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Serum IGF-1 levels were significantly lower in the lower protein group, independent of other factors like body weight and body fat (30)

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Dehydration from nausea and vomiting, electrolyte imbalances from reduced food intake, the physiological stress of rapid weight changes, interactions with caffeine, anxiety about taking a new medication, these are all factors that do not cleanly show up in trial adverse event tables but absolutely contribute to real-world palpitation experiences