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Distributed under the brand names Geref and Geref Diagnostic, it gained FDA approval in 1997 as a treatment for growth hormone deficiency but was discontinued in 2008 not out of concern for safety or lack of efficacy, but because of manufacturing difficulties.2 3 Yet it remains available in compounded form with a prescription from a licensed healthcare provider

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through isolation from human plasma

A partially purified leaf enzyme with DHAR activity was subsequently reported, but was considered likely to be cytosolic (Foyer and Halliwell 1977)

Therefore, this review will focus on the interaction between the circadian rhythm and the GH-IGF-1 axis and its effect on metabolism