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Lower doses havent been studied for long-term purposes, however for weight and appetite purposes its pretty clear if somebodys having an effect, that the low dose its clearly working, Nadolsky says

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When to Contact Your Clinician or Go to the ER Seek urgent care for chest pain, fainting, severe shortness of breath, or a pulse above 120 to 130 beats per minute that does not respond to rest and hydration