Pregnancy and breastfeeding - GLP-1 medications are not recommended during pregnancy or breastfeeding
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The counter-argument is that mechanistic evidence is strong, multiple lines of clinical evidence converge, and the risk profile at microdose levels is favorable

Theoretical potential benefits (currently unproven for rheumatoid arthritis and not studied at microdose levels): Possible anti-inflammatory effects through modulation of immune pathways Weight reduction, which may indirectly benefit joint symptoms in overweight patients Cardiovascular risk reduction, relevant given increased cardiovascular disease risk in rheumatoid arthritis (established in type 2 diabetes populations at therapeutic doses only) [28] Improved metabolic parameters in patients with concurrent metabolic syndrome Known adverse effects of GLP-1 receptor agonists at standard doses include: Gastrointestinal symptoms : nausea, vomiting, diarrhoea, constipation, and abdominal discomfort (very common, affecting more than 1 in 10 patients) Hypoglycaemia : particularly when used with other glucose-lowering medications Injection site reactions : erythema, pruritus, or nodules Pancreatitis : rare but serious, requiring immediate medical attention if severe abdominal pain develops Gallbladder disease : increased risk of cholelithiasis and cholecystitis Thyroid effects : thyroid C-cell tumours observed in rodents

Weight loss can get your periods back on a regular schedule, balance out your hormones, improve insulin resistance (which is a big factor in PCOS), and improve egg quality
A multicentre, randomised, double blind, parallel design, placebo controlled study to evaluate the efficacy and safety of uthever (NMN supplement), an orally administered supplementation in middle aged and older adults