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The Synergy of Dual-Pathway Stimulation The complementary mechanism works as follows: Sermorelin activates GHRH receptors, telling the pituitary gland when to release growth hormone Ipamorelin activates GHS receptors, amplifying how much growth hormone is released during each pulse Research on the interaction between GHRH and GHS pathways has demonstrated that combined stimulation produces GH responses that are greater than the sum of individual responses a phenomenon described as synergistic rather than merely additive (7)