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Very mild or subclinical hypothyroidism with no significant symptoms In cases of subclinical hypothyroidism, where the TSH is slightly elevated but free T4 remains normal, and the patient has minimal or no symptoms, GLP-1 therapy may be started if there is a strong clinical indication such as prediabetes, elevated waist circumference, or high cardiovascular risk

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In addition, the treatment with canagliflozin induced cell apoptosis of TC cells (Wang et al., 2022)