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Compared with lifestyle interventions or metformin, they significantly elevate SHBG and modestly reduce total testosterone (with a standardized mean difference, SMD approx

63 Furthermore, potential side effects like nausea or vomiting can lead to fluid loss, and dehydration can worsen common issues like constipation, fatigue, and headaches

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Researchers note that the consistency of effects across multiple substances and outcomes provides a strong rationale for dedicated clinical trials

Are we treating a medical problem, or rewriting the experience of appetite itself