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It upregulates some of the same pathways NAD+ feeds, which is why patients who combine them often report more consistent energy and metabolic improvement than patients on either one alone

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Where CJC-1295/Ipamorelin works by elevating GH to drive IGF-1 production in the liver, IGF-1 LR3 acts directly at the muscle tissue level binding IGF-1 receptors on muscle cells to stimulate protein synthesis, satellite cell activation, and muscle hypertrophy independently of the GH axis