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Takeaways The latest batch of warning letters reinforces a set of themes that have become increasingly consistent across enforcement actions involving compounded GLP1 products and related telehealth marketing
Ask whether the medication is a registered product
Patients who experience significant weight loss especially in a short time frame may notice: Sunken cheeks Hollow temples More visible nasolabial folds (smile lines) Loose or sagging skin A tired or aged appearance These changes occur because we naturally lose facial fat as we age
Given its prevalence and the substantial improvement in symptoms we typically see with treatment, I recommend testing for mold toxicity in most (but not all) of the individuals I treat.
Not surface-level fixes
Injectable incretin mimetics generally provide greater HbA1c reductions and weight loss compared to oral DPP-4 inhibitors, but patient preference, convenience, and willingness to use injections influence the choice between them
