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doi:10.1093/hmg/ddh076

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When to Seek Medical Advice Patients should contact their healthcare provider if they experience: Severe, persistent fatigue not improving with adequate nutrition and rest Inability to maintain adequate protein or caloric intake due to gastrointestinal side effects Signs of hypoglycemia (especially in patients taking insulin or sulfonylureas) Symptoms suggesting thyroid dysfunction Severe abdominal pain, especially if radiating to the back (possible pancreatitis) Right upper quadrant pain, fever, or jaundice (possible gallbladder disease) Persistent vomiting or signs of dehydration Concerns about excessive weight loss that should be evaluated individually These situations warrant clinical evaluation to distinguish normal treatment effects from complications requiring intervention