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Removing the skin, fat, and internal organs of the fish prior to cooking and allowing the fat to drain from the fish while it cooks will decrease exposure to a number of fat-soluble pollutants, such as PCBs (219)

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it can be found in trace amounts in our environment and accumulate in our body over time

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For comparison, Sermorelin another GHRH analog available through compounding pharmacies works through a similar mechanism but has a shorter half-life, less clinical data, and no FDA approval

The same review notes one comparison in which fatigue was 2% on placebo versus 6% on 20 mg daily , which supports a medication effect rather than coincidence