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It acts directly on several target tissues, including skeletal muscle and bone, but several effects are mediated indirectly by circulating (liver-derived) or locally produced IGF-1

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Fondriest also acknowledges lithiums efficacy, stating, Lithium has unparalleled power in stabilizing bipolar disorder, but he remains cautious about potential long-term kidney and thyroid risks, especially in younger patients

Many suitable candidates have experienced significant antipsychotic-associated weight gain, prediabetes, or established type 2 diabetes while remaining psychiatrically stable