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Elevated GH secretion drives downstream IGF-1 production, mediated primarily through hepatic GH receptor signalling, and the GH/IGF-1 axis effects of ipamorelin including anabolic signalling in skeletal muscle, lipolytic activity in adipose tissue, and effects on bone metabolism have been studied in multiple preclinical models

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Stopping treatment entirely (because B12, MMA or homocysteine values are back to standard) without the causes having been removed is not the correct way of treating a patient