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It is not yet approved for general medical use and remains in Phase 3 clinical trials, where researchers are assessing long-term safety, durability of weight loss, and broader metabolic benefits
**Never shake.** Shaking denatures peptide bonds and can reduce potency
The pharmacy formally challenged aspects of the FDAs observations, and no subsequent Warning Letter was issued, indicating the matter was resolved at the 483 level without escalation
However, exercise intensity may need to be adjusted during the first two to four weeks of keto adaptation, as energy levels can fluctuate before the body becomes efficient at using ketones for fuel
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