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Acknowledgements We thank the nference engineering team for the development of the nference federated AI platform, and Patrick Lenehan for critical review and manuscript feedback

fatigue often improves After dose increases: Temporary tiredness may return Maintenance phase: Energy usually stabilizes If fatigue lasts longer than 46 weeks or worsens over time, its important to talk with your provider

19 December 2025 This article has been retracted

Human nature being what it is , even motivated patients struggle to make and sustain lifestyle changes on their own especially while dealing with medication side effects