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NICE guideline NG145 recommends monitoring TSH every 68 weeks after any change in levothyroxine dose, and then annually once stable

"These findings add to an emerging body of growing literature reporting ocular complications with [anti-obesity medications] which warrants further scrutiny and urgent clarification for ophthalmologists," they wrote

thyroid cancer or hyperthyroidism, gastroparesis, pancreatic cancer or pancreatitis, MEN2 syndrome, or inflammatory bowel disease)

The low dietary folate intakes in patients with migraine could lead to disruption in mitochondrial function, energy production, and antioxidant defense, the key risk factors of migraine attacks incidence (68)

Fatigue : Some patients experience temporary tiredness during the initial weeks, particularly with rapid dose escalation

De plus, le glutathion peut chlater les ions mtalliques (comme le cuivre), cofacteurs essentiels de la tyrosinase, contribuant ainsi un mcanisme d'claircissement cutan au niveau enzymatique