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Once-daily protocols are sufficient for studies measuring cumulative metabolic effects (fat mass reduction, lean mass accrual, bone density changes) because GH signaling cascadesparticularly IGF-1 upregulation in hepatic tissuepersist beyond the GH pulse itself

Further research shows that THC reduces hepatic lipid accumulation, mitigates high-fat dietinduced oxidative stress in the liver, alleviates liver injury, and modulates the intestinal microbiota (Gao et al., 2022

Research has demonstrated that combined stimulation of both pathways produces synergistic effects on GH release that exceed the additive effects of either pathway alone

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This mechanism is called the carnitine shuttle, in which fatty acids cross the mitochondrial membranes bound to L-carnitine, forming acylcarnitine molecules that can cross the mitochondrial membrane through a transporter in exchange for free L-carnitine