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Ipamorelin and GHRH produce synergistic GH release when co-administered , with the combined response substantially exceeding the sum of individual responses through complementary Gq/11 and Gs signalling pathway interactions in somatotrophs, identical in mechanism to the GHRH-GHRP-6 and GHRH-GHRP-2 synergy documented for non-selective GH secretagogues but without prolactin and cortisol co-stimulation confounding the combined endocrine response