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You need proper technique, sterile supplies, and careful attention to protocol

FDA nonclinical toxicology review (2023-2024) flagged DNA damage in pituitary cells and injection-site necrosis in animal studies, plus immunogenicity and impurity risks from compounded material, alongside GH/IGF-1-axis effects such as fluid retention, joint discomfort, flushing, and headache reported by users
Exposure to industrial toxins like heavy metals, pesticides, or certain cleaning solvents can also lead to neuropathy

doi: 10.1111/j.1365-2796.2006.01623.x