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Phase 3 (months 7, 12): if growth velocity has not increased by at least 2 cm/year from baseline, reassess the GHD diagnosis and consider transitioning to rhGH per Endocrine Society first-line recommendations

By the time menopause kicked in, Gales was prediabetic and medically obese

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Both medications independently cause nausea and stomach upset, so combining them amplifies these side effects and raises concerns about ulcers and bleeding

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