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More serious complications from GLP-1 RAs include an increased risk of thyroid cancer,5 gallbladder disease,23 pancreatitis,6 or gastroparesis.29 Phentermine and topiramate have some similar GI side effects, but both add dry mouth to the picture.24 Topiramate can also cause drowsiness, tremors, and some minor bleeding issues like nosebleeds or excessive menstrual bleeding.25 Testosterone replacement therapy safety Testosterone replacement therapy (TRT) poses several significant risks to those who take these drugs and those who live with the patient