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A 2023 meta-analysis in JAMA Internal Medicine found a possible association with medullary thyroid carcinoma specifically, but the absolute risk remained very low

However, anecdotal reports suggest that women may experience more pronounced nausea at the 4mg and 8mg dose steps, particularly around menstruation when hormonal fluctuations can amplify GI sensitivity

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doi:10.1038/s41569-018-0108-7 64