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Researchers have proposed several non-exclusive frameworks, including blood-brain-barrier transport of an endogenous peptide, interaction with the stress axis, circadian and pineal signalling via the alpha-1-adrenergic receptor (PMID 3029331), and neuroprotective activity

Factors such as caloric restriction, rapid weight loss, changes in body composition, stress, sleep disruption, and concurrent medical conditions can all influence testosterone levels during treatment

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