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A reasonable approach includes: Baseline thyroid function tests (TSH and FT4) before starting GLP-1 therapy Repeat testing at 812 weeks after commencing treatment, particularly if significant weight loss occurs Further monitoring at 6 months , then annually if thyroid function remains stable Additional testing if symptoms of thyroid dysfunction develop After any levothyroxine dose change, NICE NG145 recommends re-checking thyroid function in 68 weeks to assess the adequacy of the adjustment

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