If you have neurological symptoms (pins and needles, numbness, balance issues), severe fatigue, unexplained weight loss, chest pain, breathlessness, or symptoms that are worsening, you should seek medical assessment promptly.
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Heart disease, uncontrolled hypertension, an overactive thyroid, glaucoma, and a history of substance use are all reasons to choose a different path, which is why we recommend an EKG and a full history before the first dose, then monitor blood pressure and response over the course of treatment
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