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Anything in that category is a reason to call the compounding pharmacy rather than to judge the vial yourself

SSRIs work by increasing serotonin levels in the brain

Researchers hypothesized that, while the increased thyroid hormone increased carnitine synthesis, it also accelerated mitochondrial fatty acid oxidation (similar to what was seen to happen in a hyperthyroid state), which reduced carnitine levels

The single thing worth remembering is that these signs are real and worth taking seriously, but they overlap with a dozen other common, treatable conditions, so pollution exposure, diet, sleep and an honest conversation with your doctor matter just as much as any bottle on a shelf