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J Endocrinol (2018) 237:16573

Similar to GH, IGF-1 alone stimulates the IRS1/Akt (Costoya et al., Conclusion RE-induced increases in key endogenous steroid and peptide hormone responses are likely to be an integral part of the integrated response to acute exercise and exercise-induced muscle growth

[2] [1] With neurological involvement: Hydroxocobalamin 1mg intramuscularly on alternate days until no further improvement, then maintenance injections every 2 months