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Not for domestic US flights TSA doesn't require documentation

This is especially important for individuals taking serotonergic medications, managing chronic conditions, or using multiple supplements at the same time

Kupcova Skalnikova H, Navarro R, Marsala S, Hrabakova R, Vodicka P, Gadher SJ, et al

However, clinicians should remain vigilant for signs of excessive metabolic suppression or thyroid dysfunction, particularly in patients with pre-existing thyroid conditions or those experiencing symptoms beyond cold intolerance, such as severe fatigue, hair loss, or cognitive changes that might suggest thyroid hormone imbalance requiring investigation