The worst sides ive ever seen (on high dose) 10-20i.u/day was enlargement of the head, cheek structure, chin and feet......Those are physical on abusive doses.
Internally you end up with organ growth which leads to an extended gut and other probs......
These are just things ive seen with friends. Im sure theres a lot more.
Ive never had sides on 2-4 i.u.