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Other risk factors for the development of toxicity include age (both neonatal and geriatric patients), fever, sepsis and dehydration

Those with Chronic Liver Disease and Renal Failure, Lebers Hereditary Optic Neuropathy, Megaloblastic anemia, or if you have allergies to any of the ingredients

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Ipamorelin is a selective pentapeptide growth hormone secretagogue that mimics ghrelin signaling at the GHS-R1a receptor

While one trial did show VAX-D to be more effective than TENS, concerns about study design, limited generalizability, and safety risks have kept it from being widely accepted as a standard treatment (Aetna Clinical Policy Bulletins, 2025)