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Two main signals are involved: - Growth Hormone Releasing Hormone (GHRH) stimulates growth hormone release - Somatostatin inhibits growth hormone release When GHRH signalling dominates, the pituitary gland releases growth hormone (GH) into the bloodstream

Isenberg et al., 1997

Potential side effects and how to mitigate them

Vitamin D Optimization Given the association between vitamin D deficiency and fibroid prevalence, and the antiproliferative effects of 1,25-dihydroxyvitamin D3 on leiomyoma cells in animal models, assessing and correcting vitamin D status is a reasonable, low-risk intervention. Endocrine-disrupting chemicals (EDCs) have been shown to interact with vitamin D pathways in fibroid pathogenesis. 6

Rideau Batista Novais A, Crouzin N, Cavalier M, Boubal M, Guiramand J, Cohen-Solal C, et al