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doi:10.1038/cdd.2009.107 Kavouras JH, Prandovszky E, Valyi-Nagy K, et al

Tesamorelin is a stabilized analog of endogenous GHRH that interacts with GHRH receptors to influence growth hormone signaling cascades, while Ipamorelin is a selective agonist of the ghrelin (GHS-R1a) receptor studied for its role in modulating growth hormone release without significant interaction with other hormonal pathways

In the nucleus, the THF carrier is oxidized to DHF in an NADPH-generating reaction with electrons used to reduce one-carbon units to the methyl level