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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]

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

While clinical interactions have not been documented, combining multiple compounds that affect similar pathways increases unpredictability

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