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Reports of severe adverse events include allergic reactions ranging from mild rashes to anaphylactic shock, kidney dysfunction particularly with high doses or prolonged use, liver toxicity in susceptible individuals, and thyroid dysfunction affecting hormone regulation

However, the sustained elevation comes with trade-offs

376,377,378 In a dexamethasone-induced muscle atrophy model, Ex-4 ameliorated muscle atrophy by inhibiting muscle atrophy factor and enhancing myogenic factors (MyoG and MyoD), thereby increasing muscle mass and function