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Similarly, hypoxia-inducible factor 1-alpha (HIF-1) upregulates the miR-23a/24 cluster, driving a metabolic shift toward glycolysis under hypoxic conditions and thereby accelerating cancer progression [112]

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When to choose the conservative schedule Choose the 6-week schedule if any of these apply to you: Previous strong GI reactions to GLP-1 agonists like semaglutide or tirzepatide History of IBS, GERD, or other chronic digestive conditions BMI under 30 (lower body mass can increase sensitivity to fixed doses) Current use of other medications that affect gastric motility First-time use of any GLP receptor agonist The research is clear on this point