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Persistent constipation may require investigation to exclude other underlying causes

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[4] [5] Patients experiencing symptoms potentially related to cortisol abnormalitiessuch as unexplained weight gain (particularly central obesity), persistent fatigue, muscle weakness, easy bruising, or mood changesshould undergo appropriate evaluation before attributing these to metabolic syndrome alone

Six months is a realistic horizon for the kind of change that turns heads, and the scale rarely moves in a tidy straight line

A prescribing physician should be informed about both agents

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