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IGF-1 + Steroids (e.g., Testosterone, Anavar, Trenbolone) A full-spectrum PCT should be implemented: Tamoxifen (Nolvadex) 2040 mg/day for 46 weeks DHEA 100 mg/day ZMT To restore testosterone, improve sleep, and lower estrogenic rebound Combining IGF-1 analogs with suppressive anabolics alters HPTA signaling

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This mutation results in the change of proline at amino acid position 46 to a serine and this mutation is designated P46S (p.P46S)

Activation of this pathway destroyed the expression of tight junction proteins such as zonula occludens-2 (ZO-2), occludin, and vascular endothelial cadherin (VE-cadherin) in endothelial cells, which increased endothelial cell permeability