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doi: 10.1111/exd.13887

Other relevant factors include: Pre-existing conditions: Anaemia, hypothyroidism, sleep apnoea, and depression can all independently cause fatigue and may compound drug-related tiredness, making it harder to distinguish the cause

The low initial dose is recommended, and increase incrementally, titrating to effect (1)

Fluctuations of key hormones and insulin levels occur, for a variety of reasons, including: - Perimenopause/Menopause - Polycystic ovarian syndrome - Menstrual cycles - Birth control - Pregnancy - Insulin resistance - Chronic stress and mental health disorders - Diet or dietary changes - Disorders that affect the thyroid gland, adrenal glands, pituitary gland, etc

[DOI] [PMC free article] [PubMed] [Google Scholar] 47.Salinas C.B.G., Lu T.T., Gabery S., Marstal K., Alanentalo T., Mercer A.J., Cornea A., Conradsen K., Hecksher-Sorensen J., Dahl A.B., et al

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