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Severe throat pain that interferes with swallowing liquids or solid food, or throat discomfort that develops suddenly after weeks of stable treatment, warrants prompt medical evaluation

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However, GH can also exert metabolic actions independent from IGF-1 generation in the liver via activation of the phosphoinositide 3-kinase (PI3 K) and IRS pathways [98]

Metabolic actions of insulin-like growth factor-I in normal physiology and diabetes