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The FDA does not list GERD as a contraindication, but cautions against use in patients with severe gastrointestinal disease

If the change lasts more than a few days or comes with pain, fatigue, or other symptoms, it's a good idea to check in with your doctor.

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The peptides that boost BDNF indirectly (Semax, Selank, Noopept) have more extensive safety profiles, including clinical use in Russia, but international regulatory approval remains lacking

Excessive alcohol impairs osteoblast function, reduces bone mineral density, and increases fall risk

Some clinics also offer sublingual or troche formulations, though the injectable route remains the clinical standard for consistent bioavailability and predictable dosing