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Neither guanosine nor adenosine significantly improved PB1 extrusion compared with aged groups (Supplementary Fig

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Other contributing factors include medication interactions (certain psychiatric medications, corticosteroids, and reduced exposure to oral contraceptives during dose escalation), hormonal changes (thyroid dysfunction, menopause), inadequate sleep (less than 7 hours nightly), chronic stress with elevated cortisol, and reduced physical activity as patients become more comfortable at their current weight