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Here's the mechanism: after 8-10 hours of fasting, your body needs amino acids (from protein) to trigger muscle protein synthesis

NIDDKs guide to gas in the digestive tract explains common triggers and causes

After that window, the preservative action may not be sufficient to prevent contamination, and you should discard any remaining solution

That said, sermorelin is not a stand-alone weight loss drug

Considerations for clinicians in the diagnosis, prevention, and treatment of breast cancer-related lymphedema: recommendations from a multidisciplinary expert ASBrS panel: part 1: definitions, assessments, education, and future directions