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[76] Ruminants, such as cows and sheep, are foregut fermenters, meaning that plant food undergoes microbial fermentation in the rumen before entering the true stomach (abomasum), thus allowing them to absorb the vitamin B 12 produced by the bacteria

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When engaging with GHRH receptors located in regions like the pituitary and hypothalamus, it is theorized that Tesamorelin may stimulate the secretion of HGH from the resident pituitary cells