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Options for managing tolerance include a brief dose reduction for 4 to 8 weeks ("drug holiday" at a lower dose, not complete cessation), lifestyle optimization to maximize the medication effect, evaluation for other contributing factors (thyroid function, cortisol, sleep quality, medication interactions), and consideration of adding a complementary compound to address specific aspects of the plateau

GH & IGF-1 support Studied for stimulating pulsatile growth hormone release, pairing a ghrelin agonist with a GHRH analog to raise IGF-1

The G0/G1 switch gene 2 regulates adipose lipolysis through association with adipose triglyceride lipase

Stubborn dark spots take a bit longer usually around 2-3 months for significant fading