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The American Society of Anesthesiologists recommends managing patients on GLP-1 receptor agonists as if they have a full stomach, including appropriate airway protection and rapid sequence induction

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Approach: 1.2-1.4g protein per kg body weight daily (track with an app) Iron supplementation to maintain ferritin above 50 ng/mL 30mg zinc daily with 1mg copper 5,000 IU vitamin D daily (adjust based on levels) 5,000mcg biotin daily B-complex supplement Collagen peptides 10-15g daily (provides glycine and proline for hair structure) Baseline labs before starting, repeat at months 3, 6, and 9 Consider starting 2% minoxidil preventively Monthly hair progress photos Minimum 1,400 calories daily even when appetite is low Expected outcome: Mild shedding possible around months 4-6, generally self-limiting with recovery beginning by month 8-9

However, persistent staining suggests a product quality issue

If there is ulnar variance, the surgeon can excise the ulnar bone to the proper length