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This explains why some patients experience: Temporary bloating or joint discomfort from fluid shifts Increased hunger due to ghrelin pathway activation Changes in blood sugar regulation in susceptible individuals Patients with diabetes, insulin resistance, or other metabolic conditions require medical evaluation and appropriate monitoring before and during treatment

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If it werent for that political power, government regulation could cap name-brand drug reimbursements at reasonable levels

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[53] Elderly [edit] Valproate may cause increased somnolence in the elderly