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Tumour necrosis factor, IL-1 and IL-6 also cause cardiac myocyte hypertrophy and fibrosis and have negative inotropic effects, so may directly contribute to progression of disease

The process works as follows: Stimulates Growth Hormone Release: Certain peptides bind to the growth hormone secretagogue receptors (GHS-R) in the pituitary gland, thereby promoting the natural release of human growth hormone (HGH), which leads to increased lean muscle mass

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