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There is supporting evidence reporting adverse effects from long-term rhIGF-1 treatment including neoplastic formation, cataract and renal hypertrophy, all of which seem to be the most severe effects observed and are usually rare [123, 282284]

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Sleep optimization during retatrutide use: Stop eating 3-4 hours before bed to prevent acid reflux from disrupting sleep Supplement magnesium glycinate (400-600mg) before bed for both sleep quality and muscle recovery Maintain consistent sleep and wake times Consider melatonin (0.5-1mg) if sleep onset is delayed Monitor sleep quality with a wearable device to quantify the impact and adjust dosing if needed Cardiovascular considerations for athletes The documented increase in resting heart rate (up to 10 bpm in one case) and reduced heart rate variability are concerning for athletes who rely on cardiovascular efficiency for training performance