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The key factor is that bile acid malabsorptiona possible consequence of cholecystectomymay worsen diarrhea in some patients if GLP-1 doses escalate too quickly

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Depressive symptoms, social support, and lipid profile in healthy middle-aged women Psychosom Med 1997

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Doubling the dose after a missed injection does not compensate for the methylation gap because methyl donor pathways saturate at physiological thresholds