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Adjusting Sermorelin Dosage: Monitoring and Side Effects Recognizing Signs of Underdosing or Overdosing Underdosing signs Persistent low energy and poor sleep quality Minimal change in body composition IGF-1 remains below age-adjusted normal Overdosing signs Joint or muscle aches Fluid retention and mild swelling Numbness or tingling in hands (carpal tunnel symptoms) Common Side Effects and How to Mitigate Them Injection-site redness or itching: apply a cold compress

Comment: Most commenters supported our proposal to effectuate full realignment of the IPPS and OPPS wage index values in CY 2026 by eliminating the low wage index hospital policy under the OPPS and using the IPPS wage index in CY 2026 and subsequent years

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