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When used together, there may be an additive effect on heart rate , which could be clinically significant in patients with pre-existing cardiovascular conditions, including hypertension, arrhythmias, or coronary artery disease

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While the benefits can be substantial, it's important to approach their use with care, under professional guidance, and as part of a comprehensive approach to health and fitness

Night-time application and alternating frequency (2-3 times weekly initially) may help minimize sensory irritation and erythema in darker skin phenotypes