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Factors Indicating Against Dose Escalation Maintain current dose when experiencing significant side effects at present level, achieving satisfactory subjective improvements (better sleep, energy, recovery), IGF-1 increased adequately (50+ ng/mL) for optimization goals, or financial constraints make higher dosing unsustainable

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This may indicate inadequate response to the medication, requiring dose adjustment, evaluation of administration technique, or consideration of alternative or adjunctive therapies

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