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Acid reflux and digestive issues Acid reflux on semaglutide can worsen on keto because high-fat meals relax the lower esophageal sphincter, allowing stomach acid to rise

This is not due to thyroid damage, but rather because: Weight loss alters hormone needs Improved metabolic health can change dosing requirements My Clinical guidance to patients: If you lose 1020 pounds, recheck thyroid labs within 812 weeks to avoid over- or under-treatment