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These may include: Fluid retention and edema (swelling in the hands and feet) Joint pain and muscle aches Carpal tunnel syndrome Increased insulin resistance and associated diabetes risk with prolonged use Gynecomastia (enlarged breast tissue in men) Potential suppression of natural pituitary function These effects are more likely to occur because synthetic HGH provides constant, unregulated hormone levels rather than the natural pulsatile (rhythmic) secretion pattern the body is designed to produce