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Some patients carry genetic variants associated with heightened GLP-1 receptor sensitivity, meaning they experience more pronounced gastrointestinal effects at standard doses

That 2.7 percentage point gap suggests prior receptor exposure may genuinely reduce subsequent responsiveness

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NRF-1, nuclear respiratory factor 1

The result is that some people taking thyroid replacement and L-carnitine may feel less benefit, and laboratory tests may show changes such as a rising TSH