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According to TeleHealth Med's FAQ, licensed providers adjust dosing carefully and monitor progress throughout treatment to help minimize discomfort

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Additionally, new or worsening constipation accompanied by unexplained weight loss (beyond expected therapeutic weight reduction), persistent changes in stool caliber, or alternating constipation and diarrhea warrants evaluation to exclude structural or neoplastic causes, particularly in patients age 45 or older or those with family history of colorectal cancer

This dose is not therapeutic but serves as a tolerance-building phase

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