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The Vanderbilt University Medical Center study used sensitivity to GLP receptors as a proxy for the action of the drugs

Not mild discomfort or cramping, but sharp, severe, or worsening pain

Any concerning symptomsincluding severe gastrointestinal distress, allergic reactions, chest pain, or neurological changeswarrant immediate medical evaluation and discontinuation of the product

A degraded peptide from improper storage might produce inconsistent appetite suppression and, potentially, inconsistent digestive side effects from dose to dose

2) Antioxidants/hepatoprotective drugs Vitamin E Oxidative stress has been implicated to have an important role in the progression of NASH [10, 11]