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As noted above, in late 2023 the FDA moved 17 peptides popular among longevity enthusiasts BPC-157, TB-500, and others into Category 2, banning them from compounding, while a gray market of self-proclaimed RUO sellers continued operating behind disclaimers the FDA does not recognize for these products as they are being promoted

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These factors collectively drive the progressive damage of biliary epithelial cells by autoantibodies, leading to cholestasis, fibrosis, and potential progression to cirrhosis or liver failure (217)