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2017 Jun;36(2):79-85

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Mechanism Diagram GHK-Cu vs Growth Peptides (Key Differences) GHK-Cu - Copper binding tripeptide - Acts locally in tissue - Modulates gene expression and ECM remodelling - Not endocrine - Does not elevate GH or IGF-1 GH Secretagogues (e.g., Ipamorelin, Hexarelin, MK-677) - Act via endocrine receptors - Stimulate systemic GH release - Increase IGF-1 - Primarily hormonal These compounds operate in completely different biological domains

Transfusion threshold generally Hgb 60 or prior thrombosis): cytoreductive therapy with hydroxyurea (first-line) or interferon-alpha (preferred in younger patients, pregnant women, or hydroxyurea intolerance)