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Given the strong female predominance of AITD and the midlife rise in metabolic risk during the menopausal transition, targeted trials in perimenopausal and postmenopausal women are warranted, with attention to hormone status, body-composition change, cardiovascular risk, and dose adjustments of thyroid medications during weight loss [1,2,66] (Figure 2)

Persistent vomiting or diarrhea raises dehydration concerns

Common side effects include gastrointestinal symptoms such as nausea, vomiting, diarrhoea, abdominal pain, and decreased appetite