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Deficiency can be caused caused by inadequate intake, impaired absorption in the GI tract, and by certain medications

However, clinicians should remain vigilant for signs of excessive metabolic suppression or thyroid dysfunction, particularly in patients with pre-existing thyroid conditions or those experiencing symptoms beyond cold intolerance, such as severe fatigue, hair loss, or cognitive changes that might suggest thyroid hormone imbalance requiring investigation

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severe gastrointestinal disease (including gastroparesis)

Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1)

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