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For anyone on levothyroxine, separate dosing from the injection, keep levothyroxine dosing fasted and consistent, and recheck TSH, as absorption can be sensitive to changes in gastric motility

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Some variants correlate with needing higher doses or dual-compound therapy

Most people don't experience significant weight loss at the 0.25 mg or 0.5 mg starting doses

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Factor in verified purity (a cheaper product at lower purity may actually cost more per milligram of active compound), shipping conditions (temperature control matters for semaglutide stability), payment protection (can you dispute charges if the product is defective?), and customer service responsiveness