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Myokines produced by skeletal muscle, such as interleukin-6 (IL-6) and irisin, play a key role in mediating these immune and metabolic responses through autocrine, paracrine, and endocrine effects

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You should consider speaking to your GP if: You have been consistently following a calorie deficit for four to six weeks or more with no measurable change in weight or body measurements You are experiencing unexplained fatigue, cold intolerance, hair loss, or constipation , which may suggest an underactive thyroid (hypothyroidism) see NICE CKS: Hypothyroidism You have irregular menstrual cycles , excess facial or body hair, or acne, which may indicate PCOS see NICE CKS: Polycystic ovary syndrome You have a personal or family history of metabolic conditions, type 2 diabetes, or cardiovascular disease You are considering a very low-calorie diet (below 800 kcal per day), which should only be undertaken under medical supervision see NHS guidance on very low-calorie diets You notice unexplained weight gain despite a genuine deficit You experience unintentional weight loss , persistent changes in bowel habit, rectal bleeding, unexplained fevers or night sweats, or symptoms of high blood sugar (such as increased thirst, frequent urination, or fatigue) these warrant prompt assessment

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