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Common causes include inadequate dietary intake, particularly in those following strict vegetarian or vegan diets that exclude meat, eggs, and dairythe primary sources of B12

Enzymatic conversion of IGF-I to des(1-3)IGF-I in rat serum and tissues: a further potential site of growth hormone regulation of IGF-I action

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In combination, ipamorelin and CJC-1295 without DAC (also known as Modified GRF) exhibit a synergistic effect, elevating both GH and IGF-1 levels in a pulsatile, physiologic manner