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The growth-promoting effects of growth hormone include muscle tissue hypertrophy (which may be desired by some but represents an anabolic effect), bone growth and remodeling (problematic after growth plates close), organ enlargement with chronic supraphysiologic doses (cardiac hypertrophy, acromegaly features), connective tissue proliferation (potentially contributing to joint pain and carpal tunnel syndrome), and cellular proliferation that may support tumor growth in susceptible individuals