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[1] Because intrinsic-factor-dependent uptake in the distal ileum can be absent in conditions such as autoimmune gastritis, pancreatic insufficiency, or bariatric surgery, the intramuscular or subcutaneous route bypasses gastrointestinal barriers and reliably restores serum concentrations

In these areas, studies reported reduced activity of non-ETC mitochondrial enzymes, such as aconitase and pyruvate dehydrogenase

Its oral bioavailability distinguishes it from all peptide-based GH secretagogues, which require injection

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