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Nausea peaks, fatigue is most noticeable, and appetite changes feel most dramatic

If left untreated, the deficiency can cause severe neurologic problems and blood diseases

The American Association of Clinical Endocrinologists recommends individualized decision-making, considering the patient's complete metabolic profile, pancreatitis history, and availability of alternative therapies

E&OE The author was formerly executive director of Indian Journal of Clinical Practice in an era when there were only JAMA and BMJ as the leading medical journals available for Indian clinicians

Most clinicians recommend stopping the medication 2-3 months before you intend to try conceiving, giving your body time to eliminate the drug and for metabolic patterns to stabilize

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