The following considerations, drawn from the authors clinical experience, aim to highlight the specific contributions of each professional within an integrated care approach: From the endocrinologists perspective, baseline evaluation involves assessing the patients eligibility for treatment through a detailed clinical history, identification of comorbidities and contraindications, and review of laboratory findings, including metabolic profile and renal, hepatic, and pancreatic function
In some cases, excessive intake of B12 may cause other side effects such as headaches, fatigue, dermatological issues, and nerve damage
Nature Reviews Endocrinology , 17(12), 757769
However, published case reports and a 2024 retrospective cohort in Thyroid (N=112 patients on stable levothyroxine who started semaglutide) found that 28% required a TSH recheck within 6 months because of new hypothyroid symptoms or rising TSH, compared with 9% in a matched control group not starting GLP-1 therapy [7]
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