Octreotide has been shown to inhibit gallbladder contractility and decrease bile secretion in normal volunteers. In clinical trials, the incidence of biliary tract abnormalities was 63% (27% gallstones, 24% sludge without stones, 12% biliary duct dilatation). Less than 2% of patients treated with octreotide for 1 month or less developed gallstones. Octreotide alters the balance between the counter-regulatory hormones, insulin, glucagon and growth hormone, which may result in hypoglycemia (3%) or hyperglycemia (16%). Studies have also demonstrated that octreotide suppress thyroid stimulating hormone (12%). Pancreatitis, bradycardia, poor dietary fat and B12 absorption have also been reported. Most reports are in patients with acromegaly who are prone to the before mentioned problems and the true incidence in the non-acromegaly population is not known.