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If IGF-1 levels remain elevated for extended periods, issues with cardiac rhythm and heart valves may develop

B vitamins, including B12, are vital for energy production within the body

The metabolic adaptations that occur are limited to the enhanced expression of beta-3 adrenergic receptors in adipose tissue, which actually represents a favorable metabolic improvement rather than a dependence-creating change

Further, Tesamorelin's N-terminus is adorned with an acetyl group (CHCO-), a modification that might further amplify the molecule's stability and biological efficacy

In theory, that could also feed hidden cancers though this has not been shown in people