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The two peptides work through complementary mechanisms: tesamorelin stimulates anterior pituitary somatotrophs to release endogenous growth hormone (GH) through GHRH receptor activation, while ipamorelin amplifies GH pulse amplitude without stimulating prolactin or cortisol release, a selectivity advantage over earlier secretagogues like GHRP-6

The rate of carnitine excretion is not a useful indicator of carnitine status because it can vary with dietary carnitine intake and other physiologic parameters

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