 2. Abnormal or unstable for 3 months prior to enrollment endocrine blood chemistries that might otherwise explain insulin resistance. TSH 0.2 or 12μIUmL, morning cortisol 22μgdL, IGF-1 115ngmL, total testosterone 200ngdL men 15ngdL women. Use of testosterone, ACTH, thyroid hormone, or rhGH replacement to normalize low levels is permitted, but must be stable on hormone replacement for 3 months prior to enrollment and will not discontinue this replacement during enrollment. Hormone replacement cannot be started during treatment. 