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Physical or emotional trauma: Events such as surgery, injury, or significant psychological stress can trigger CFS

Use caution in patients with a history of anaphylaxis or angioedema to other GLP-1 receptor agonists because it is unknown whether such patients will be predisposed to serious reactions with semaglutide

Surgeons may remove part or all of the thyroid as a treatment for hyperthyroidism a large goiter thyroid nodules, which are noncancerous tumors or lumps in the thyroid that can produce too much thyroid hormone small thyroid cancers Radiation treatment of the thyroid Radioactive iodine, a common treatment for hyperthyroidism, gradually destroys thyroid cells

Solutions: Extend trial to 6 months before concluding inefficacy (some benefits take longer), increase dosing within safe ranges if using lower end, switch peptides (try Cerebrolysin if using BPC-157, or vice versa), add comprehensive eye exam to rule out progression versus peptide failure, consider peptides preventing worsening rather than producing improvement, discontinue if truly no benefit after 6 months rigorous trial