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Heartburn that doesnt respond to any of the above measures and is occurring daily, pain or difficulty swallowing, a sensation of food getting stuck, unexplained weight loss beyond what the medication accounts for, or heartburn accompanied by chest pain that radiates to the arm or jaw are all symptoms requiring medical evaluation rather than self-management

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People tend to lose more fat than lean body mass, according to Gizmodo , but losing muscle can be a concern for more vulnerable populations, like older adults

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Diabetic eye problems (diabetic retinopathy)

With its highly exergonic free energy change, the flow of electrons through complex I is more than adequate to drive ATP synthesis