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The answer lies in the following: Ozempic is more stable than endogenous GLP-1: Where the naturally produced GLP-1 breaks down within a few minutes by bodily enzymes, Ozempic can last for a week (thats why it is injected once weekly) due to modifications in its molecule

Long distances also heavily impact supply chains

Osmotic Laxatives (e.g., Polyethylene Glycol/MiraLAX, Magnesium Hydroxide/Phillips Milk of Magnesia, Magnesium Citrate): How they work: Draw water into the colon from the bodys tissues, softening the stool and promoting bowel movements

During mastication they are enzimatically converted into thiocyanates, goitrin metabolites, that cause a competitive inhibition of the sodium/iodide symporter, thus inhibiting the thyroid hormones synthesis and possibly causing hypothyroidism [156]