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Persistent white patches can be due to leucoplakia , which is associated with alcohol and (particularly) smoking, and is premalignant

If youre experiencing chronic fatigue or low energy, the first step is a thorough consultation with our experienced team

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Subclinical hypothyroidism (elevated TSH with normal free T4) is also not a contraindication, though optimisation of thyroid function before initiating weight management therapy is often advisable

Temperature determines degradation speed