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Rosen LS, Abdi E, Davis ID, Gutheil J, Schnell FM, Zalcberg J, et al

IGF-1 is useful precisely because it is slow-moving: unlike GH, whose serum level swings across a single pulse and is hard to capture with a spot measurement, IGF-1 integrates GH exposure over roughly a day, so a sustained rise in IGF-1 is strong evidence that GH output has genuinely increased rather than merely been re-timed