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This is related to the rapid weight loss rather than the medication itself, a phenomenon called telogen effluvium that occurs with any significant weight loss
Because ovulation, clinical pregnancy, time to pregnancy, and live birth were inconsistently defined and sparsely reported across trials, no confirmatory quantitative synthesis or treatment ranking was undertaken for these reproductive outcomes
Combined with baseline biomarker assessment, this information supports more confident protocol decisions and may reduce trial-and-error timing adjustments
Selenium plays a crucial role in thyroid hormone metabolism
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