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Symptoms include a mass in the neck, dysphagia (difficulty swallowing), dyspnea, hoarseness of voice

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10.1016/j.jhep.2015.08.038 6 ArvanitakisK.KoufakisT.KotsaK.GermanidisG

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Stepping down from 2.4 mg to 1.7 mg, or even further to 1 mg, may resolve symptoms while maintaining some of the metabolic benefits of the medication