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In cells from articular cartilage, synovial tissue and fluid from patients with OA, elevated levels of the transcription factor hypoxia inducible factor (HIF)-1 were found, indicating hypoxic conditions, that are associated with progressive joint damage (114, 115)

Delaying treatment to await cheaper options may extend years of metabolic risk, missed cardiovascular benefits, and continued weight-related complications

Important safety considerations include risks of pancreatitis, gallbladder disease, and acute kidney injury from dehydration

Higher growth hormone levels help tissues repair themselves and support recovery after exercise

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