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A low SAM/SAH ratio may result from insufficient SAM, elevated SAH or both

Per FDA's June 2026 warning letters, "clinically proven" language applied to compounded GLP-1 medications specifically is one of the flagged violation patterns - because the clinical trials that established GLP-1 efficacy tested FDA-approved finished products, not compounded preparations

Since GLP-1 receptor agonists work by slowing gastric emptying, they can lead to side effects like nausea, vomiting, constipation, and diarrhea