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doi: 10.1007/s10549-011-1585-0 89 TanakaYIwayaCKawanamiTHamaguchiYHorikawaTShigeokaTet al

In most cases, either approach can work

Cycle Duration and Monitoring Typical cycle: 1224 weeks Monitoring: baseline and 1012 week IGF-1 measurement is the most common biomarker Washout: 48 weeks between cycles is standard practitioner practice Contraindications Active malignancy GH/IGF-1 axis elevation is a theoretical oncogenic concern Diabetes mellitus GH elevates insulin resistance

Slow-digesting, high-fiber carbohydrates may help stabilize blood sugar levels and reduce spikes

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