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10.1186/s12933-014-0171-2 [DOI] [PMC free article] [PubMed] [Google Scholar] 17.Bethel MA, Patel RA, Merrill P, Lokhnygina Y, Buse JB, Mentz RJ, et al

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Clinicians should also consider alternative medical explanations for new-onset fatigue, including thyroid dysfunction, anemia, sleep apnea (which may improve or persist despite weight loss), chronic kidney disease, or cardiovascular conditions

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compounding does not reduce safety requirements or replace medical evaluation