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Reduced pituitary ACTH output (not adrenal failure) is the upstream dysregulation in OTS

Increased muscle mass and strength IGF-1 LR3 drives muscle development through two primary mechanisms: hyperplasia (increasing muscle cell numbers) and mitogenesis (developing new muscle fibers)

Mpalaris, Vasilios, et al

The clinical data in humans doesnt exist yet

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The published human data supporting BPC-157 may not be strong, but, he argued, forbidding American companies from providing it would move it deeper into a market with no production or sourcing standards, no physician, no monitoring, and no record. That view was echoed by Jeffrey Egler, the chief medical officer at the telehealth company Noom