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Current research limitations include the absence of large-scale randomized clinical trials in humans, an still partial understanding of the precise molecular mechanisms, and a lack of detailed pharmacokinetic data in humans

After 28 days, the preservative may not be strong enough to prevent bacterial growth

Eric Topol of Scripps Research Translational Institute was more direct: "These peptides have no data to support their safety and efficacy." The clinical proponents argue that the FDA's safety concerns immunogenicity risk, impurity risk, organ toxicity are theoretically valid but speculative in practice

In contrast, fluoxetine, a widely prescribed selective serotonin reuptake inhibitor (SSRI) for depression, is associated with an increased incidence of metabolic conditions like NAFLD (291, 292)

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Using sterile water without preservative would require discarding unused portions after each use, which is wasteful and impractical