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Proinflammatory cytokines produced by microglia and astrocytes upon activation cause upregulation of MMP-9 expression in endothelial cells, which results in the degradation of tight junction proteins and causes the breakdown of the BBB (223)

The efficacy results are in the same ballpark as data on existing oral GLP-1 drugs by Eli Lilly and Novo Nordisk

If you've completed 46 weeks at standard dosage without measurable body composition change, the issue is likely dietary (insufficient caloric deficit) rather than dosage insufficiency

Serious side effects like severe abdominal pain warrant immediate medical evaluation, but routine adjustment symptoms reflect normal pharmacological activity

Denison HJ, Cooper C, Sayer AA, Robinson SM