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In some cases, it may be through changes to the skin microbiome, but its not a guaranteed trigger

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Aptamer-based approaches in leukemia: a paradigm shift in targeted therapy

Al Rubaiy HHM, Altemimi A, Al Rikabi AKJ, Lakhssassi N, Pratap-Singh A (2021) Sustainable biosynthesis of antioxidants from koji rice fermented with Aspergillus flavus using microwave-assisted extraction

MK-677 is an orally active ghrelin mimetic that increases GH pulse frequency similarly to Ipamorelin but lacks the GHRH pathway stimulation that Tesamorelin provides, so it cannot amplify pulse amplitude

The signal was very small in the Control group