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Other factors associated with hyporesponsiveness include chronic occult blood loss, aluminum toxicity, cobalamin or folate deficiencies, testosterone deficiency, inadequate dialysis, hyperparathyroidism and superimposed primary bone marrow disease, and these should be addressed in patients whose anemia does not respond as expected to ESA therapy

Thus, in summery the lipophilic character of the side chain in position 1 is essential and the proper orientation of the Tyr 2 side chain in space is critical for activity and IRAP inhibition while various alternations and topography at the C-terminal are more acceptable

Understanding these recommendations helps prevent both deficiency and unnecessary over-supplementation

Bacteriostatic water is the recommended reconstitution medium for BPC-157, TB-500, CJC-1295, Ipamorelin, Epithalon, GHK-Cu, and virtually all other lyophilized research peptides