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The 0.5 mg pre-ramp is not in the Jastreboff protocol

The present critique further addresses the importance of distinguishing between statistical and clinical significance

However, high doses ( 0.5 mg/kg/d) may activate the SREBP-1c pathway, increase liver fat synthesis, and lead to hypertriglyceridemia and fatty liver

Inflammation of the pancreas is a serious but rare side effect

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Research in animal models has documented increased longitudinal bone growth in young subjects (PMID: 10373343) and increased bone mineral content (BMC) due to increased volume of bone, though bone mineral density itself remained unchanged (PMID: 10828840)