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A 2019 study in the Journal of Clinical Endocrinology & Metabolism found that calorie restriction without pharmacological intervention increased plasma lipid peroxidation markers (malondialdehyde) by 18% over 12 weeks in obese adults

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It underscores the importance of cyclical protocols rather than continuous administration, allowing the body's insulin sensitivity to reset

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Both forms can cause the same GI effects (nausea, constipation, looser stools), usually heaviest in the first few weeks

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