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Since I had the doctors ear and even though I was not experiencing acute signs nor symptoms of low B12 (pernicious anemia), I took the opportunity to ask him about the possibility of beginning monthly vitamin B12 injections He was aware of my years of nursing practice and thoughtfully considered my request

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Functional/Acquired IGF-I Deficiency - Uncoupling of GHR Signaling to IGF1 Gene Transcription and Maintained GHR Metabolic Signaling Due to Insulin Deficiency Increased GHR signaling in obese children does not generally result in elevated IGF-I, due to negative feedback inhibition of GH