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Nat Rev Microbiol 2021;19:14154 2

Timing and Circadian Effects The pituitary also has intrinsic rhythmicity and responsiveness that varies throughout the day and in different metabolic states - somatotrophs are more responsive to GHRH stimulation during certain circadian phases (particularly during sleep), after exercise, during fasting, and in the presence of ghrelin (the "hunger hormone" that synergizes with GHRH to amplify GH release)

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Peptides like enclomiphene and gonadorelin can raise testosterone 30 to 60 percent above baseline while preserving natural production and fertility