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For instance, Wilmington et al

10.1186/s13643-016-0384-4 42 Parry-StrongA.LangdanaF.HaeuslerS.WeatherallM.KrebsJ

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Its anabolic and growth-promoting effects are largely indirect, primarily via stimulation of hepatic IGF-1 production, whilst its direct metabolic effects, particularly those related to lipid metabolism and adipose tissue regulation, are believed to be mediated by specific domains within the GH molecule itself

In these scenarios, the abnormalities may be transient, although may also be unavoidable