The realistic middle is worth stating plainly
2020:e196650
On the other hand, several preclinical trials have investigated the peptides effect on muscle mass, appetite, body weight, bone mass, and more: Increased Appetite, Muscle, and Body Weight: Laboratory studies have pointed out that ipamorelin may contribute to weight gain, associated with increases in both lean and fat mass
Molecular pathways documented in preclinical research include: (1) activation of nitric oxide (NO) synthesis via L-arginine/eNOS pathway, (2) transcriptional upregulation of VEGF-A and FGF-2 favouring angiogenesis, (3) modulation of the Egr-1 early transcription factor involved in fibroblast proliferation, (4) interaction with 5-HT2A and dopaminergic receptors in some behavioural models, (5) stabilisation of endothelial function via eNOS modulation and reduction of oxidative stress (8-OH-dG, MDA)
Of note, Jacob et al
This mechanism relies on intact pituitary and hypothalamic function, making efficacy dependent on baseline hormonal reserve and individual receptor sensitivity