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Clinical Scenarios Favoring Monotherapy IGF-1 is 20-30% below the age-adjusted reference range but not severely deficient The patient is age 30% below range) | | Age | 50 | | Prior response to sermorelin | IGF-1 normalized at 12 weeks | IGF-1 unchanged or minimally changed | | Pituitary reserve assessment | Normal GH stimulation test | Subnormal peak GH on stimulation | | Cost tolerance | Lower | Higher | | Concurrent anabolic goals | Baseline wellness | Body recomposition, recovery | Dosing the Sermorelin + CJC-1295 Protocol No published RCT has evaluated the combination protocol head-to-head against monotherapy in adults