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Patience during titration is not optional
A comprehensive 2022 meta-analysis by Dicembrini et al
The ideal medical team includes: Endocrinologist: Manages thyroid function, monitors TSH and antibodies, adjusts levothyroxine, screens for thyroid nodules and cancer risk Obesity medicine specialist or prescribing clinician: Manages GLP-1 dosing, titration, and side effects Registered dietitian: Develops nutrition plans that address both autoimmune support and adequate intake on reduced appetite Communication between these providers is essential
*Routine preoperative fasting instructions are designed for the general population and typically assume normal gut motility
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