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Referral to an endocrinologist is recommended for patients who are pregnant or planning pregnancy, pediatric patients, those with nodules or goiter, discordant laboratory results, persistent symptoms despite normal TSH, or suspected myxedema coma (requiring urgent care)

It is expected to match the original in strength, dosage form and clinical performance

Ramping up the dose too quickly shocks the system, leading to much more intense side effects like severe nausea and vomiting

However, certain situations may merit GLP-1 use during breastfeeding

Good food sources include: Fruits and vegetables (especially leafy green vegetables) Lentils Chickpeas Most beans Your doctor may also want you to take a folic acid supplement, as well as a supplement for some of the other B vitamins such as vitamin B6 and vitamin B12