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After a night of no sleep, I was in severe pain, my heart rate was spiking, and I was very dizzy

Required documentation typically includes the prescription, two years of relevant medical records, prior weight-loss attempt history, lab values (lipid panel, A1c, CMP), and any comorbidity workup (sleep study for OSA indication, CV imaging for SELECT indication)

Similarly, patients who have required hospitalization or biologic immunosuppressant therapy (such as TNF inhibitors) within the past year should exercise extreme caution, as their disease is less stable and their gut barrier may be more vulnerable to treatment-induced stress

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