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The presence of Sec as a catalytic group is thought to ensure a rapid reaction with hydrogen peroxide and a fast reduction of GSH [65]

Protein intake timing is critical because IGF-1 activates mTOR, the nutrient-sensing kinase that drives protein synthesis only when sufficient amino acids (particularly leucine at 2.53g per meal) are present to co-activate the pathway without adequate dietary protein, IGF-1 receptor activation occurs but downstream translation of mRNA into new muscle protein is blunted by lack of substrate

If IGF-1 remains below the age-adjusted lower quartile and the patient tolerates the dose without fluid retention or glucose elevation, increase to 100 to 150 mcg twice daily

The orexigenic hormone acyl-ghrelin increases adult hippocampal neurogenesis and enhances pattern separation