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Standard practice includes: Baseline thyroid function tests (TSH and free T4) before initiating GLP-1 therapy Repeat testing at 812 weeks after starting treatment or after dose escalation Regular monitoring every 36 months during active weight loss Return to annual monitoring once weight is stable and thyroid function remains consistent Adjustments to levothyroxine dosing may be necessary as weight changes

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Importantly, after adding the covariates, i.e., BMI ( p .010), sex ( p .019), years with SAD ( p .012), smoking ( p .004), concurrent SSRIs ( p .017), and prepost change in proportion of lymphocytes to monocytes ( p 0.020), the significant relationships remained between changes in LSAS-SR symptoms and telomerase and GPx activity, respectively