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A: Nothing

Works immediately

Telehealth providers must screen for contraindications (personal/family thyroid cancer, multiple endocrine neoplasia type 2, severe renal or hepatic disease) before prescribing, though this screening is limited to provider questionnaires and cannot replicate in-person physical examination

What most don't tell you: raw milk thistle powder has only 13% Silymarin the compound actually responsible for liver protection

Once removed from the refrigerator, vials and pens can generally be kept at room temperature for a limited period, but your pharmacys specific instructions should govern this