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Persistent insomnia beyond 4-6 weeks despite implementing all strategies in this guide suggests either an unrelated sleep disorder or a contributing factor that has not been identified

This observation lacks rigorous controlled trial data but appears consistently in user reports

Routine heart and blood pressure checks are recommended

While most individuals stabilize between 10 mg and 15 mg weekly, the ideal dose is highly personalized and should only be modified under medical supervision

Because hepatotoxicity can rarely occur in patients treated with tamoxifen, liver function tests should be monitored periodically during tamoxifen therapy

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