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However, what is unclear from these studies is whether elevated serum B12 is a cause of increased mortality and related morbidities (e.g., cardiovascular disease, cancer), a consequence of other conditions associated with increased mortality (e.g., hematological, liver or kidney disease), or simply coincidental to these conditions

Ipamorelin : 2nd-generation GHRP, highly selective for GHS-R1a, no significant impact on cortisol or prolactin the current darling of modern protocols GHRP-6 : first generation, potent but triggers marked hunger (ghrelin-like action on the arcuate nucleus) and slight prolactin/cortisol elevation Hexarelin : most potent on acute GH release, but rapid GHS-R1a desensitization after prolonged use and more pronounced cortisol elevation Key point: GHRPs add an amplifying signal that potentiates GHRH, but chronic monotherapy triggers receptor down-regulation

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