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Safety data lacks large-scale human trials, which limits verified dosage standards and long-term risk evaluation

Blood glucose should be monitored closely and a medication review sought from your GP or diabetes specialist (see NICE NG28: Type 2 diabetes in adults: management)

Treatment with a ghrelin agonist in outpatient women with anorexia nervosa: a randomized clinical trial

That means you chew it when you actually need it 15 minutes before the final climb, the last 4K of a 10K, or the moment pace starts slipping and it is already working by the time it matters