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Referral to endocrinology, cardiology, or lipid specialists may be warranted for complex cases involving multiple cardiovascular risk factors, familial hypercholesterolemia, severe hypertriglyceridemia (500 mg/dL), or inadequate response to initial therapy

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In addition to this enhanced federal scrutiny, state attorneys general have signaled a willingness to engage in consumer protection enforcement relating to compounded drugs, particularly those marketed online