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reduce somatotroph sensitivity | Blunts GH response | IGF-1 at 8 weeks | | Octreotide / lanreotide | SSTR2/5 agonism | Abolishes GH response | Avoid concurrent use | | rhGH (somatropin) | Redundant GH axis stimulation | Excessive IGF-1 | 7-day washout before starting sermorelin | | Oral oestrogen | Reduces hepatic GH receptor density | Lowers IGF-1 per unit GH | Prefer transdermal route