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The most commonly reported effects are mild injection-site irritation, short-term fatigue during TB-500 loading, and occasional headache

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Men with uncontrolled diabetes, insulin resistance, or metabolic disease should be evaluated carefully before starting peptides, since some peptides may affect appetite, blood sugar, insulin sensitivity, or fluid balance

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Sex steroid replacement therapy should be initiated early with gradual dose escalation to mimic physiological puberty, alongside regular monitoring and correction of vitamin D deficiency to maintain serum 25-hydroxyvitamin D levels above 30 ng/mL