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Contact your GP if you experience: New or worsening symptoms suggesting thyroid dysfunction, such as extreme fatigue, significant unintended weight changes, palpitations, anxiety, or depression Persistent gastrointestinal side effects from GLP-1 medications that interfere with taking levothyroxine appropriately Neck swelling, pain, difficulty swallowing or persistent hoarseness , which could indicate thyroid changes requiring assessment, potentially via urgent suspected cancer pathways if concerning features are present Symptoms of hypoglycaemia (if you have diabetes), particularly if you take other glucose-lowering medications alongside GLP-1 therapy Severe, persistent abdominal pain (with or without vomiting), which could indicate pancreatitis requiring urgent medical attention Right upper abdominal pain, fever, or yellowing of the skin or eyes , which might suggest gallbladder problems, a known risk with GLP-1 medications and rapid weight loss New or worsening visual symptoms if you have diabetic retinopathy, as rapid improvement in blood glucose can sometimes temporarily worsen retinopathy [19] [20] Regular medication reviews are essential