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According to Ricardo Correa, the endocrinology fellowship director at the University of Arizona College of Medicine , compound pharmacies "are probably using the same active pharmacological part [semaglutide], but when you combine things and you add different excipients, the effectivenessif you don't measure that in a randomized controlled trialwill not be the same." "I can tell you, the consensus amongst legitimate practicing obesity endocrinology specialists is to avoid this, because it's just too much unknown," Nadolsky said

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PloS Negl Trop Dis (2020) 5:119

Cold peptide (directly from refrigeration) causes vasoconstriction that delays absorption and increases localized discomfort