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Continuous GH elevation (as with exogenous GH administration) suppresses this natural pulsatility and can downregulate GH receptors

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It binds IGFBP-1, IGFBP-2, IGFBP-4, IGFBP-5, and IGFBP-6 with somewhat lower but still substantial affinity

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Conversely, obesity is often associated with slightly elevated TSH levels

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