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This is why precise water volume measurements matter: even a small deviation changes every subsequent dose

Reduced IGFBP affinity increases in-vitro potency yet can actually accelerate in-vivo clearance because binding proteins serve as a stabilizing reservoir

It declines with age due to oxidative stress and mitochondrial dysfunction, with aneuploidy rates rising from ~20% in the early 20s to over 80% by the early 40s

Additionally, some medicines can increase the risk of deficiency

Vitamin D, especially in active forms like calcitriol, increases calcium levels and must be used carefully in renal patients