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The findings show that SMVI is an important safety concern often associated with suboptimal communication, feeling undignified in care interactions, and perceived lack of clinician knowledge or trustworthiness

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IGF-1 Upregulation Downstream Anabolic Signaling Both peptides indirectly stimulate insulin-like growth factor-1 (IGF-1) production through sustained growth hormone elevation: Growth hormone binds to hepatic GH receptors activating JAK-STAT signaling pathways Increased transcription of IGF-1 gene in liver tissue Elevated plasma IGF-1 levels mediate anabolic effects in muscle, bone, and adipose tissue IGF-1 provides negative feedback regulation preventing excessive growth hormone secretion Studies report IGF-1 increases of 1.5- to 3-fold for 9-11 days following CJC-1295 administration, with the ipamorelin combination providing more sustained elevation

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