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Baseline Labs Before Starting Obtain these labs before the first dose of either agent: IGF-1 (serum, age- and sex-adjusted reference range) Fasting insulin and fasting glucose HbA1c Comprehensive metabolic panel (CMP) including liver enzymes Serum copper and ceruloplasmin Lipid panel Prolactin (MK-677 may modestly raise prolactin via ghrelin receptor signaling) Testosterone (total and free) in male patients, as GH axis changes can alter androgen dynamics Week-6 Follow-Up Labs At 6 weeks, check IGF-1 and fasting glucose as minimum targets