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However, symptoms occurring more than twice weekly, especially when accompanied by difficulty swallowing, persistent cough, or sleep disruption, indicate a more serious condition requiring comprehensive management

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Sample 8-Week Starting Protocol | Time | Ipamorelin | GHK-Cu | |------|-----------|--------| | Bedtime (fasted) | 200 mcg SQ | 1 mg SQ | | Morning (optional, fasted) | 200 mcg SQ | Skip or 1 mg topical | | Duration | 8 weeks | 8 weeks | | Washout | 4 weeks | 2 weeks (shorter, no pituitary axis concern) | Dose adjustments should be guided by IGF-1 levels drawn at week 4 (see Monitoring section below)