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But the reviewers graded the evidence as very low quality, with high risk of bias, and the trials were concentrated in a handful of countries: three in China, one in Russia, one in Romania, one unclear

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However, CJC-1295 (especially the DAC version) can cause sustained elevation in IGF-1, whichif mismanagedmay increase the risk of: Insulin resistance Carpal tunnel syndrome Soft tissue growth (in rare, prolonged cases) Pituitary overstimulation That said, these issues are more often associated with excessive dosing or continuous high-frequency use