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In a study by Suchankova et al

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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Lancet (London, England) 404 , 20772093

Funding Statement This research received no external funding

Intestinal release of GLP-1 augments initial insulin secretion in vivo in part through a vagal-vagal reflex leading to cholinergic stimulation of islet beta cells

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