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Ipamorelin alone triggers GH-release pulses through the GHSR pathway, producing a research signal, but without the CJC-1295 sensitivity amplification the magnitude is smaller than the combination

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Higher-dose oral B12 (e.g., 1000 g daily) is sometimes used but should only be considered under clinical supervision with appropriate monitoring, particularly in cases of malabsorption where intramuscular treatment remains the first-line approach in UK practice

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