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The oral daily dose far exceeds the vitamin requirement because the normal transporter protein-mediated absorption is absent, leaving only very inefficient intestinal passive absorption

At 52 weeks of continuous daily use, 34% of patients still had IGF-1 levels more than 2 standard deviations above their starting point meaning the downstream IGF-1 signal was still very much working a full year in

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M., Poulin, M

This correlates directly with delayed gastric emptying, as food sitting in the stomach longer creates a sense of pressure and bloating