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A study evaluating the effect of a pulsatile vs continuous iv administration of hGH in GH-deficient patients (38) found that eight boluses (given at 3 h intervals starting at 8:00 pm) or a continuous infusion of a fixed total hGH dose were equally effective in generating an increase in IGF-1, whereas the same amount of hGH given as two large boluses (at 8:00 pm and 2:00 am) resulted in a significantly smaller increase in IGF-1

Based on these studies, we believe that there is an individual difference between clinical manifestations/presentation, pathogenesis pathways involved, and hence treatment options adopted [158]

It may also cause numbness

Overall, mitochondrial diseases are increasingly recognized as pathway-based disorders rather than merely energy-related conditions