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The similarity of symptoms is why many experts recommend baseline vitamin B-12 testing when hypothyroidism is first diagnosed and periodically afterward

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✓ Consider increasing when Side effects are mild and controlled Appetite suppression is incomplete most of the week Weight trend has been flat for 3–4 consecutive weeks ⏸ Consider holding when Nausea, reflux, constipation, or fatigue is lingering You are already getting full faster and eating less Weight is still trending down, even slowly “We share the journey with the patient