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He Y, Fan X, Liu N, Song Q, Kou J, Shi Y, et al

Ethanol activates hepatic stellate cells to produce abnormally large amounts of collagen production and results in changes in liver structure which cause fibrosis

Titrate (Weeks 34): Increase to 40 mcg daily if the first two weeks are well tolerated with no significant hypoglycemic symptoms

While this number must be contextualized against the millions of doses administered, it underscores that quality control issues in compounded products are not hypothetical