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Optimal protocols coordinate thyroid and growth hormone optimization through comprehensive baseline thyroid testing (TSH, free T4, free T3, reverse T3, thyroid antibodies) before starting Sermorelin, ensuring adequate thyroid replacement in hypothyroid patients, with TSH targets individualized based on clinical context, patient age, and comorbidities per major endocrine guidelines, monitoring thyroid function every 3-6 months during Sermorelin therapy adjusting doses as needed, and recognizing that thyroid optimization often proves necessary prerequisite for achieving full Sermorelin benefits rather than optional consideration

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