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There is no clear consensus on when to initiate drug management for MALFD

Spicy condiments may trigger reflux, heartburn, or nausea in some people on a GLP-1, especially when paired with larger or higher-fat meals, because GLP-1 medications slow gastric emptying and can make GI symptoms more noticeable (3)

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The indirect effects via SHBG would still be the primary mechanism to observe