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This paradoxical response may result from inadequate dosing, incorrect injection technique, dietary factors, underlying medical conditions, or lifestyle influences such as poor sleep

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doi: 10.1002/(SICI)1096-9861(19980615)395:4 3.0.CO;2-2 136 CuiHSohnJWGautronLFunahashiHWilliamsKWElmquistJKet al