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Hepatology 38(1):123132

Jean Mariani lUniversit Pierre et Marie Curie (Paris, France)

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Water Retention Presentation: Mild hand or ankle swelling Puffy appearance, especially upon waking Slight weight gain (water weight) Ring or shoe tightness Usually resolves within weeks as body adapts Joint Discomfort: Stiffness, particularly in hands and wrists Carpal tunnel-like symptoms Morning joint tightness Generally mild and temporary Management Approaches: Reduce sodium intake: Lower dietary salt reduces water retention Adequate hydration: Paradoxically, drinking more water helps regulate fluid balance Lower dose: Reduce GH peptide dose by 25 to 50% Potassium rich foods: Support electrolyte balance Time and adaptation: Most water retention resolves after 2 to 4 weeks Joint mobility work: Gentle stretching and movement helps stiffness Severe or persistent edema may indicate underlying issues requiring medical evaluation