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Seek urgent medical advice if you experience: Severe or recurrent hypoglycaemia (blood sugar below 4 mmol/L) Symptoms of hypoglycaemia that do not improve with treatment Severe, persistent abdominal pain, especially if radiating to the back (this could indicate pancreatitis, a rare but serious side effect of GLP-1 receptor agonists) [2] Persistent or severe gastrointestinal symptoms such as vomiting, severe diarrhoea, or abdominal pain Signs of dehydration (dry mouth, reduced urination, dizziness) Any new or worsening symptoms after starting berberine If you cannot reach your GP and need urgent advice, contact NHS 111

doi: 10.1097/JCP.0b013e318174f92a

The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population

it involves systematic checks for both expected and unexpected physiological changes