I see it appear suddenly and unpredictably in both new starters and long-term users, suggesting multiple overlapping mechanisms are usually at play rather than a single isolated cause
I recommend eating modest amounts, about one serving per day (if you can tolerate them)
Both were also motivated by personal experience

When to seek immediate medical attention: Severe abdominal pain that doesn't resolve, possibly radiating to the back (potential pancreatitis) Persistent nausea and vomiting preventing adequate fluid intake (dehydration risk) Signs of allergic reaction: difficulty breathing, swelling of face or throat, severe rash Symptoms of thyroid tumors: lump in neck, hoarseness, difficulty swallowing (rare but serious) Severe hypoglycemia symptoms when used with insulin or sulfonylureas: confusion, seizures, loss of consciousness Changes in vision or eye pain (potential diabetic retinopathy complications, particularly with rapid improvement in blood glucose) Signs of kidney problems: decreased urination, swelling in legs or feet, unusual fatigue Symptoms of gallbladder problems: pain in right or middle upper abdomen, fever, yellowing of skin/eyes These medications carry a boxed warning regarding the risk of thyroid C-cell tumors, based on animal studies

A cellular and spatial map of the choroid plexus across brain ventricles and ages