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doi: 10.1155/2019/5861537 398 PinsuwanSAmnuaikitTUngphaiboonSItharatA

The combination of reduced IGFBP binding (increasing local concentration) and enhanced receptor affinity creates a molecule approximately 10 times more potent than native IGF-1 in stimulating tissue growth

In patients on antipsychotics, antidepressants, or mood stabilizers, drug-drug interactions and additive GI toxicity are open questions