Several factors might account for the shift in growth factor readings, and the pattern isn't unusual once you consider the details. The medication boosts growth hormone release in pulses, yet the downstream marker relies a lot on how the liver responds, along with diet, insulin levels, swelling, and any recent strain or sickness. Carrying extra weight creates resistance to growth hormone. At the start of treatment while still carrying more mass, the liver didn't react strongly, keeping the marker low. Dropping dozens of pounds can restore better liver response, raising the marker even after pausing the medication. Tight calorie limits often hold the marker down temporarily, but once intake stabilizes and insulin handling improves thanks to the other agent, readings commonly climb again. The timing around the procedure added inflammatory strain that can dip the marker briefly, with a later upswing during healing. Test results themselves fluctuate quite a bit across visits because of meal timing, hour of day, minor sickness, or how binding proteins behave. The dual agonists don't lift the marker on their own, though better insulin action can nudge the liver toward higher output. In my situation the rise tracks with restored sensitivity after the big drop in weight, rather than any odd reaction to pausing the medication. Should the marker keep moving well above normal range without any secretagogues, tracking the direction over time matters more than one reading. I would run another test in roughly two to three months with the same setup, like morning fasted state at steady weight, before making much of it.