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Other non-insulin mechanisms of hepatic GH resistance in anorexia nervosa have also been described, including fibroblast growth factor-21, sirtuin 1, triiodothyronine, leptin and testosterone (63)

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Serotonin Serotonin is synthesized through a two-step process involving a tetrahydrobiopterin-dependent hydroxylation reaction (catalyzed by tryptophan-5-monooxygenase, also called tryptophan hydroxylase) and then a decarboxylation catalyzed by DOPA decarboxylase (also known as aromatic L-amino acid decarboxylase)