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feeding into the small intestine) may be necessary when there are severe, refractory symptoms associated with dehydration or malnutrition, but again, the evidence base for this approach is limited [65]

Headache or mild fatigue reported in a subset of subjects

Any perceived energy increase results indirectly from improved blood sugar control, weight loss, and resolution of obesity-related symptoms rather than pharmacological stimulation

Oxidative stress can damage reproductive cells and decrease fertility potential

Injections also reach the dose levels used in the largest weight-loss trials