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Growth hormone secretion from the anterior pituitary gland is controlled by two primary opposing signals: Growth hormone-releasing hormone (GHRH): Produced by the hypothalamus, GHRH stimulates GH synthesis and release from pituitary somatotroph cells Somatostatin: Also produced by the hypothalamus, somatostatin inhibits GH release, creating a pulsatile pattern of secretion A third regulatory pathway involves ghrelin and growth hormone secretagogues (GHS) , which act through a separate receptor system (GHS-R1a) to amplify GH release independently of GHRH (1)

When B12 levels are insufficient, the bone marrow produces fewer but larger red blood cells a pattern known as megaloblastic anaemia

This process supports the formation of new blood vessels and is associated with improved organization of healing tissues in controlled settings

Anthony RM, MacLeay JM, Jewell DE, Brejda JJ, Gross KL