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The prostate gland exhibits unique metabolic features characterized by extraordinary citrate production (up to 180 mM in prostatic fluid) to support sperm energetics, sustained through zinc-mediated inhibition of mitochondrial aconitase(m-ACNT), which blocks citrate-to-isocitrate conversion (71)
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The FDA specifically noted that "multiple reports of adverse events, some requiring hospitalization" were related to dosing errors with compounded and grey market injectable tirzepatide products
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