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Detailed observations of psychiatric symptom changes, such as continuity and diurnal variation, should have been made

In counties with known arsenic, nitrate, or PFAS issues, annual or semi-annual screening for these substances is strongly advised

Common signs include: Nasal congestion, itchy skin, or watery eyes Digestive upset such as bloating, abdominal pain, diarrhea, or nausea Systemic symptoms like fatigue, migraines, brain fog, or rapid heart rate This wide range of effects makes it easy to misdiagnose, especially since the symptoms fluctuate depending on food choices, stress, or environment

Active or recent pancreatitis contraindicates use

Orders placed before the daily cutoff are typically shipped the same business day