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Yes, a consultation with a licensed healthcare provider is a legal and safety requirement for obtaining any GLP-1 medication

After suffering a left arm injury that lasted more than four years, I faced a long and complicated settlement process

doi:10.1113/jphysiol.2006.125799 Wall BT, Stephens FB, Constantin-Teodosiu D, Marimuthu K, Macdonald IA, Greenhaff PL (2011) Chronic oral ingestion of l-carnitine and carbohydrate increases muscle carnitine content and alters muscle fuel metabolism during exercise in humans

A 2023 case series in Headache: The Journal of Head and Face Pain (Robbins et al.) reviewed 847 patients starting semaglutide and found: 14% reported headaches during the first 16 weeks Of those, 23% noted clear positional worsening (worse lying down or worse standing, depending on individual CSF dynamics) 89% of positional headaches resolved by week 20 without intervention beyond hydration 2.1% required temporary dose reduction 0.4% discontinued due to intolerable headache The positional component is underreported because patients don't always connect the pattern

So we, our solution specifically, we're not violating any terms of a PBM contract

The second rationale is plateau management