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The presence of thyroid peroxidase (TPO) antibodies or thyroglobulin antibodies supports an autoimmune aetiology but is not essential for diagnosis
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Currently Synedica Retatrutide Injection Pen Kits are only available with a prescription in Germany from private clinics

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N Engl J Med 383(15):14131424 Bhatt DL, Szarek M, Steg PG, Cannon CP, Leiter LA, McGuire DK, Lewis JB, Riddle MC, Voors AA, Metra M, Lund LH, Komajda M, Testani JM, Wilcox CS, Ponikowski P, Lopes RD, Verma S, Lapuerta P, Pitt B (2021) SOLOIST-WHF Trial Investigators

This creates a frustrating cycle where, over time, your ratio of "bad" visceral fat to "less bad" subcutaneous fat gets worse, leading to that "old man lean" look where someone might have visible abs but still has a protruding belly
