Sides are normal, per the society of endocrinology rHGH Adult Treatment Guidelines. It’s an issue of too high a dose for a particular individual, often escalated too quickly.
They switched from calculating dose based on weight, to starting low, slowly titrating up until they reached the IGF-1 target that want, which instead of “middle of the range” like it used to be is now allowed to vary based on individual doctor judgement / patient preference, all the way to Z score +2 (max physiological IGF), and go on to note even at that “high” level, there’s no reason it can’t continue being used safely, for life, provided IGF-1 target is adjusted down according to age.
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Full clinical rHGH guideline actual doctors use attached if you want to nerd out.