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Tendon issues seem to get more discussion than cartilage

E may support cardiovascular protection

Pulsatile release matches natural physiology and feedback mechanisms.

Cell cultures lack complexity of whole organism systems.

Metabolism alters compounds differently inside living bodies.

Exogenous GH creates steady elevated levels lacking pulses.

Natural pulses coordinate better with IGF1 production timing.

Dosages effective in vitro unrealistic in vivo conditions.

Absorption barriers prevent reaching target tissues effectively sometimes.

Exogenous dosing may suppress endogenous secretion temporarily somewhat.

Pulsatile patterns support balanced metabolic and recovery effects.

Interactions with hormones enzymes change expected outcomes dramatically.

Isolated cells ignore immune system influence entirely often.

Constant exposure may increase desensitization risk over time.

Secretagogues mimic pulsatile release more physiologically accurate overall.