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Beyond the pituitary, GHS-R1a is also expressed on enteric and vagal neurons (relevant to gut motility), on pancreatic islet cells, and in hypothalamic appetite circuitry the receptor-level explanation for why ghrelin-receptor agonists as a class tend to increase appetite, a pattern that shows up in ipamorelin's own real-world reports below

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Sadly, theres not a lot you can do about the second