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Work by Goldstein and colleagues, who first characterised the thymosin family of peptides, established thymosin beta-4 as a major actin-sequestering protein with roles in wound healing and anti-inflammatory signalling

These include: Tier 2 services : Community-based lifestyle interventions Tier 3 services : Specialist multidisciplinary teams for complex obesity Tier 4 services : Bariatric surgery assessment and procedures Referral criteria for these services are outlined in NICE guideline CG189 for obesity management

Symptoms can last seconds in BPPV or be constant in other disorders (Vestibular Disorders Association, n.d

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Understanding these potential pathways helps contextualise the symptom and guides appropriate management strategies