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Ipamorelin is a selective GH secretagogue

Arch Biochem Biophys 82:7077

This causes a rise in lipid peroxidation, which triggers the death of hair cells, supporting cells, stria vascularis cells, and SGNs (Rabio-Costa et al

Hyperactivity in the dorsal cochlear nucleus after intense sound exposure and its resemblance to tone-evoked activity: A physiological model for tinnitus

Some ingredients do cause a warm sensation such as magnesium and some can cause a person to move toxins in your body and can make you initially feel a little off