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The high levels of insulin have been shown to reduce the levels of the Insulin-like growth factor (IGF) binding protein, which can tightly bind to IGFs, resulting in excessive free IGF-1 in cells and tissues

The review also discusses emerging data in peripheral artery disease (e.g., STRIDE trial)

When your cells are properly hydrated, your body is better at signaling true hunger versus thirst, which naturally reduces overeating

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For example, Piagnerelli et al

Clinical trials tested weekly doses up to 12 mg for 48 weeks with manageable side effect profiles