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Exclusion criteria were as follows: abnormal blood pressure, history of alcoholism or illicit drug use, positive pregnancy test, refusal to use acceptable contraception throughout the study period (unless surgically sterilized or postmenopausal), vaccination or surgery within the prior 3 months, or use of antitumor necrosis factor (anti-TNF) therapy in the prior 6 months

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The Endocrine Society's 2016 clinical practice guideline on GH deficiency in children states: "Monitoring of IGF-1 levels is recommended every 6 months and should be maintained within the normal range for age and sex to minimize potential risks." [7] That standard applies directly to sermorelin-treated adolescents, since the downstream outcome (IGF-1 elevation) is the same regardless of whether GH is given directly or stimulated endogenously

Hepatotoxicity Induced by the 3Ks: Kava, Kratom and Khat