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in contrast, when these two proline residues are non-hydroxylated, HIF-1 is transferred to the nucleus and activates the expression of downstream genes (Schofield and Ratcliffe, 2004

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If fasting glucose stays elevated, triglycerides do not improve, or weight loss plateaus despite meeting the protein, fiber and exercise targets, it treats that as the signal to bring your results to a provider rather than repeating the same approach indefinitely