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However, exercise intensity may need to be adjusted during the first two to four weeks of keto adaptation, as energy levels can fluctuate before the body becomes efficient at using ketones for fuel

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So use in patients with cardiovascular disease or a family history of sudden death and heart rhythm problems should be avoided

**Never shake.** Shaking denatures peptide bonds and can reduce potency

It is not yet approved for general medical use and remains in Phase 3 clinical trials, where researchers are assessing long-term safety, durability of weight loss, and broader metabolic benefits