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Safety: what we know, what we don’t What clinical trial safety reviews suggest The clinical safety review literature reports several reassuring signals: No meaningful increase in IGF-1 in monitored long-term studies (jofem.org) No clear negative effect on carbohydrate metabolism in testing described (contrast with full hGH) (jofem.org) No clear immunogenicity signal (e.g., anti-AOD antibodies) in the subset assessed in those trials (jofem.org) The major limitation: long-term real-world certainty is thin The problem with many peptides is not that “everything is dangerous”—it’s that the certainty level is often lower than patients assume

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Gastroenterology 105 , 733–739 (1993)