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Stacking IGF-1 LR3 with upstream GH secretagogues like Ipamorelin or CJC 1295 Ipamorelin is mechanistically sound because they stimulate endogenous GH release, which has independent anabolic pathways (JAK-STAT signaling, direct lipolysis) that don't compete with IGF-1R binding

10.1161/01.hyp.36.1.142 224 VazulkaS.SchiavinatoM.WagenknechtM.Cserjan-PuschmannM.StriednerG

The overall results were mixed

Patients should maintain regular contact with their GP or hepatology team to ensure appropriate surveillance and timely intervention when deficiencies or disease progression are detected