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Clinical red flags (any one of these requires provider contact within 24 hours): Three consecutive days under 800 calories Five consecutive days under 1,000 calories Inability to finish one protein-containing meal (15+ grams protein) per day for 48 hours Dizziness, lightheadedness, or near-fainting episodes Resting heart rate increase of more than 10 bpm from baseline New-onset hair thinning or hair loss (sign of protein deficiency, usually appears 8-12 weeks after sustained undereating) Cold intolerance or feeling cold in normal-temperature environments (sign of metabolic slowdown) Loss of menstrual period in premenopausal women not on hormonal contraception Amber-zone patterns (require self-monitoring and proactive adjustment within 3-5 days): Four to six days per week under 1,200 calories (women) or 1,500 calories (men) Skipping two meals per day more than three days per week Protein intake under 60 grams per day for more than one week Difficulty concentrating or "brain fog" that's new since starting medication Workout performance decline (cannot complete usual sets, fatigue earlier than baseline) The most reliable single indicator is the one-protein-meal test