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In my practice, we approach discontinuation carefully: Gradual taper when appropriate Maintenance nutrition plan Structured exercise Continued metabolic monitoring Some patients benefit from extended maintenance therapy

Report the issue to the FDA MedWatch program at www.fda.gov/medwatch or 1-800-FDA-1088

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This practice potentially exposes these individuals to serious side effects

The compounded version is not FDA-approved as a finished product, a distinction that carries real implications for quality assurance and consistency

The Flexibility Principle Remember: these meal plans are templates, not rules