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Warning signs include: Sudden rash or hives spreading across the body Generalized itching that is not isolated to the application site Swelling of the face, lips, tongue, or throat Difficulty breathing or shortness of breath Symptoms suggestive of a severe allergic reaction (anaphylaxis) require prompt medical attention

However, the evidence for chronic fatigue syndrome/myalgic encephalomyelitis (ME/CFS) remains limited, and NICE guideline NG206 does not recommend supplements as a treatment for ME/CFS

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Animal models of localized IGF-1 overexpression show muscle hypertrophy is satellite cell-dependent (PMID 10632630), and satellite cell activation in humans requires mechanical loading

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