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doi: 10.1111/nmo.13196

Contamination Every time a needle enters the septum, it introduces a microscopic amount of environmental contamination

In a 10-week clinical trial, a daily dose of 20 mg oral semaglutide achieved a steady-state plasma concentration of 30 nM, and when daily dose of oral semaglutide was increased to 40 mg, the semaglutide plasma concentration reached about 60 nM (102), which was over a thousand times higher than the EC50 of semaglutide for GLP-1R activation (95)

The months that follow build a different pattern around that quieter baseline

these signaling molecules can enter the circulation and act directly on the brain, or they can act indirectly via paracrine action on local vagal and spinal afferent neurons that innervate the gut