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(2006) Ghrelin modulates the activity and synaptic input organization of midbrain dopamine neurons while promoting appetite

The logic is that GH-axis compounds are not dose-linear in a helpful way past a point: once the pulse is being driven hard, adding drug mostly buys more IGF-1 exposure, more fluid retention and more glucose disturbance rather than proportionally more benefit

Keep a water bottle accessible and aim for steady hydration rather than drinking large volumes at once

They consider the individuals heart rate and other health indicators, ruling out contraindications and ensuring safe use of the medication

The results of the subgroup analyses (pre-planned, based on baseline A1C levels, heart failure class II-III, prior MI/stroke and renal impairment) were consistent with the results from the primary analysis