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Other reasons to contact your provider include: Weight loss that significantly exceeds your prescribed treatment plan Cold sensations accompanied by sweating, tremor, or confusion (possible hypoglycemia, especially if taking insulin or sulfonylureas) Persistent fatigue with pallor or weakness (possible anemia) Severe or persistent symptoms that significantly impact quality of life or do not improve with conservative measures Your healthcare provider can assess whether symptoms represent expected physiological adaptation, require investigation for alternative causes (including blood tests for thyroid function, complete blood count, iron studies, or vitamin B12 levels), or indicate a need for medication adjustment