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Some patients report temporary fatigue, headache, flushing, joint aches, or increased hunger

Unlike GLP-1 agonists, the changes are compositional rather than scale-weight driven: patients may not lose significant total body weight but will show meaningful reduction in waist circumference and visceral fat volume

Succinate, a key intermediate metabolite of the TCA cycle in the mitochondrial matrix, accumulates under conditions such as intense physical exertion, ischemia-reperfusion, or poisoning, where the mitochondrial respiratory chain is inhibited

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