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In such cases, the NHS standard treatment is intramuscular hydroxocobalamin injections, typically given every 2-3 months for maintenance after an initial loading regimen

For researchers seeking enhanced fat loss alongside GH therapy, the more common approach is to combine GH with GH-releasing peptides such as ipamorelin or GHRH analogs like sermorelin or tesamorelin, which amplify endogenous GH pulsatility rather than providing a redundant fragment

This process, in some cases, we have seen happen over several years