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without enough water, ones heart and other vital organs will work harder to function

Eu J Pharmacol 2007

Pairing a GHRH analogue with a GHS-R1a agonist is a long-standing design in secretagogue research, following the work of Bowers and colleagues showing that the two classes produce a greater combined response than either alone

This is the billion-dollar question

I suspect this is from the glucagon agonism of the drug as glucagon stimulates the formation of extra bile acids/bile salts in the liver which can be very irritating to the intestinal lining causing diarrhea