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Instead, it increases growth hormone levels, which can indirectly affect other hormones in the body

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Understanding this difference helps clarify why dose increases alone sometimes fail to restore the original effect, and why alternative strategieslike medication rotation or genetic optimizationmay be necessary

The mechanism has been associated with enhanced blood flow to active musculature, however, it might be more far-reaching as either ammonia homeostasis could be improved, or ATP production could be increased via greater availability of malate