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While the evidence for this with secretagogues is much weaker than with exogenous GH, it is worth noting for individuals with a personal or family history of certain conditions

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Reactions fall into five general categories

BMC Med 10 , 153, (2012)

A wide range of studies reported both overt and subclinical hypothyroidism as a risk factor of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), the chronic liver diseases that might progress to cirrhosis and hepatocellular carcinoma [3741although some newly published studies failed to find such an association [42,43]

This lack of standardization makes it impossible to ensure proper dosing and exposes patients to unnecessary risks