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42 The mechanisms of these complex effects are still being elucidated, and it is unclear whether there is a direct effect via GLP-1 receptors in bone cells or indirect effects mediated through the gut

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maintaining adequate fluid intake is important, and renal function should be monitored if severe vomiting or diarrhoea occurs Thyroid concerns : The MHRA advises caution regarding potential risks of thyroid tumours based on animal studies, though there is no confirmed evidence of increased thyroid cancer risk in humans at therapeutic doses

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