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Given its role in catalyzing the conversion of pyruvate to lactate in glycolytic cancer cells and the observation that LDHA deficiency results in only relatively mild symptoms, such as exertional myopathy, LDHA represents a pivotal and safe therapeutic target (150,167)

Stable or rising IGF-1 with reduced subjective benefits

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A1C should typically be monitored every 3 months until stable, with more frequent visits during dose titration to assess tolerability