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This means: The same dose stops working as effectively Higher doses may be required (not sustainable) Side effects or inflammatory signals may increase Cellular response plateaus or worsens Strategic cycling allows receptors to reset, restore sensitivity, and respond optimally to the peptide

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[1] This was by far more than any other carnitine precursor

This may be related to sympathetic activation by DPP4 inhibition (Packer, 2018)