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Important Caveats: This observation is anecdotal, not registry-derived It is not a substitute for controlled epidemiology It provides real-world context consistent with MTC rarity and absence of compelling causal signals in highest-quality human evidence Clinical Significance: In a practice seeing more thyroid cancer than anywhere globally, we are not observing an MTC wave in GLP-1 users

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Fifth, although preventive medications were excluded, acute medication use (triptans, NSAIDs, or simple analgesics) was permitted with a minimum 72-hour washout period before scanning