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sustained growth-hormone-axis stimulation also carries a theoretical, class-wide concern for worsened insulin resistance, a recognized effect of excess growth hormone exposure generally Evidence snapshot: The strongest available evidence is a small 1997 randomized, placebo-controlled human trial (19 adults aged 55-71) testing a closely related GHRH(1-29) analog over 16 weeks, which found increased IGF-1 in both sexes, a significant lean-mass increase in men only, and increased skin thickness in both sexes

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Other side effects included decreased appetite and fatigue

Overall, older people have a higher incidence of SIBO due to poorer gastrointestinal function, which could lead to an indirect association between PPI and SIBO (Rao and Bhagatwala, 2019)