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Ethics declarations Ethics approval and consent for publication The present study was approved by the CPRD Research Data Governance (#23_002545), the Research Ethics Board of Sunnybrook Health Sciences Centre (PIN: 6013), and the Research Ethics Board of University of Toronto (#46463)

Study Significance of IGF-1 A deregulation or imbalance in the IGF system could have implications in a number of different disorders including perturbations with normal growth, cancer and diabetes

Future research should prioritize high-quality RCTs to determine the clinical applicability, optimal dosing, and long-term efficacy of these redox-modulating interventions in FM