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The Endocrine Society's 2019 clinical practice guideline on GH replacement in adults notes that oral GH secretagogues remain "investigational" and recommends against off-label use pending adequate safety data 24

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Both preclinical and clinical studies show that circadian disruption aggravates BBB injury, characterized by reduced expression of tight junction proteins (ZO-1, occludin, claudin-5), heightened neuroinflammation (TNF-, IL-1), MMP-9/2mediated extracellular matrix degradation, and HPA axis dysregulation

It may also reduce production of pro-inflammatory cytokines while supporting production of anti-inflammatory compounds, helping restore proper immune balance

Kirkman HN, Gaetani GF

Be aware of warning signs that require prompt medical attention