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Peripherally, GLP-1 RAs delay gastric emptying, lower levels of the hunger hormone ghrelin, and improve glucose and lipid metabolism by enhancing insulin secretion, reducing glucagon release, and promoting fat utilization

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Furthermore, similar to ACLY, ACSS2 can translocate into the nucleus and supply acetyl-CoA for histone acetylation to regulate gene expression 108,114

Important caveat: the idea that a GHRH analog plus a ghrelin agonist produce additive or synergistic GH output is a reasonable hypothesis, but it has not been validated for this specific blend or its dosing