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It must not be frozen once reconstituted, as ice crystal formation can irreversibly damage the peptide structure

Vitamin Ds effect on insulin sensitivity is mediated via the expression of the vitamin D receptor on pancreatic -cells, which improves insulin secretion and glucose uptake (24)

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The ultra-long half-life means adverse effects may persist longer if they occur

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Continue your usual annual monitoring once stable, or more frequently if symptoms suggest your levothyroxine dose needs adjustment