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Ghrelin is an orexigenic peptide hormone secreted from stomach in response to fasting situations and stimulates the ghrelin receptor in the brain to initiate appetite 1,2,3,4

Two key contributors: blood sugar reduction (even modest drops can cause tiredness during adaptation) and dehydration, since electrolyte imbalance prevents water from reaching cells even when fluid intake seems adequate

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GLP-1 medications activate the GLP-1 receptors in the brain

Additionally, injecting through clothing should be avoided, as fabric can deflect the needle or introduce contaminants