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Excess glucocorticoid exposure suppresses GH secretion mainly through the increase in hypothalamic somatostatin tone, whereas low cortisol levels causes relative GHD that is reversible by glucocorticoid therapy (“Giustina’s effect”) ( Figure 5 ) ( Figure 5 Effects of weight loss Short-term fasting is an important stimulator of GH secretion ( Table 1

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7/17 (41.2%) of the STG group had received VB12 or made arrangements to receive supplemental VB12 if it was indicated