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A well-structured protocol for a 65-year-old with suboptimal IGF-1, sarcopenia, and visceral adiposity might look like this: Baseline labs IGF-1, GH stimulation assessment, HbA1c, fasting insulin, CMP, CBC, lipid panel, PSA (men), thyroid panel, DEXA scan for bone density Peptide selection typically sermorelin or low-dose CJC-1295/ipamorelin for GH axis support

Increased hepatic glucose production contributes to the development of MASLD by driving hyperglycemia and consequent hyperinsulinemia, but hyperglycemia per se (independent of insulin) can also promote liver lipid accumulation by promoting the nuclear translocation of carbohydrate-responsive element binding protein (69)

Zhou HF, Li J-Y, Niu et al

Key takeaways: The oral GLP-1 era is real