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doi: 10.1016/j.soard.2018.03.029

Regulatory and commercial factors rather than safety concerns explain this limitation

First, hyperhomocysteinemia detected only in the fasting state (approximately 23% of patients), which might mainly result from an inhibition of the homocysteine remethylation pathway (folate, cobalamin, or functional methionine synthase deficiencies or thermolabile MTHFR mutation), and which increases the cardiovascular risk 1.6-fold

BPC-157 is an anabolic peptide

Refrigeration slows degradation

Prevention strategies significantly reduce the incidence and severity of injection site reactions with tirzepatide