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Since levothyroxine requires an acidic gastric environment for optimal dissolution and absorption, and its absorption can be affected by the rate of gastric emptying, patients may experience variations in thyroid hormone levels when starting semaglutide therapy

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**Biotin can interfere with some laboratory testing, this may cause results to be either falsely elevated or decreased

Acid suppression medications and metformin also reduce vitamin B12 absorption and so increase the risk of deficiency