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An exercise physiologist at UC Davis Health clarified this point directly: We are losing around 20% of muscle mass, but that is not different from diets that restrict calorie intake

DOI: 10.1677/joe.0.1650569

However, administration of calcitriol or activation of renal calcium reabsorption by a retinoid derivate restored plasma IGF-1 levels.110 Importantly, chondrocytes isolated from rats with renal insufficiency also show decreased response to the anabolic effects of IGF-1 compared to chondrocytes from rats with normal renal function,111 suggesting that intracellular alterations as causing factors for IGF-1 resistance

MK-677 is contraindicated in subjects with a history of cancer or active malignancies, as increased GH and IGF-1 levels can stimulate the proliferation of cancer cells and disease progression