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The grey market, meanwhile, continues to operate in parallel unless: customs enforcement increases, FDA criminal enforcement expands, or new laws explicitly target peptide sales labeled as research-only but marketed for human use

In patients using GLP-1 therapy: Substrate arrival in the intestine may be delayed

Rising diabetes and obesity prevalence, strong clinical outcomes, patient awareness, insurance coverage, and demand for effective, convenient metabolic therapies drive growth

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doi: 10.1111/dom.15636

Vendors operating through social media DMs, temporary websites, or anonymous email addresses create accountability gaps that make recourse impossible if something goes wrong