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doi: 10.1016/j.jaad.2021.04.097

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Full-length human growth hormone binds to growth hormone receptors distributed throughout the body, triggering a cascade of effects including stimulation of IGF-1 production in the liver, alterations in glucose and insulin metabolism, protein synthesis in muscle tissue, bone growth and remodeling, organ enlargement with prolonged use, and fluid retention

Certain nutrients fuel ATP production and help mitochondria repair themselves , while otherslike processed foods and excess sugarcause oxidative stress and damage

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In practice, the timeline to generic entry depends on: last relevant composition patent expiration, whether use patents survive, whether exclusivity (regulatory) extends market protection, and whether litigation blocks or delays approval of biosimilar/4th-gen analogs (depending on jurisdiction)