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Conversely, while the metabolic burden in the reproductive subtype is relatively lighter, ovulatory dysfunction and hyperandrogenic symptoms are more prominent, suggesting that the mode of benefit may differ in these patients (51, 54)

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Some patients report that berberine's gastrointestinal irritation is poorly tolerated even without GLP-1 use, making combination therapy intolerable

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Metabolic rebound after GLP-1 receptor agonist discontinuation: a systematic review and meta-analysis