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Because IGF-1 signalling promotes cell proliferation, a recognized theoretical concern is that it could promote the growth of existing tumors , and excess dosing can cause hypoglycemia

Further, a secondary analysis of a trial in women at high risk for or with existing cardiovascular disease reported that high-dose supplemental B-vitamins (1 mg/day of vitamin B 12 , 50 mg/day of vitamin B6, and 2.5 mg/day of folic acid) for 7.3 years had no effect on risk of non-vertebral fractures (122)

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