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Hypothalamic GHRH stimulates the pituitary gland to release GH, which in turn stimulates hepatic production of IGF-1

Carnitine levels and the ability to synthesize carnitine decline as we age [7], which may help explain why energy levels tend to dip and metabolic health tends to decline as we get older, even if all else remains pretty stable

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Yang H, Kuhn C, Kolben T, et al

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Biochem J 439:479485 Qiu X, Liu K, Xiao L, Jin S, Dong J, Teng X, Guo Q, Chen Y, Wu Y (2018) Alpha-lipoic acid regulates the autophagy of vascular smooth muscle cells in diabetes by elevating hydrogen sulfide level