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E.MarxN.et al (2019)

Food and Drug Administration (FDA) for obesity management, have shown efficacy not only in weight reduction but also in improving metabolic 10,11,12,13,14,15 and cardiovascular outcomes 16

A 2024 study from Rong Xus group at Case Western Reserve, published in Annals of Internal Medicine , analyzed EHR data from over 222,000 patients with type 2 diabetes and a history of tobacco use

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Standard semaglutide titration: Weeks 1-4: 0.25 mg weekly Weeks 5-8: 0.5 mg weekly Weeks 9-12: 1.0 mg weekly Week 13+: 1.7 mg or 2.4 mg weekly (target dose) Hashimoto's-adjusted approach: Weeks 1-6: 0.25 mg weekly (extended to allow thyroid monitoring at week 6) Weeks 7-12: 0.5 mg weekly (TSH check before increasing) Weeks 13-16: 1.0 mg weekly Week 17+: Assess whether higher doses are needed The extended timeline allows for thyroid function checks at each step, ensuring levothyroxine doses are adjusted proactively rather than reactively