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This leads to reduced production of malonyl-CoA and consequently relieves the inhibition of carnitine palmitoyltransferase 1 (CPT1), promoting fatty acid -oxidation

Although the underlying mechanisms are not fully understood, proposed contributors include reductions in N-terminal proB-type natriuretic peptide levels [95], improvements in cardiac remodeling [96], and anti-inflammatory effects [97]

This self-regulating feature makes it significantly more difficult to reach supraphysiological GH levels compared to direct HGH injection, reducing the risk of side effects associated with GH excess

Naylor et al., 1998

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