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The mechanism may involve modulation of somatostatin (GH inhibitory hormone) release from the hypothalamus, or interaction with GHRH neurons

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37 Senescent fibroblasts promote degradation of the extracellular matrix (ECM) by secreting matrix metalloproteinase-1 (MMP1) and other proinflammatory factors, 38 ultimately leading to thinning of the epidermis and decreased barrier function, 39 while the selective removal of senescent cells leads to normalization of the ECM and a reduction in inflammation

So if you have someone coming in who has insomnia or constipation, no matter what kind of protocol you put them on, if they're not sleeping and they're not pooping, you're not going to get very far, right