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[5] [6] The effects of persistent high cortisol are wide-ranging and can include: Weight gain , particularly around the abdomen and face Insulin resistance and increased risk of type 2 diabetes Hypertension (high blood pressure) Osteoporosis and increased fracture risk Mood disturbances , including anxiety and depression Immune suppression , leading to increased infection susceptibility Muscle weakness and skin changes The relationship between cortisol and metabolic health is particularly significant

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These results have been replicated in real-world clinical practice, where compounded semaglutide demonstrates comparable efficacy to brand-name formulations