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Adjusting Sermorelin Dosage: Monitoring and Side Effects Recognizing Signs of Underdosing or Overdosing Underdosing signs Persistent low energy and poor sleep quality Minimal change in body composition IGF-1 remains below age-adjusted normal Overdosing signs Joint or muscle aches Fluid retention and mild swelling Numbness or tingling in hands (carpal tunnel symptoms) Common Side Effects and How to Mitigate Them Injection-site redness or itching: apply a cold compress