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The synergy between exogenous MOTS-c and exercise is not merely additive: because MOTS-c mimics one of the molecular consequences of high-intensity exercise (AMPK activation via AICAR accumulation), concurrent exercise training may amplify the peptide's effects on GLUT4 translocation and mitochondrial biogenesis

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Conservative dosing also reduces risk of excessive energy deficit and the metabolic stress markers (low T3, menstrual irregularity) that emerge when both compounds are pushed to upper dose ranges simultaneously.

Importantly, neurological symptoms can occur even without anaemia and require prompt assessment