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doi: 10.1007/s12011-008-8117-8 43 SpallholzJEBoylanLMLarsenHS

If cold sensitivity persists beyond six months of stable weight or significantly impairs quality of life, discussing dose adjustment or alternative treatment strategies with healthcare providers is appropriate

Discoloration : Discoloration may occur with high doses of methylene blue, causing a blue-green color in urine, stool, skin, or nail beds

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During discontinuation and washout, a structured plan to minimize weight regain and glycaemic deterioration is advisablefor example, reinforcing dietary/physical-activity targets and, where clinically indicated, using metformin as a maintenance optionso that metabolic stability is preserved before ART initiation