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Telemedicine Practice Standards States Regulate: Consultation Requirements: Some states require live video or phone (not just messaging) Others allow asynchronous (message-based) consultations Documentation requirements vary Patient consent forms differ Prescribing Standards: What can be prescribed via telehealth Whether initial in-person visit required (rare for weight loss now) Documentation needed in medical record Follow-up requirements Examples of State Variations: More Restrictive States: May require video consultation (not just questionnaire) Additional documentation requirements More stringent informed consent Limitations on initial prescribing More Permissive States: Allow asynchronous consultations Streamlined documentation Fewer restrictions on telehealth prescribing Legitimate providers comply with each states specific requirements

Daily Dosage: Do not exceed the recommended daily dose

Users who quit before 16 weeks often miss the inflection point where results become obvious

Vaz FM, Wanders RJ: Carnitine biosynthesis in mammals

Goode PN, Farndon JR, Anderson J, Johnston IDa, Morte JA

Medical supervision is recommended