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If you are dealing with melasma or pigmentation, it is a useful strategy to combine both agents

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The thiamine-induced increases in contractions of the intestine smooth muscle and peristalsis, observed in a number of independent in vitro experiments on muscle strips of gastrointestinal tract (207, 219222), support the action of thiamine on ACh signaling in ENS in the absence of central regulation (236)

Hypoglycemia (Low Blood Sugar) Because IGF-1 mimics insulin, it can cause increased glucose uptake into cells which, without adequate carb intake, may lead to symptoms of hypoglycemia (shakiness, fatigue, dizziness)