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This synthetic peptide, derived from the fragment 177-191 of human growth hormone (hGH), is designed to selectively stimulate fat metabolism without engaging growth hormone receptors that influence tissues beyond fat cells (2)

When symptoms do occur, they may include 7,46,47 : Debilitating fatigue Itching and numbness Headaches Muscle cramps Weight loss Sleep disturbances Lack of appetite Nausea and vomiting Shortness of breath Seizures Edema (swelling) of the extremities CKD is often discovered in people who do not have significant symptoms when they either attend their yearly physical and undergo lab testing or have blood work done for other reasons

This dual action (build new, clear old) results in a more thorough skin remodeling effect

It exerts a protective effect by scavenging peroxynitrite and preventing the release of AIF and EndoG from mitochondria and subsequent nuclear DNA breakage (Du et al., 2015)

People with conditions such as pernicious anaemia or other absorption disorders may require regular Vitamin B12 injections

The biggest change to current clinical practice is likely to be the advice to consider periodic monitoring of B12 levels in patients taking metformin who are at risk of deficiency, which includes a wide range of our patients living with type 2 diabetes