Absolute Contraindications Active malignancy Pregnancy and lactation Severe hypoglycemia disorders Known hypersensitivity to IGF-1 Active proliferative retinopathy Relative Contraindications Diabetes mellitus Renal impairment Cardiac impairment History of hyperplasia Family history of certain cancers Severe hepatic impairment Dosing & Administration Starting Dose 2050 mcg/day subcutaneously Begin at the lower end for sensitive patients Assess tolerance for 12 weeks before titration Therapeutic Range 50120 mcg/day for most indications Maximum dose: 200 mcg/day Individualize dosing based on response and tolerance Cycling Protocol 46 weeks on therapy 4 weeks off therapy Helps prevent receptor desensitization Supports long-term efficacy Administration Guidelines Hypoglycemia Prevention: Always administer IGF-1 LR3 with or shortly after carbohydrate-containing meals
Regular monitoring of fasting glucose, fasting insulin, HOMA-IR, and HbA1c is suggested to monitor changes and refine dosing or lifestyle plans
Eligible patients may qualify for telehealth wellness consultations
The Problem of Caloric Restriction Severe caloric deficit, whether from medication-induced appetite suppression or intentional restriction, triggers adaptive responses that consume muscle tissue
doi:10.3892/etm.2020.9557 Hauser RA, Lyons KE, McClain T, Carter S, Perlmutter D
