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When you lose significant weight, thyroid-stimulating hormone (TSH) and free T4 levels may shift as the body adjusts its metabolic setpoint

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6 DRUG DOSING IN OBESE PATIENTS THE PHARMACOKINETIC CHALLENGE Obesity profoundly alters drug distribution, metabolism, and elimination standard doses may under-treat infection or over-treat causing toxicity: Volume of distribution (Vd): Increased for lipophilic drugs some antimicrobials under-dosed at standard weight-based dosing