There is substantial variation between individuals in tolerability and whether the tradeoffs make its use rational for an individual. Risks of rhGH use include edema (fluid retention) & arthralgia (joint & bone pain), as well as frank osteoarthritis (that comport with
@bigzzz experiences). Depending on body surface area (a function of height and mass), 1 IU/d may very well be supra-physiologic; and if bigzzz is a hyper-responder (-d3 homozygous in the GHR gene), it may be too high a starting dose, or simply unnecessary. Symptoms of lethargy in particular, but negative side effects broadly, may be associated with a high dimer content (as well as reduced potency for the growth & metabolic effects that we seek). In pharmaceutical preparations that comply with USP Pharmacopeia standards, <= 4% dimer content (i.e., Limit of high molecular weight proteins) is the upper threshold.