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Previous studies showed that adiponectin expression in degenerative discs was decreased or absent while AdipoR1 and AdipoR2 expression increased or decreased with the Pfirrmann grade of degenerative discs (44)

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Other concerning symptoms that necessitate medical consultation include: Severe abdominal distension or inability to pass gas/stool (possible ileus or bowel obstruction) Nausea that worsens rather than improves after 812 weeks Inability to maintain adequate nutrition or hydration Unintentional weight loss exceeding clinical targets New or worsening heartburn or reflux symptoms Visual changes (especially with rapid blood sugar improvement) Severe headache or altered mental status Signs of gallbladder disease (right upper quadrant pain, especially after eating) Hypoglycemia symptoms if taking insulin or sulfonylureas Patients should generally not discontinue GLP-1 medications without medical guidance, except in emergencies such as suspected pancreatitis or severe allergic reaction

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Conversely, resmetirom may be preferable in patients with normal body weight or in those who have not responded adequately to GLP-1-based strategies