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This protocol has successfully standardised care for this patient group and allowed continuation of this essential service provision during the COVID-19 pandemic

He developed symptoms of toxic encephalopathy gradually over the course of 6 months such as concentration difficulties, memory loss, bilateral upper limb trembling, involuntary movements (parkinsonism), holding instability, unsteady gait, and increased muscle tone

Of course, the fundamental medications did not contain SGLT2i inhibitors

Stacked Protocol (Sermorelin + Ipamorelin) Dose: 0.2 mg Sermorelin + 0.2 mg Ipamorelin (= 4 clicks) Duration: 8 12 weeks Frequency: Daily, before sleep Cycle Interval: 4 weeks off before repeating Goal / Description: Combined GHRH and GHRP pathways investigated for amplified GH release and IGF-1 response