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Kitaguchi et al

Chronic ACTH stimulation may blunt adrenal reserve over time, and elevated prolactin can suppress testosterone in men and affect menstrual cycling in women

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doi: 10.1016/j.lfs.2023.122060

It is also unknown how much of resistance of endogenous signaling contributes to the heterogeneity observed in metabolic disease and the variable patient responses to pharmacological treatments including DPP4 inhibitors, GLP-1R agonists and bariatric surgery

What this means clinically is that GHK-Cu works on multiple fronts simultaneously