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Common, usually mild: Injection-site reactions (redness, bruising, mild swelling), most frequent Mild fluid retention in the first 12 weeks as IGF-1 rises Joint stiffness or mild arthralgia Headache or flushing after injection Less common, dose- or response-related: Carpal-tunnel-like wrist symptoms (sign IGF-1 may be too high) Elevated fasting glucose / mild insulin resistance, GH antagonizes insulin Peripheral edema persisting beyond the first few weeks Skin sensitivity at injection sites The monitoring that matters

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