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My work increasingly suggests that sustainable regeneration may require restoring system integrity first, not forcing isolated pathways harder. Growth hormone pulses naturally during slow-wave sleep

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Prevalence and confounders the 60% figure, why it almost certainly captures all three FOR/NFOR/OTS categories plus REDS, depression, and illness, and why the residual true training-load-induced OTS in an otherwise healthy athlete may be vanishingly rare

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