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doi: 10.1056/NEJMoa2403347

Patients who are pregnant, breastfeeding, or have known allergies to cobalt, cobalamin, or any injection components are not eligible for this private service and may be referred to their GP

Management: Limit use to 46 week cycles with at least equal time off Consider using GH peptides like GHRP2 or CJC1295 during off cycles to maintain baseline IGF-1 activity Risk of Unwanted Growth (Organs, Gut, Tumors) Long-term, excessive IGF1 can theoretically increase the risk of visceral organ growth , insulin resistance , or even tumor promotion , due to its role in cell proliferation

Direct Adrenergic Agonism: Ephedrine is also able to directly bind to multiple post-synaptic adrenergic receptor subtypes to initiate intracellular signaling cascades: : Activation of vascular smooth muscle 1 -Adrenergic Activation 1 -adrenergic receptors produces arterial and venous vasoconstriction, leading to an increase in systemic vascular resistance (SVR), diastolic blood pressure, and systolic blood pressure (Solanki et al, 2014)

16 LindermayrC.SaalbachG.DurnerJ

ALL of my inflammation is gone