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9 Several preexisting diseases, particularly cardiopulmonary diseases (such as pulmonary hypertension and bleeding disorders), may increase susceptibility to high-altitude disease

If you've completed 46 weeks at standard dosage without measurable body composition change, the issue is likely dietary (insufficient caloric deficit) rather than dosage insufficiency

Malaguarnera, M., Vacante, M., Giordano, M., Motta, M., Malaguarnera, M., Bella, R

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4,6,8,50,52,53 In clinical practice, signs of unintentional toxic ingestion typically present later, when the above-mentioned complications are already apparent and have progressed