Insertional Achilles, two years in, what actually moved the needle

Two year writeup since people keep asking me in other threads. Insertional Achilles tendinopathy, both sides, right much worse. Marathon background, was running about 50 miles a week when it started. Ranked by how much I think each thing mattered, most to least: 1. Stopping the thing that caused it. Hill repeats twice a week on a body that was sleeping six hours. Obvious in retrospect, invisible at the time. 2. Loading, specifically heavy slow resistance with limited dorsiflexion. Insertional is different from mid portion here. Full range heel drops off a step made mine dramatically worse for months and that is apparently a known thing that nobody told me. 3. Sleep. I went from six hours to seven and a half. This is boring and it is the second biggest lever I found. 4. Time. Genuinely. Month 14 to month 20 improved on a curve that I did not do anything special to produce. 5. A compounded peptide, prescribed after review, started around month 11. Somewhere in the middle of that improvement curve, which makes it maximally difficult to interpret. I do think the morning stiffness dropped faster than my prior trend, and I also know that is exactly the kind of claim I would be skeptical of if someone else made it. What did not help: rest, ice, three different shoe changes, a boot for six weeks that made everything weaker, and reading forums at 1am including this one. Where I am: 30 mile weeks, no hills yet, morning stiffness about five minutes on a bad day. Not the runner I was. Fine with that most days.