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It acts by mimicking the endogenous hormone ghrelin and binding to the growth hormone secretagogue receptor type 1a (GHS-R1a) in the anterior pituitary gland

These are pathway-level signals they do not predict how you will respond to any specific compound, but they describe the biological terrain a clinician is working within

Two downstream consequences are mechanistically central: nicotinamide is preserved for re-entry into the NAD+ salvage pathway (raising intracellular NAD+ availability), and SAM is preserved for other methylation reactions

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This guide will help you understand your condition and partner with your surgeon to choose the best path forward