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Example: Someone stable on levothyroxine for years, TSH around 2, starts an over-the-counter supplement with L-carnitine and notices increasing tiredness and a later TSH of 5

At the 5mg dose, 85% of participants lost at least 5% of their body weight

It documented how major PBMs used their formulary power to disadvantage competing pharmacies, how rebate dollars were retained rather than passed through to patients, and how spread pricing inflated costs for employer plan sponsors who lacked the leverage to audit their own contracts

Rybelsus belongs to a group of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists

Regular thyroid stimulating hormone (TSH) testing helps identify whether dose changes are needed, ensuring stable thyroid control throughout GLP-1 therapy

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