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Growth Hormone (HGH) Replaces GH directly Bypasses pituitary regulation Can suppress endogenous GH production May raise IGF-1 excessively Higher risk of edema, insulin resistance, and carpal tunnel syndrome Tesamorelin Stimulates the pituitary gland Preserves physiologic pulsatility Maintains feedback control Lower risk of GH excess Improves IGF-1 within normal ranges From a functional medicine standpoint, tesamorelin is a restorative therapy , whereas HGH is a replacement therapy

Intramuscular (IM) B12 injections using hydroxocobalamin, the preferred licensed form in the UK are recommended when: Oral supplementation has failed to correct a documented deficiency The patient has difficulty adhering to daily oral regimens Serum B12 levels remain persistently low despite adequate oral dosing There is clinical evidence of neurological or haematological complications In line with BNF guidance, the standard IM regimen for confirmed deficiency without neurological involvement is a loading course of 1 mg hydroxocobalamin on alternate days for two weeks , followed by maintenance of 1 mg every three months

Also, sleep disorders have been associated with weight gain and insulin resistance [7377]

When Tesamorelin binds with the GHRH receptor in the pituitary glands, it stimulates the release of the growth hormone that sends signals to the liver to produce insulin-like growth factor-1 (IGF-1)