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J Endocrinol 219:R37R57 Rubinek T, Modan-Moses D (2016) Klotho and the growth hormone/insulin-like growth factor 1 axis: novel insights into complex interactions

Serious side effects are extremely uncommon , especially with intramuscular (IM) and IV administration using clinically appropriate doses

Concerns about potential teratogenicity (birth defects), effects on pregnancy, or safety during lactation have not been adequately studied, so use during pregnancy or breastfeeding is not recommended absent compelling indication and appropriate medical supervision

Gastroenterology 103, 16211624
[DOI] [PubMed] [Google Scholar] Bakkenist AR, de Boer JE, et al

These conditions, if of sufficient severity, could make receiving a coffee enema an extremely painful experience
