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Combining the two activates GHRH and ghrelin receptors simultaneously a 2-3x greater GH pulse than either alone (Bowers et al., JCEM 1991)
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Eur J Heart Fail 2021;23:1648-58
People who consistently show stronger effects include those with overweight or obesity, older adults who may have declining muscle carnitine stores, and people with low dietary intake of carnitine
However, the American Medical Association, the Endocrine Society, and the Obesity Medicine Association all recommend considering pharmacotherapy for patients with my BMI and comorbidity profile
The GLP-1/GIP receptor agonist also showed promising benefit in pre-diabetic patients
