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What it does WELL: Consistently elevates IGF-1 in randomized controlled trials and restores GH secretion to young-adult levels Increases fat-free mass over weeks and months in two-year double-blind RCT data Improves nitrogen retention and protein balance Enhances REM sleep and total sleep duration — an approximately 50% increase in stage IV sleep and 20% increase in REM versus placebo Stimulates appetite via central ghrelin signaling What gets ignored: Consistently worsens insulin sensitivity and raises fasting glucose in multiple human trials — a repeatable and replicable finding Commonly causes edema and joint discomfort The ensuing appetite dysregulation often leads to unwanted fat gain (i.e

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2 Together, GHRH and GH orchestrate growth and development across multiple tissues through both direct and indirect actions—a system known as the hypothalamic–pituitary–somatic (HPS) axis 2 (Figure 1A)

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