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Clinical trials and post-market surveillance revealed risks in specific populations (history of medullary thyroid cancer, pancreatitis, severe kidney disease) that require pre-treatment screening unavailable in OTC settings

This is also evidenced by observations that changes in intestinal motility and the gut microbiota are key factors in IBS, along with inflammatory immune activation, all three factors that converge in a feedback loop [295]

Notably, lack of replication in publicly available datasets does not necessarily exclude biological relevance, particularly for variants that may be ancestry-specific or underpowered in prior studies

[DOI] [PubMed] [Google Scholar] 56.Haider S.A., Lemberger R.J., Fisher C., McCulloch T.A