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Therapeutically, this complexity necessitates the deployment of multitargeted and adaptive strategies with clinical trials (Table 2)

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An initial 4-8 week assessment period allows evaluation of individual response and tolerance before committing to extended therapy

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The broader secretagogue field offers a sobering precedent: the orally active GHS ibutamoren (MK-677) durably raised IGF-1 in trials, yet did not reliably convert that biochemical change into the functional benefits investigators hoped for

Other subclassesfor example, the flavan-3-ols (catechins found in green tea) and isoflavones (soy-derived phytoestrogens)also exhibit neuroprotective activities in experimental models of PD (28)