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Mitigating Receptor Downregulation Any time you continuously stimulate a receptor with a potent agonist, you run the risk of receptor downregulation

In addition to treating the cardiac stresses that occur with obesity and associated morbidities, such as OSA, additional cardiovascular benefits of GLP-1s are thought to be mediated by their action on vascular smooth muscle cells and endothelial cells

Reasons we do not know of yet and that are still being studied

A counteraction with the stable gastric pentadecapeptide BPC 157 (PL 14736) Journal of Physiology and Pharmacology 2010, 61, 2, 241-250 (3) E.Lee and Padgett (2021) Intra-Articular Injection of BPC 157 for Multiple Types of Knee Pain Alternative Therapies in Health and Medicine, 2021 Jul;27(4):8-13

IV data support feasibility when systemic delivery is preferred

Compounding pharmacies don't follow the same manufacturing controls as FDA-approved medications like Zepbound