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Older Adults (50+) : May need to use the standard or advanced doses of GHSs (Sermorelin, Ipamorelin ) to achieve the same GH pulse that a younger person gets from a beginner dose
Options for managing tolerance include a brief dose reduction for 4 to 8 weeks ("drug holiday" at a lower dose, not complete cessation), lifestyle optimization to maximize the medication effect, evaluation for other contributing factors (thyroid function, cortisol, sleep quality, medication interactions), and consideration of adding a complementary compound to address specific aspects of the plateau
Crucially, this happens without IGF-1 stimulation
When a billing team codes an interlaminar procedure as 64483 or vice versa, the payer receives a code-approach mismatch
It is not used to mix injections
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