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Routine measurement of serum calcitonin levels or thyroid ultrasound screening before starting GLP-1 therapy is not recommended in asymptomatic patients without specific risk factors

Patients should be advised to contact their GP or NHS 111 if they experience: Red flag symptoms requiring urgent assessment: Severe, persistent abdominal pain , particularly if in the upper abdomen and radiating to the back (may indicate pancreatitis) Severe abdominal pain and distension with vomiting and inability to pass wind or stools (may indicate bowel obstruction) Persistent vomiting , particularly if unable to keep down fluids, raising concerns about dehydration Abdominal distension with rigidity or extreme tenderness on palpation Blood in vomit or stools (melaena or haematochezia) Unintentional weight loss beyond expected therapeutic effects Fever accompanying abdominal symptoms , which may suggest infection or inflammation Right upper quadrant pain or jaundice (yellowing of skin/eyes), which may indicate gallbladder disease For severe symptoms, call 999 or go to A&E immediately