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While the introduction of the International Standard for IGF-1 (02/254) in 2009 was a step in the right direction, there clearly still exists quite some way to go if testing for IGF-1 is to produce results that can be interpreted and used with confidence

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Warning signs include persistent fatigue despite adequate sleep, cold intolerance (especially cold hands and feet), menstrual irregularity or cessation in female subjects, hair thinning or shedding, and mood disturbances (irritability, low motivation)