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As far back as the 1970s, there were case reports in the literature of B12 deficiency associated with metformin use, with several observational studies reporting the same, but very little in the way of high-quality, well-powered, prospective studies

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Full-length growth hormone produces fat loss but also elevates IGF-1 (with implications for cell proliferation and aging), worsens insulin sensitivity and elevates blood glucose (problematic for diabetics and pre-diabetics), promotes muscle growth and protein synthesis (which may be desired or unwanted depending on goals), causes fluid retention and edema in many users, and requires careful medical monitoring with regular blood work

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