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Serious risks like pancreatitis or thyroid issues are rare but require baseline screening and ongoing care

Conversely, estrogen therapy can affect glucose metabolism and insulin sensitivity, though effects vary based on formulation, dose, and route of administration

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By inhibiting osteoblast differentiation of VSMCs, GLP-1RAs can ameliorate phosphate-induced vascular calcification, which is mediated by the AMPK/mTOR pathway or AMPK/receptor activator of nuclear factor kappa B ligand (RANKL), as occurs in the osteoblast differentiation of VSMCs [128, 129]

I recommend that you try a 2 week trial on a low-FODMAP diet