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Esophageal monitoring If you have persistent reflux symptoms for more than 3 months despite adequate treatment, or if you have alarm symptoms (difficulty swallowing, pain with swallowing, unintentional weight loss beyond therapeutic effects, anemia), endoscopic evaluation is appropriate

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Once B12 levels improve and you are no longer deficient, your treatment may be switched to supplements

In that paper, we found that skeletal muscle function and thyroid hormone levels were recovered in most GD patients treated with methimazole for 12 weeks