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For exercise performance and VO2 max improvement, the evidence from human exercise studies suggests that MOTS-c's acute rise following high-intensity training is part of the adaptive signal driving mitochondrial biogenesis and cardiovascular remodeling

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Starting with 1 mg daily for the first week, then adjusting based on tolerance and initial response, provides a conservative approach

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Hormonal fluctuations, oral contraceptives, and prolonged stress are additional associated factors