Thymus Regeneration, Immunorestoration, and Insulin Mitigation Extension Trial

Inclusion Criteria: * Male or female volunteers * Aged 40 to 80 years, inclusive * All ethnicities * Able to participate in 12-month study * Able to provide informed consent Exclusion Criteria: * Malignancies or high risk of malignancy, as suggested by familial risk or personal medical history * Premenopausal women * Postmenopausal women on HRT * IGF-1 levels \< 90 ng/ml or \>300 ng/ml * Diagnosed or suspected growth hormone resistance * Known growth hormone deficiency based on stimulation testing * Pre-existing carpal tunnel syndrome * Significant arthritis/arthralgia/joint swelling * Bradycardia (\<55 bpm), significant hypertension (systolic \>160 mmHg, or diastolic \>90 mmHg) despite treatment, serious angina, or other serious cardiovascular disease or cardiovascular disease risk factors * Excessive skin growths (e.g., flat warts) without cryosurgical options * BMI of 35 or greater * PSA level above the age-adjusted normal range for reasons other than confirmed prostatitis * Testosterone levels above the upper limit of normal * Levels of C-reactive protein (CRP) above the upper limit of normal * Type 1 or pre-existing Type 2 diabetes * Uncorrected hypothyroidism * HIV infection * Allergy or other sensitivity to study medications * Other unstable medical conditions * Use of GH within the last 5 years * Participation in a clinical research trial within 30 days prior to enrollment * Use of chronic glucocorticoid therapy * Unwilling to discontinue androgen supplementation if testosterone levels are above the upper limit of normal * Ongoing treatment with carbonic anhydrase inhibitors * Ketogenic diet, calorie-restricted diet, or prolonged fasting, without willingness to discontinue these diets or adhere to an alternative diet during the study * Alcoholism or drug addiction * Smoking or unwillingness to quit smoking * Cognitive impairment, illiteracy, inability or unwillingness to give voluntary informed consent