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Persistence improves considerably among patients who remain on therapy beyond the initial adjustment period

Kahn J, Gillespie A, Tsokos M, Ondos J, Dombi E, Camphausen K, et al

Full-length growth hormone produces fat loss but also elevates IGF-1 (with implications for cell proliferation and aging), worsens insulin sensitivity and elevates blood glucose (problematic for diabetics and pre-diabetics), promotes muscle growth and protein synthesis (which may be desired or unwanted depending on goals), causes fluid retention and edema in many users, and requires careful medical monitoring with regular blood work

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Aim for 200-300 calories per mini-meal

She has allowed some of the Rybelsus claims to continue, but others need to be amended first