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If you have any of these symptoms, stop taking this medication and go to the emergency room right away: extreme weakness or tiredness unusual muscle pain trouble breathing unexplained stomach pains with nausea, vomiting, and diarrhea cold feeling in arms and legs slow or irregular heartbeat Low blood sugar (hypoglycemia)*

And perhaps most critically, compounded GLP-1s are not approved by the FDA

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We and others have demonstrated that GLP-1R signalling elevated ATP levels 38, 39 , strengthening the hypothesis that the incretin hormone may promote -cell function through regulation of energy metabolism, especially considering the central role that ATP generation and an increase in ATP/ADP ratio play during GSIS