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Melatonin biosynthesis in plants: multiple pathways catalyze tryptophan to melatonin in the cytoplasm or chloroplasts
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Providers should monitor weight trajectory , GI tolerability (nausea, vomiting, constipation) , signs of pancreatitis (persistent severe abdominal pain vomiting), gallbladder disease (RUQ pain, fever, jaundice), hydration/renal function when clinically indicated (risk of AKI with severe GI effects), blood pressure , and glucose metrics (especially if combined with insulin or sulfonylureas due to hypoglycemia risk)
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