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Glycemic Targets: Standards of Medical Care in Diabetes-2021

Two peptides that both strongly increase GH axis signals can induce excess IGF-1, fluid retention, or glucose dysregulation

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This likely reflects the additive gastrointestinal effects of combining two separate appetite-suppressing compounds

There are no other absolute contraindications reported for hydroxocobalamin use in deficiency states, but caution is advised in individuals with conditions such as early Lebers optic neuropathy (a rare hereditary optic atrophy) due to the theoretical risk of worsening vision