GLP-1 medications (e.g., compounded semaglutide): Do not use if you or your family have a history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN2). In animal studies, semaglutide caused thyroid C-cell tumors; it is unknown whether it does in humans. Tell your clinician about any history of pancreatitis, gallbladder disease, kidney problems, diabetic retinopathy, or if you are pregnant or planning pregnancy. Common side effects include nausea, vomiting, diarrhea, constipation and stomach pain. Seek care right away for severe stomach pain, signs of an allergic reaction, or a lump or swelling in the neck.

Hormone therapy (TRT/HRT): Requires lab monitoring. Risks may include blood clots, elevated red blood cell counts, and effects on the heart, breast or prostate. Testosterone is a controlled substance. Peptides & NAD+: compounded products are not FDA-approved. Methylene blue: can cause serotonin syndrome with many antidepressants; not for people with G6PD deficiency.

This is not a complete list. Your clinician will review full risks, benefits and alternatives. Draft ISI pending medical and legal review. In an emergency, call 911.