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There is a theoretical concern, supported by some biological evidence, that elevated IGF-1 activity in a patient with occult or a history of certain hormone-sensitive cancers could be problematic

But without long-term human data, we must be cautious

Clin Neuropharmacol 36:103106 Remington R, Lortie JJ, Hoffmann H, Page R, Morrell C, Shea TB (2015) A nutritional formulation for cognitive performance in mild cognitive impairment: a placebo-controlled trial with an open-label extension

The enrichment analysis revealed that the biosynthesis of cofactors and amino acids (such as cysteine and methionine metabolism, and alanine, aspartate, and glutamate metabolism), and carbon related pathways (e.g., starch and sucrose metabolism) were down represented in the caeca of birds with improved NR