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TB-500 operates primarily through actin dynamics: it binds G-actin monomers to regulate the monomeric actin pool, which is thought to influence cell migration in experimental wound models

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Mechanistically, its protective effects are mediated by the Nrf2/HO-1 pathway, as inhibitors such as brusatol (Nrf2 inhibitor) and zinc protoporphyrin (Znpp, an HO-1 inhibitor) reverse its anti-apoptotic, antioxidant, and anti-inflammatory effects

Other fatty acids, which were found to be decreased by L-carnitine administration, were not decreased by the concomitant administration of L-carnitine and EPA

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Elevated IGF-1 levels raise concerns about potential proliferative effects on existing malignancies, making growth hormone therapy problematic for individuals with cancer history or elevated cancer risk