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Nevertheless, direct evidence for ergogenic effects in healthy athletes is limited and methodologically weak ( Mechanistic cardio-protective rationale During intense or prolonged exertion, elite athletes may develop cardiac remodeling, transient myocardial hypoxia, oxidative stress, and accumulation of acylcarnitines, factors that can compromise function and promote arrhythmias ( -oxidation, promoting glucose oxidation (e.g., via pyruvate dehydrogenase and hexokinase), and thereby improving myocardial energy efficiency under hypoxic conditions ( Experimental work suggests modulation of PPAR- /PGC-1 linked pathways, suppression of mitochondrial ROS, and improved recovery of cardiac function after ischemic or metabolic insult (4143)

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At 3 months, the mean placebo-adjusted body-weight difference was only approximately 3.6%, and patients were still in the protocol dose-escalation phase

Patients should also be advised to monitor their blood glucose levels more closely if they have used potentially degraded semaglutide, as reduced efficacy could lead to hyperglycemia

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