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Endocrinology 138 , 44104415 (1997)

62,63 PNs also support fibroblast activity, increasing production of structural and ECM components

If muscle symptoms are severe or persistent despite these interventions, clinicians should consider laboratory evaluation including creatine kinase, comprehensive metabolic panel with separate magnesium and calcium testing, thyroid function tests, vitamin D levels, and vitamin B12 levels to exclude alternative diagnoses