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The medication suppresses appetite through direct receptor activation, and when that activation stops, appetite returns, often stronger than baseline due to metabolic adaptation

Participants experienced improved recovery, reduced soreness, and lower levels of muscle damage markers like creatine kinase

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However, when these germ-free mice were then put into a non-sterile environment for a few weeks, their guts were colonized with bacteria that started converting the dietary choline and L-carnitine into TMA and led to increasing TMAO levels in their blood