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There is supporting evidence reporting adverse effects from long-term rhIGF-1 treatment including neoplastic formation, cataract and renal hypertrophy, all of which seem to be the most severe effects observed and are usually rare [123, 282284]

The trials produced signals consistent with the mechanism (the peptide does what its pharmacology predicts it would do), but the effect sizes were not large enough to support a successful path to drug approval as a standalone obesity treatment

These symptoms may indicate advanced deficiency requiring immediate treatment, particularly in pregnancy, infancy, or following nitrous oxide exposure

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