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They should: Review your complete medication list for potential interactions or contributing factors Assess for underlying anxiety disorders or other mental health conditions Check for physical causes (thyroid function, electrolyte imbalances, cardiovascular issues) Evaluate whether Wegovy dose adjustment or temporary discontinuation is appropriate Consider referral to mental health services if panic symptoms are severe or recurrent NICE guidance (CG113) on panic disorder recommends cognitive behavioural therapy (CBT) as first-line treatment for panic attacks

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Common causes encompass metabolic disorders like fatty acid oxidation defects and organic acidemias, renal issues such as carnitine loss due to chronic renal failure, Fanconi syndrome, dialysis, or certain medications (e.g., vancomycin), dietary factors including vegetarianism, starvation, or specific diets like the ketogenic diet, and liver diseases such as cirrhosis and fatty liver