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The BP of the plant species called Echium vulgare possesses high pyrrolizidine alkaloid contents in most European countries (1, 206), while the toxic elements include aluminum, lead, strontium, cadmium, arsenic, chromium, nickel, and mercury, which can cause neurotoxicity and other abnormalities (1, 207)

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doi: 10.1038/s41579-020-0433-9 8 GruppenEGGarciaEConnellyMAJeyarajahEJOtvosJDBakkerSJLet al

However, some of these symptoms overlap with either diabetes itself or expected effects of GLP-1 therapy, particularly weight changes and gastrointestinal symptoms, making clinical assessment essential

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