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others feel the effects build gradually over a day or two

Frequent bouts of vomiting can cause severe dehydration, malnutrition, irritation and injury to the esophagus, acidic erosion of the tooth enamel, and tooth loss

Its defining modification is a trans -3-hexenoyl group attached to the N-terminal tyrosine, a chemical change designed to protect the peptide from rapid cleavage by dipeptidyl peptidase-4 (DPP-4), the enzyme that quickly inactivates native GHRH

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