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If patients experience new or worsening symptoms of hypothyroidismsuch as increased fatigue, cold intolerance, constipation, dry skin, or unexplained weight gain despite tirzepatide therapythyroid function testing may be needed to assess whether levothyroxine dose adjustment is required

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10.1053/j.gastro.2012.05.049 54 MonfeugaT.NorlinJ.BuggeA.GaalsgaardE

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Risk rises when factors accumulate, for example dose escalation, timing near large meals, existing reflux, or diabetic neuropathy, and a small subset of users, about 1 in 50 (2%), report persistent hiccups that need clinical attention