3 ms·

Where is the evidence that anyone has been harmed by these unapproved GLP1s? Until I see that I will assume the government is 100% in the wrong.

Fezzik 8mo ago
I just started taking Wegovy. Went the regulated route through my doctor, getting a prescription. She’s been monitoring loads of patients and noted that some of her patients going the ‘compound’ route had, in fact, had allergic reactions to their shots, or experienced their shots being less effective, after months of no problems. Nothing life threatening. But the fact is there is no oversight to what the GLP-1 is compounded with.
- terminalshort 8mo ago
  You had the choice to go the expensive route and you took it. Don't tell other people they can't make their own choices too.
  - Fezzik 8mo ago
    Can you quote from the five sentences I wrote where I said anything about telling people what to do? I simply noted that my medical provider has first-hand experience with people getting questionable results from unregulated GLP-1s.
  - phil21 8mo ago
    Personally I feel the hims etc of this world need to go away. They give a false sense of security and they mask an incredibly shady industry. I also think people should be able to source from the grey market if they can figure it out. This means they understand the risks and likely take measures like ensuring their compounds are properly tested before injecting them. I’d feel differently if I didn’t understand how the average medspa gets their product and the corners they cut. I honestly trust some outright black market dealers better than most of those shops. They actually do testing on their product before shipping it. Likely sourced from exactly the same manufacturer as the guy in the locker room buys from. So long as the choices are informed I agree. The issue is hims/hers puts a fancy veneer of “sanctioned medical system” on top of what amounts to a black market. They are laundering and obscuring the risk and many patients simply do not understand this fact. It’s the difference between buying Xanax from a legit pharmacy vs a street dealer. The street dealer transaction you understand the risks involved and are making an informed decision. If you thought you were buying from a legit pharmaceutical company but they ended up just rebranding the same shit the street dealer is selling from his wholesaler - that is not informed consent even a little bit. There is something in the middle here but some HLPC testing I’ve seen of supposed legit compounding pharmacies hasn’t been great for these drugs.
    - SR2Z 8mo ago
      Their industry is only shady because lots of fairly harmless drugs require a prescription. Viagra, the GLPs, and minoxidi+finasteride come to mind. For a long time in this country, a flesh-eating bacteria infection required an amputation. In Russia and Eastern Europe, it was easily treatable with bacteriophages and people normally kept their limbs. There's still no process for approving a bacteriophage treatment in this country for general use. Our system is ossified to protect big pharma and doctors. Liberalization is needed; hims and their like need to be regulated, but with a lighter touch than the current requirements.
- cthalupa 8mo ago
  > experienced their shots being less effective People report this with HPLC tested stuff that is proven to be of the same purity/concentration too, "feels" reports are notoriously unreliable in medicine.
  - Fezzik 8mo ago
    What she presented to me was that more than one of her patients taking unregulated GLP-1s simply stopped losing weight, and in an unexpected way. I have no idea how many patients this was. My doctor is rad and very much pro-GLP-1s and pro-preventative-care. This is ultimately an anecdote.
    - scheme271 8mo ago
      There's a well known plateau effect with GLP-1s where the body adjusts to the changes in caloric intake and the medication itself so that weight loss levels off and stops after a period of time. It could be that but it's hard to tell with 2nd hand info.
  - Balgair 8mo ago
    My company makes HPLCs. Yes, they can 'prove' what is in something to the limits of the physics. However, the human in the loop is quite frail for most operators. In that, these very fancy and very expensive instruments are mostly run by high school grads and serviced by field engineers with a huge backlog. For a first time one off test of something's composition, I'd go for at least 3 companies and preferably you have a history with them. This stuff is terribly complicated and misinterpretation is shockingly common. If the tech hasn't used the standards before then your at the mercy of fate. Like, we have 5 (!) places on the home screen that do the exact same function of ending a run because when we try to consolidate it to just 1, our customers freak out and can't find where the button went to. Granted they pay $100k+ per instrument plus service plan, so we add it back in no question ( and this is life critical equipment in many cases), but I hope that shows how embedded to routine these operators get.
    - cthalupa 8mo ago
ryan_n 8mo ago
So you think it's better to wait until people are harmed than for companies to go through the proper approval process for these drugs?
- terminalshort 8mo ago
  Yes. Drugs are too damn expensive and innovation is too damn slow. Better to allow higher risk options. And if you don't like it, you are always free not to use them.
  - wussboy 8mo ago
    "If you don't like it don't take it" ignores all of human history. A huge majority of substances can be fatal if ingested. Are you sure you want to live in a world where Elon can speed run figuring out what won't kill "most" people?
    - terminalshort 8mo ago
      I'm on death row. So are you. The only thing that has a chance of giving me a stay of execution is rapid technological advancement so I'm willing to accept a lot of risk here. It's a matter of self preservation.
- JCharante 8mo ago
  I'd argue more harm is done by any delays in approval
arzke 8mo ago
This is precisely why we have clinical studies. We want to measure the efficiency and the innocuousness of drugs. You seem to imply we should just go ahead and try those directly on the general population.
- terminalshort 8mo ago
  What do you mean "try them on the general population?" Who is forcing anyone to take any of this?
  - arzke 8mo ago
    Has anybody ever been forced anyone else to take any drug? The problem is not about being forced, it is about making an informed decision. When you don't have enough safety data you are effectively gambling with your health.
    - SR2Z 8mo ago
      Most people are not capable of understanding exhaustive safety data for a drug, but are still in charge of their own health. They should be allowed to make bad choices like they are everywhere else.
Aurornis 8mo ago
The individually compounded versions have a higher risk because there's a person involved who can make mistakes, as opposed to a carefully controlled and tested manufacturing line. Compounded drugs have higher rates of bacterial problems, doses being too high or low, and other issues. Someone I know worked for a company that took over a poorly run compounding pharmacy and cleaned up their process. Some of the stories I've heard have made me want to avoid compounded medications wherever possible.

Fezzik 8mo ago

I just started taking Wegovy. Went the regulated route through my doctor, getting a prescription. She’s been monitoring loads of patients and noted that some of her patients going the ‘compound’ route had, in fact, had allergic reactions to their shots, or experienced their shots being less effective, after months of no problems. Nothing life threatening. But the fact is there is no oversight to what the GLP-1 is compounded with.

terminalshort 8mo ago
You had the choice to go the expensive route and you took it. Don't tell other people they can't make their own choices too.
- Fezzik 8mo ago
  Can you quote from the five sentences I wrote where I said anything about telling people what to do? I simply noted that my medical provider has first-hand experience with people getting questionable results from unregulated GLP-1s.
- phil21 8mo ago
  Personally I feel the hims etc of this world need to go away. They give a false sense of security and they mask an incredibly shady industry. I also think people should be able to source from the grey market if they can figure it out. This means they understand the risks and likely take measures like ensuring their compounds are properly tested before injecting them. I’d feel differently if I didn’t understand how the average medspa gets their product and the corners they cut. I honestly trust some outright black market dealers better than most of those shops. They actually do testing on their product before shipping it. Likely sourced from exactly the same manufacturer as the guy in the locker room buys from. So long as the choices are informed I agree. The issue is hims/hers puts a fancy veneer of “sanctioned medical system” on top of what amounts to a black market. They are laundering and obscuring the risk and many patients simply do not understand this fact. It’s the difference between buying Xanax from a legit pharmacy vs a street dealer. The street dealer transaction you understand the risks involved and are making an informed decision. If you thought you were buying from a legit pharmaceutical company but they ended up just rebranding the same shit the street dealer is selling from his wholesaler - that is not informed consent even a little bit. There is something in the middle here but some HLPC testing I’ve seen of supposed legit compounding pharmacies hasn’t been great for these drugs.
  - SR2Z 8mo ago
    Their industry is only shady because lots of fairly harmless drugs require a prescription. Viagra, the GLPs, and minoxidi+finasteride come to mind. For a long time in this country, a flesh-eating bacteria infection required an amputation. In Russia and Eastern Europe, it was easily treatable with bacteriophages and people normally kept their limbs. There's still no process for approving a bacteriophage treatment in this country for general use. Our system is ossified to protect big pharma and doctors. Liberalization is needed; hims and their like need to be regulated, but with a lighter touch than the current requirements.
cthalupa 8mo ago
> experienced their shots being less effective People report this with HPLC tested stuff that is proven to be of the same purity/concentration too, "feels" reports are notoriously unreliable in medicine.
- Fezzik 8mo ago
  What she presented to me was that more than one of her patients taking unregulated GLP-1s simply stopped losing weight, and in an unexpected way. I have no idea how many patients this was. My doctor is rad and very much pro-GLP-1s and pro-preventative-care. This is ultimately an anecdote.
  - scheme271 8mo ago
    There's a well known plateau effect with GLP-1s where the body adjusts to the changes in caloric intake and the medication itself so that weight loss levels off and stops after a period of time. It could be that but it's hard to tell with 2nd hand info.
- Balgair 8mo ago
  My company makes HPLCs. Yes, they can 'prove' what is in something to the limits of the physics. However, the human in the loop is quite frail for most operators. In that, these very fancy and very expensive instruments are mostly run by high school grads and serviced by field engineers with a huge backlog. For a first time one off test of something's composition, I'd go for at least 3 companies and preferably you have a history with them. This stuff is terribly complicated and misinterpretation is shockingly common. If the tech hasn't used the standards before then your at the mercy of fate. Like, we have 5 (!) places on the home screen that do the exact same function of ending a run because when we try to consolidate it to just 1, our customers freak out and can't find where the button went to. Granted they pay $100k+ per instrument plus service plan, so we add it back in no question ( and this is life critical equipment in many cases), but I hope that shows how embedded to routine these operators get.
  - cthalupa 8mo ago

ryan_n 8mo ago

So you think it's better to wait until people are harmed than for companies to go through the proper approval process for these drugs?

terminalshort 8mo ago
Yes. Drugs are too damn expensive and innovation is too damn slow. Better to allow higher risk options. And if you don't like it, you are always free not to use them.
- wussboy 8mo ago
  "If you don't like it don't take it" ignores all of human history. A huge majority of substances can be fatal if ingested. Are you sure you want to live in a world where Elon can speed run figuring out what won't kill "most" people?
  - terminalshort 8mo ago
    I'm on death row. So are you. The only thing that has a chance of giving me a stay of execution is rapid technological advancement so I'm willing to accept a lot of risk here. It's a matter of self preservation.
JCharante 8mo ago
I'd argue more harm is done by any delays in approval

arzke 8mo ago

This is precisely why we have clinical studies. We want to measure the efficiency and the innocuousness of drugs. You seem to imply we should just go ahead and try those directly on the general population.

terminalshort 8mo ago
What do you mean "try them on the general population?" Who is forcing anyone to take any of this?
- arzke 8mo ago
  Has anybody ever been forced anyone else to take any drug? The problem is not about being forced, it is about making an informed decision. When you don't have enough safety data you are effectively gambling with your health.
  - SR2Z 8mo ago
    Most people are not capable of understanding exhaustive safety data for a drug, but are still in charge of their own health. They should be allowed to make bad choices like they are everywhere else.

Aurornis 8mo ago

The individually compounded versions have a higher risk because there's a person involved who can make mistakes, as opposed to a carefully controlled and tested manufacturing line. Compounded drugs have higher rates of bacterial problems, doses being too high or low, and other issues. Someone I know worked for a company that took over a poorly run compounding pharmacy and cleaned up their process. Some of the stories I've heard have made me want to avoid compounded medications wherever possible.