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Hormonal alterations Since stress has been described as a potential trigger for ME/CFS (422) and cause of symptom flare-ups (423, 424), it is likely that the HPA axis- the neurobiological stress system- may be implicated in ME/CFS (53, 425, 426), as well as abnormalities in growth hormone (GH) secretion and dysfunctional adrenergic metabolism (255)
These drugs are contraindicated in patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. Other potential risks include: Acute pancreatitis Gallbladder disease (cholelithiasis, cholecystitis) Acute kidney injury Hypersensitivity reactions Patients should be monitored for persistent abdominal pain, changes in renal function, and other signs that may require discontinuation or additional workup
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