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If the patient suffers from gastrointestinal side effects due to dose escalation, contemplate delaying the escalation for another four weeks

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Metabolic changes included a reduction of the usage of muscle glycogen (i.e., its carbohydrate stores) during low-intensity exercise (consistent with an increase in lipid utilization) and streamlined glucose metabolism and mitochondrial flux during high-intensity exercise, leading to reduced anaerobic ATP production (which is what leads to lactic acid build-up in muscles)