Indirectly promotes: Muscle growth Lipolysis (fat breakdown) Collagen synthesis and tissue repair Bone density improvements Mechanistically, HGH activates: JAK2/STAT5 pathway for gene transcription IGF-1 production which then triggers anabolic action GH exerts its growth-promoting effects primarily through the stimulation of IGF-1, which acts in an endocrine, paracrine, and autocrine manner. Laron, Growth Hormone & IGF Research Insulin-like Growth Factor-1 (IGF-1) Produced by the liver in response to GH, but also delivered directly through peptide analogs like IGF-1 LR3 or IGF-1 DES
Blood tests may sometimes be recommended before starting therapy
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Vitamin B12 There is four types of parenteral Vitamin B12 available: Cyanocobalamin 100 mcg/ml and 1000 mcg/ml best used as IM to prevent rapid loss via kidneys Hydroxycobalamin IM (compounded 1000 mcg/ml or more) known as long acting B12 (binds better to plasma proteins than cyanocobalamin) Methylcobalamin IV (compounded 1000 mcg or more up to 5000 mcg/ml) Adenosylcobalamin IV Common dose is 1000 mcg IM or IV Vitamin B12 as hydroxycobalamin is synthesized exclusively by microorganisms and is found in the liver of animals bound to protein as methylcobalamin = metabolically active form of Vitamin B12 Hydroxycobalamin is a chelator of cyanide and is used in cyanide poisoning Hydroxocobalamin is most generally used for vitamin B12 replacement therapy and is considered the drug of choice for vitamin B12 deficiency by the Martindale Extra Pharmacopoeia (Sweetman, 2002) and the World Health Organization (WHO) Model List of Essential Drugs
McClain M, Beckett A, Cover T (2017) Helicobacter pylori vacuolating toxin and gastric cancer
