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The FDA has issued multiple warning letters to compounders selling unapproved peptides

Richani D, Dunning KR, Thompson JG, et al

However, clinicians should remain vigilant for signs of excessive metabolic suppression or thyroid dysfunction, particularly in patients with pre-existing thyroid conditions or those experiencing symptoms beyond cold intolerance, such as severe fatigue, hair loss, or cognitive changes that might suggest thyroid hormone imbalance requiring investigation

Carnitine is an amino acid produced by the body, found in certain foods, and nutrition supplements