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Other recognised triggers and associations include viral illness (including COVID-19), autoimmune conditions, pregnancy, significant blood loss or dehydration, prolonged bed rest or deconditioning, and certain medications

IGF-1 promotes MSC chondrogenic differentiation and chondrocyte proliferation mainly through the activation of IGF-1R

It is not a normal side effect of tirzepatide and should not be dismissed as an expected adjustment

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