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Some of them are made by research labs Some of them are made by compounding pharmacies ⇒ Peter discusses the compounding pharmacy world in great detail in AMA #52 They’re typically sold online or in markets with very little oversight (like a med spa) Peter points out, “ The FDA doesn’t regulate the practice of medicine, so it doesn’t police individual doctors who prescribe peptides .” State medical boards regulate physicians and they frankly are only going to intervene if there’s clear misconduct or harm This has largely been unproblematic for individual physicians or clinics So that’s the sort of way that’s how they get away with it But to get more specific, this is what happens The selling company labels it for “research purposes only” and “not for human consumption” They have to have those statements on the product they’re selling So they avoid any explicit statements about clinical effects or dosing for humans They use very scientific language rather than therapeutic claims So they’ll say it binds the growth hormone receptor instead of builds muscle burns fat Under that facade, somehow no pre-market approval or manufacturing standards apply The products can be sold like lab reagents rather than drugs Now, because these products are indeed being marketed for human use, the FDA can step in to crack down on manufacturers because the FDA regulates based on intended use, not simply what a product is And the intended use is actually inferred from the totality of circumstances: website copy testimonials, dosing charts, before and after photos, influencer marketing, all of that can serve as evidence Peter suspects that most of the companies that are selling this are keeping a little bit of distance between them and the marketing side of this Peter thinks the FDA’s enforcement history here shows that it basically only intervenes when a company crosses into overt health claim territory If a site claims that they’re treating arthritis or burning fat or something, posting very clear dosing instructions for self-administration Peter explains, “ In other words, it’s not that peptide sales are legal, it’s that they’re NOT explicitly illegal until someone markets them as therapy .” This is the gray market in which this world exists in this very narrow semantic gap between sold as a research material and sold as a drug In the AMA on compounding pharmacies , we learned they can exist on a huge spectrum—some can be very legitimate, some can be very illegitimate

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4.2 Mitochondrial functionality 4.2.1 Seahorse Oxidative stress is characterized by the accumulation of ROS, which can induce damages to the mitochondrial respiratory chain, influence Ca 2+ homeostasis, and impair mitochondrial functionality