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Interestingly, despite GH deficiency and low serum IGF-I concentration, they exhibit normal levels of testicular IGF-I[119]

Issues raised in academic and consumer reviews include irritation in cosmetic-formulation use, very wide variation in product quality across the unregulated marketplace, formulation-stability problems, ingredient-interaction concerns, and a thin clinical-trial evidence base relative to the strength of consumer marketing claims

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Other strategies include dopamine agonists that bind to the dopamine receptors in the pituitary gland and block the secretion of prolactin and GH