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Myocardial remodelling characterized by fibrosis and hypertrophy, impaired microcirculation, abnormal protein function caused by advanced glycation end products, changes in myocardial metabolism and abnormal mitochondrial function have been noted as associated factors of diabetic cardiomyopathy [14]

In rare situations, elevated testosterone levels can cause mood swings, headaches, high testosterone face, and a drop in sperm count, potentially impacting fertility

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But controlled human efficacy data is sparse, and the single Phase 2 trial tested oral administration rather than the subcutaneous injection most users employ today

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The most common reasons phentermine loses effectiveness are prior stimulant exposure, dose that has become insufficient as the body adapts, sleep deprivation, and dietary habits that have plateaued