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Comprehensive evaluation should include complete thyroid panel (not just TSH), fasting insulin and HOMA-IR for insulin resistance assessment, cortisol testing for adrenal dysfunction, sex hormone panel (testosterone, estrogen, progesterone), sleep study if sleep apnea is suspected, medication review for weight-promoting drugs, and psychological evaluation for eating disorders or food addiction

The dynamic interactions of post-translationally modified chromatin proteins, covalently modified cytosines inside DNA (also known as the fifth and sixth bases) and non-coding RNA define the complex pattern of gene expression beyond the four bases of DNA (Jenuwein and Allis, 2001

Vomiting: Some people may experience vomiting, especially when starting the medication

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