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Talk with a healthcare professional (like one at Midi) about options that may have a bigger impact

You need to understand what the clinical trials found, what real users experience, what separates normal adjustment from genuine concern, and what you can do to minimize unwanted effects

However, less is known about peripheral IGF-I activity and it is possible that there are more secondary metabolic and nutritional issues that could lower local IGF-I production and impact on linear growth

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Testing for MTHFR and transcobalamin mutations can show metabolic challenges