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Several factors can reduce the results of peptide therapy, even when the protocol itself is appropriate: Poor sleep, which can interfere with recovery, growth hormone signaling, and tissue repair

Treatment with galanin or apelin, which are both peptides released in the intestine, results in decreased duodenal contraction via the ENS, which subsequently signals to the hypothalamus, leading to increased hypothalamic NO release and whole-body glucose utilization 79,80