows is about you.
The remedy graveyard (and the week resets anyway)
When I ask "what have you already tried?", the list is the same in Leeds as it is in Kent. Nobody on it has been sitting on their hands.
Kiwis and prunes. "I eat more prunes, apricots and kiwis than I know what to do with." Her words, not mine. They help the stool. Sometimes.
Psyllium, fibre, three litres of water. Sensible. Keep doing it. It makes the push smaller. It doesn't undo the pushes already done.
Movicol, Laxido, senna. They work, on the right thing. A laxative softens what's leaving. It was never designed to do anything else.
The cream from the chemist, bought at the self-checkout, obviously. It calms the sting on the surface for a few hours. The swelling underneath is still exactly where it was.
Going "low and slow" on the dose. Some people stay on a starter dose for months, scared of what the next step up will do to their bowels. Paying full price for half the result, to protect their bottom.
And then there's the advice everyone gets, from everyone: "drink more water, eat more fibre, keep moving." As if you weren't already living like a saint.
Here's the pattern, and as you look back over that list you'll see it yourself. Every single thing on it works on the stool. Nothing on it works on the vein. Not because anyone was careless. It's because nobody told them there were two sides to the problem at all.
The patient who made me write this page
I'll call her Dawn, because that isn't her name.
Dawn, 52, four and a half stone down in fourteen months. The success story of her whole family. She came to my clinic with a carrier bag (I'm not exaggerating) of everything she'd bought for her problem. Sachets, suppositories, two creams, a sitz bath still in its box.
I'll be honest about what I believed then: jab slows the gut, constipation causes piles, fix the constipation, job done. I had said it myself, more than once.
Then Dawn said something I still ponder most weeks.
"The Movicol works now. I go most days. And it still flares every jab week. So it's not the constipation any more, is it? Then what is it?"
That's the bit nobody writes in the welcome email. The remedies fixed the stool side of the problem. Nobody had ever treated the vein side at all. And as long as the vein side goes untreated, the week keeps resetting, softer stools or not.
So we worked through, together, what a jab week actually does down there. That was the picture that changed how I talk to every patient on the injections, and it's where the third half-truth falls apart.
The three things everyone on the jab is told (and the one that keeps day six coming back)
The first: "drink more water, eat more fibre." Half right. It helps what passes. It was never the whole answer.
The second: "a laxative will sort it." Half right. It sorts the stool. Piles are not made of stool.
The third: "once you're regular again, the piles will settle on their own." This is the trap. Dawn believed it. I believed it. Almost everyone in those forums believes it.
Here's the boring medical fact, straight from the NHS: piles (haemorrhoids) are swollen blood vessels: little veins in and around your back passage. And one of the main things that makes them swell is straining.
Now let me give you one image to keep: a garden hosepipe with a kink in it.
When a hose kinks, the water doesn't stop. It bulges behind the kink. The rubber stretches. Do it once, it springs back. Do it every single week, and the wall of the hose gets a little slacker each time, until it bulges at the slightest pressure.
That's your jab week. Here's the cycle:
1The jab slows everything down
That's not a malfunction. It's partly how it works. Food sits longer, you eat less, there's less to move and it moves slower. Days one to three: nothing.
2The week builds the pressure
By day five or six, what finally has to leave is harder and drier. One woman called it concrete. She wasn't exaggerating much.
3The big push hits the same veins
Every push sends pressure into the small veins of the back passage, and the hosepipe bulges. Then the week resets, and it happens again. Once a week. 52 times a year. On the same veins.
A laxative straightens the hose for a day.
The cream soothes the outside of the rubber.
Neither one makes the hose any stronger. Nobody in your routine is treating the vein.
And that explains the thing that confuses almost everyone, including, maybe, you.
"But I'm not even constipated any more, and it still flares"
This is Dawn's question, and it's the question I hear from everyone who has done everything right. The Movicol works. They're regular. And the piles are still there. Some people flare after a week of perfectly soft, daily, textbook mornings, and conclude they must be doing something wrong.
They're not. Think of the hosepipe: after months of weekly pressure, the vein wall is already stretched. A stretched vein doesn't need "concrete" to bulge any more. It flares at a fraction of the pressure it used to handle. One woman on the injections put it perfectly: even slightly constipated, and it feels like everything is on fire.
That's why "being regular again" didn't give you your old bottom back. The stool side of the problem is fixed. The vein side has never been treated at all.
If that last sentence landed like a brick, good. That's a year of jab weeks suddenly making sense. So the honest question isn't "which laxative next?". It's: does anything actually work on the vein itself?
For fifty years, one country has had an answer.
The vein answer France has used for fifty years
In France, when a patient walks in with piles, doctors have been prescribing the same thing since the early 1970s: two citrus flavonoids called diosmin and hesperidin, in a precise 90-to-10 ratio, micronised. It's one of the most dispensed treatments in French pharmacies. Generations of French patients have taken it as a matter of course.
Cross the Channel, and almost nobody has heard of it. In the words of one UK Reddit user: "Most physicians in the UK don't seem to have heard of it, pharmacists don't supply it."
It's a capsule, by mouth. Not a cream, not a laxative. It does nothing to the skin and nothing to your stool, which matters when your gut is already being reorganised by a weekly injection. It works on the other side of the problem: the vein wall (the "snap" of the rubber in our hosepipe) and normal circulation in exactly the kind of small vessels piles are made of.
The evidence, with its limits. A meta-analysis of 14 clinical trials, over 1,500 patients (Alonso-Coello and colleagues, 2006), found that flavonoids of this family reduced bleeding, pain and recurrence in people with haemorrhoid complaints. Individual trials vary in quality, and researchers rightly call for better ones. I'd rather you heard that from me than from a refund form. That's why I write "studied", never "miracle". Anyone who promises you a miracle for this problem is selling you one.
So why have you never been offered it? Not because anyone hid it. The French brand was simply never brought to the UK market, and the British answer to piles has always been fibre, water, cream, and surgery if it gets bad. There is a lot of room between cream and surgery. In France, that room has a name.
While that makes sense, the natural next step is simply to see what the UK version looks like.
See the UK version: dose and label →Before you buy any diosmin: four things to check
Because here's the next trap, and I'd rather we walked round it together. Type "diosmin" into Amazon and you'll find dozens of cheap tubs with thousands of reviews. I've read the labels. Most quietly fail the standard the French prescription product set, and the people who buy them conclude "diosmin doesn't work" when what they took barely contained it.
Before buying any diosmin (including the one I'm about to recommend), check four things:
- Micronised. The studied form was absorbed at nearly double the rate of ordinary powder. The £9 tub shares a name, not a particle size.
- The 90:10 ratio, printed. 900 mg diosmin + 100 mg hesperidin per daily dose. Not a "citrus bioflavonoid complex" with the dose hidden.
- Milligrams in plain sight. If you can't find the actual dose per capsule in ten seconds, that's your answer.
- Independent lab testing. Every batch checked by an outside lab, not just the maker's word.
If a page doesn't give you all four, close the page. Any page.
Diosmin & Hesperidin 900/100 by Vital Rems
The one I point patients to is the Diosmin & Hesperidin 900/100 from Vital Rems, because it's the only one I've found on the UK market that passes that checklist in full:
- Micronised diosmin, 900 mg per daily dose.
- Hesperidin 100 mg. The 90:10 ratio printed on the label, exactly as studied.
- Two ingredients, full doses. No "proprietary blend", nothing hidden.
- Independent lab testing on every batch.
And the part that matters most for a person on the injections: it asks nothing of you. Two small capsules with breakfast, next to the psyllium and the magnesium you're already taking. Zero calories, so it doesn't touch your deficit. It's not a laxative, so it won't add chaos to a gut the jab has already reorganised. It works on the other end of the problem, the vein, and leaves everything else alone.
Plainly: it is NOT a cream, a numbing gel or a laxative. It is NOT the French brand, and nobody should tell you it is. It IS the same two flavonoids, the same ratio, the same daily dose, micronised, with an English label.
And if you're expecting day six to vanish by Friday, skip it. A wall that took months of weekly pressure to stretch doesn't firm up over a weekend. This is for people willing to give it three full jab cycles. Plain box, discreet billing. Nobody needs to know about the jab, or about this.
Check availability →
The Jab-Week Test
Don't judge it on my words. Judge it on your calendar.
You already know your jab day. From today, that day has a second job: it's not just the day of the pen any more. It's the start of a measurement. Mark it, and judge what day five and day six feel like, cycle by cycle, on your own numbers, not mine.
What to expect, honestly
First daysProbably nothing
I'm telling you now because this is where people give up. If anything, you'll notice you're watching the calendar harder than ever. That's the test starting. (If a product promises relief "in minutes", it's a numbing cream. That's a different job.)
Weeks 1-2The flares calm down
In the research, bleeding and acute symptoms are where these flavonoids showed effects first. Keep the fibre and water going: they're the other half of the job.
Day 21The first verdict
Most customers feel relief within 21 days: three full jab cycles. Compare your third jab week against your first. That's your number, not mine.
Picture one evening in that third week. I'm not sure just how clearly you can already imagine it: Sunday night, pen out of the fridge, two minutes, done. And nothing to dread about Friday.
Dawn told me, around week five, that she'd had to check her diary to remember which day her "bad day" used to be. "I'd forgotten which day I was supposed to be scared of."
And notice what quietly changes with that. Right now, part of you is "the person who dreads day six": the one who scans every room for the soft chair, who plans the diary around their bowels. The people who treat the vein stop being that person. They go back to being what they were becoming anyway before this side effect interrupted: a person who's four stone down and simply getting on with it, whose week has seven ordinary days. That's who the capsules are for. Not for your piles. For her.
Any new or changed bleeding during those weeks still goes to your GP first. This supports the vein wall. It doesn't replace a doctor's eyes.
What people on the injections write after
"I nearly came off my jab over this, which sounds mad now. I was 'regular' thanks to Movicol but still flaring every single week. Six weeks in with these and my last two jab weeks have been… just weeks. Still on my jab, still losing."
"The plain box matters more than you'd think. Nobody in my house knows about the injections, let alone the rest. Capsules go next to my psyllium at breakfast and that's it. Day 6 used to be a write-off. Last week I genuinely forgot which day it was."
Do the maths
Now that the third jab week feels that close, the practical question is simply how to get there. So let's count, together, what day six has already cost.
In money: you're already spending serious money every month on the pen, plus the prunes, the sachets, the creams quietly added at the self-checkout. All of it on the stool side of a vein problem. Then the cost with no number on it: the chairs you scan for, the meetings you shift through, and the thought (at least once) of giving up the best decision you ever made.
Diosmin & Hesperidin 900/100 is sold as a single bottle, or as a 3-month or 5-month programme. The programme is where the price falls hardest: the full 5-month service works out at well under £1 a day, a fraction of what the pen costs you, to protect the part of the journey the pen can't.
Why the programme? The first weeks calm the flares. The months after are when the wall firms up and the flares stop arriving. One bottle tends to end in "it helped and then it came back". The full programme tends to end in "I'd forgotten about it".
No contract. Your choice. Pay once and that's it, or pick Refill & Save for the lowest price and pause or cancel in two clicks.
I'm not asking for a yes. Just a maybe.
Many guarantees only apply to sealed bottles: try it, and you can't return it. This is the exact opposite. The 99-Day Empty-Bottle Guarantee: ninety-nine days, and if your jab weeks haven't changed, write to customer service and you get your money back. Even on an empty bottle. No hoops, no hidden subscription, free UK tracked shipping.
So, while you're still deciding, notice that the decision isn't "does this work". It's smaller: "am I willing to find out, with someone else carrying the risk". Ninety-nine days is more than four full rounds of the Jab-Week Test, with margin. Mark your jab days. Decide on your own numbers.
The only real risk is doing nothing, and reading this page again in a year, another 52 day sixes from now.
Choose your supply: 99 days to try it →✓ FREE tracked shipping · ✓ 99 days, even on an empty bottle · ✓ No contract: pay once, or refill and cancel anytime
Before you decide
Now, as you sit there reading this (possibly on the loo, possibly at 10.30 at night with the house quiet), we've walked a long way from that Sunday at the fridge. So let me say the next part plainly, as a person who has already done the responsible thing.
I'm not sure just how clearly you can already picture a jab day a few weeks from now: pen out of the fridge, two minutes, done, and no part of you counting forward to Friday.
And I don't know which feeling will reach you first that evening. The relief of a week with seven ordinary days. The quiet of a mind that's stopped planning around a bathroom. Or the slightly silly pride of having fixed the one thing nobody warned you about, without giving up the thing that's working.
It doesn't really matter why you choose to start, for whatever reasons feel right to you. What I do know is this: you didn't start the injections to trade one problem for another. You're four stone closer to the body you wanted. Don't let the last stretch be decided by the one side effect nobody prepped you for.
So you can simply allow yourself to make the decision you already made somewhere around the hosepipe. Choose your supply on the next page: the 5-month programme if you want the full job done.
The choice is yours. Nobody on this page can convince you of something you already know.
Choose your supply →✓ FREE tracked shipping · ✓ 99 days, even on an empty bottle · ✓ No contract: pay once, or refill and cancel anytime
Two ways this can go
So now that you know what day six actually is, there are two ways this ends.
The first: close the page, keep the kiwis coming, and hope that one week it stops on its own. For the people in those forums it has been nine months, a year, longer. It doesn't, because nothing in that routine touches the vein.
The second: let someone else carry the risk for 99 days, and find out what a jab week feels like when it's just a week.
None of this was your fault. Nobody prepped you for it. But now that you know what day six is actually telling you, you're the one responsible for what it says next week.
This isn't about a bottle. It's about who takes the pen out of the fridge on Sunday: the person who dreads day six, or the person who's forgotten which day it was.
Keep the jab. Protect your bottom.
Important questions before you start
Still here? Good. These are the questions patients ask once they've decided; as you read them you may find your own already answered.
Can I take it alongside Mounjaro or Wegovy?
Diosmin and hesperidin are plant flavonoids taken with food. Not a laxative, with no effect on your stool. But you're on a prescription medicine, so the right person to confirm your personal situation is your prescriber or pharmacist: show them the label (diosmin 900 mg + hesperidin 100 mg daily). They'll recognise it: it's been dispensed in French pharmacies for decades.
I'm on blood thinners (warfarin, apixaban, aspirin). Can I take it?
Ask your pharmacist or GP first and show them the label. In 2026 the Canadian regulator flagged a possible link between diosmin and bleeding risk on anticoagulants. It's a question for them, not for this page.
Will it affect my pill, my HRT or other daily medicines?
If you take daily prescription medicines, check with your pharmacist or GP before adding anything new, this included. It's a two-minute conversation, and it's the right one to have.
I'm pregnant or breastfeeding.
Not recommended during pregnancy or breastfeeding.
I've seen blood. Can't I just take this?
No. New, changed, darker or heavier bleeding goes to your GP first, every time, even if you're "sure" it's piles. Once you've been checked, this page will still be here.
Is it a laxative? Will it upset a gut that's already on the jab?
It's not a laxative and has no effect on your stool. Take the capsules with breakfast. If you have a sensitive stomach, take them mid-meal rather than on the first bite.
How long before I can judge it?
Most customers feel relief within 21 days (about three jab cycles), so give it at least that before you judge it. Flare intensity usually speaks first (weeks 1-2). You have 99 days: more than four full tests.
What if it's not for me?
You have 99 days to try it. Even on an empty bottle: write to customer service (support@vitalrems.com) and you get your money back. No hoops.
Why isn't it in Boots or on Amazon?
Two reasons. We sell direct, so we can keep the price fair and honour the 99-Day Empty-Bottle Guarantee ourselves, with no middleman deciding whether you get your money back. And the cheap look-alikes on Amazon often skip what matters: the micronised form, the full 900/100 dose and third-party testing. Only buy it here.
Ordered after reading this exact page sitting on the loo at 11pm 🙈 Week 5 now. First jab week in over a year I haven't thought about it once. Why does nobody tell you this stuff?? The welcome email warns you about nausea and that's IT.
189The kiwi and prune routine ladies know exactly what I mean. I was doing EVERYTHING right and still dreading the end of the week.
41Sarah, thank you for writing this. You did everything right. The welcome email just only covers one end of the week. The other end is why this page exists.
57Honest question. Is this not just another supplement that does nothing? I've got a drawer full of things that were supposed to fix my gut on Mounjaro.
52I was exactly the same Mandy. The difference is everything in your drawer works on the stool. This is a capsule that works on the vein itself. Took about 3 weeks for me but my jab weeks have been normal since September. And the 99 days is real: I emailed to ask before buying and they confirmed, even opened.
96Tracey Bolton 3 weeks is fair enough. And 99 days means I'm not really risking much is it.
143 stone down on the pens, 5lb from goal and I was THIS close to stopping because of my bottom. Reading "you don't have to choose" made me cry a bit, not going to lie. Month 2 now. So glad I didn't quit.
154Had piles since my second baby (he's 14 😅), the jab woke them right up. 2 months on these + kept my fibre going. Night and day.
38Angela Hurst the jab waking up old ones is so real. Nobody warns you about that either.
22Not just the ladies. I'm 45, on Mounjaro since Feb, desk job, same story. The meeting chair line got me. 5 weeks in. The hosepipe bit makes complete sense once you read it: everything I'd tried was on the stool side.
61Same here mate. 52, lorry driver, on the jabs since spring. Sitting 8 hours a day plus the jab week was brutal. 6 weeks on these and the day after the big day is honestly ridiculous. Wish I'd found it sooner.
33I'm on apixaban as well as the jab. Can I take this?
17Donna, please ask your pharmacist or GP first and show them the label. The FAQ above explains why. It's a quick conversation and it's the right one to have before adding anything.
29For the sceptics: my mum lived in France for years and laughed when I showed her the label. Said every pharmacy there has this behind the counter and has done forever. Only us that's never heard of it.
118I said the same when I read that part. In France it's normal, here it's cream and hope for the best.
24Week 5 update for anyone sitting on the fence. Days 1 to 10 nothing, like the page says. Week 3 the flare after jab day was half what it usually is. This cycle, nothing worth mentioning. I checked my diary on Friday and realised day six had been and gone. Honestly cried a bit.
241This made me well up Sue. The forgetting which day thing. That's all I want.
39Jan Hollis give it the full 21 days Jan. I nearly gave up at day 10.
31Does it come in plain packaging? Nobody in my house even knows about the injections.
28Plain box Linda, nothing on the outside at all. Mine came with the post and my husband thought it was a phone case 😂
21This content does not replace medical advice. Any bleeding from the back passage should be assessed by a doctor before you take anything. If you are on prescription medication, including weight-loss injections and anticoagulants, speak to your prescriber or pharmacist before adding any supplement. Diosmin & Hesperidin 900/100 is a food supplement: it is not intended to diagnose, treat or cure any condition and does not replace a varied diet and healthy lifestyle. Do not exceed the recommended daily dose. Keep out of reach of children. Quoted sentences in the opening sections are real public online posts reproduced verbatim: they describe the problem and are not testimonials about any product. "Dawn" is a composite of patient accounts, with details changed. Individual results vary. 3,879 customers have already chosen Vital Rems.
Sources: NHS, Piles (haemorrhoids): causes and treatment · Alonso-Coello et al., Br J Surg 2006, meta-analysis, 14 trials, 1,514 patients · Garner et al. 2002, pharmacokinetics of micronised diosmin · Health Canada safety review, 2026 · Product label, Vital Rems.
