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Effects Synergistic increase in muscle mass Synergistic effect of fat burning Synergistic effect on tendon repair Synergistic effect on strengthening bone tissue Increased risk of side effects from excessive IGF-1 levels Use with insulin As the name IGF-1 implies, it has a structure similar to insulin, and binds not only to its own IGF1R receptor, but also to the insulin receptor and vice versa

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Concise Answer: You know you may have a vitamin deficiency requiring an IV if blood tests reveal low levels and youre not responding to oral supplementation