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But the side effects that receive the least attention online are the ones that matter most to anyone considering it: significant lean muscle loss documented by DEXA scanning, dopamine suppression that can flatten mood and drive, and dosing decisions where the difference between 8 mg and 12 mg is roughly 1 percent more fat loss and approximately double the side effects

S.HirasawaR.et al (2016)

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This method is less precise because it does not deposit the medication near the target nerve root, and the steroid solution is free to spread within the epidural space