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Monitoring focuses on glucose handling, IGF-axis context, cardiovascular risk, and symptoms that may suggest excessive pathway activity
Medication review is prudent, as numerous medications can cause cognitive side effects
Laboratory evaluation may include complete blood count, iron studies (ferritin, iron, TIBC), comprehensive metabolic panel, thyroid function tests, and vitamin B12 and vitamin D levels
These processes result in the production of anticitrullinated protein antibodies (ACPAs) and rheumatoid factor prior to clinical symptom onset
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