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Differential Diagnosis Serotonin syndrome is a diagnosis of exclusion, and has features similar to neuroleptic malignant syndrome, anticholinergic syndrome, malignant hyperthermia, and thyroid storm 3 (Figure 4)

For patients needing additional energy or stress support, B-Complex is sometimes combined with B12, amino acids, or MIC (Methionine-Inositol-Choline) injections in wellness or weight-management protocols

Some peptide therapies may be compounded and are not FDA-approved medications

The history provided (no ascites or encephalopathy) does not suggest decompensated cirrhosis, so esophageal varices as a bleeding source are less likely

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