Heart, Liver & Kidney

02 Fewer heart attacks and strokes

• Cardiovascular protection: SELECT trial cut major adverse cardiovascular events 20% (HR 0.80) in people with obesity and heart disease without diabeteshuman phase 3 RCT34

03 Kidney and liver protection

• Kidney protection: FLOW trial reduced major kidney outcomes 24% and slowed eGFR decline in type 2 diabetes + CKD, also lowering CV events and deathhuman RCT
• Liver: accelerated FDA approval for MASH with F2-F3 fibrosis

Sources for this benefit 56

02 Less liver fat in HIV

• Reduces liver fat in HIV-associated NAFLDhepatic fat fraction -4.1 points vs placebo over 12 months; human RCT78

02 Blood sugar and heart risk

• Glycemic control in type 2 diabetes and cardiovascular event reduction in high-risk adultsFDA label, SURPASS program910

03 Less visceral fat, better lipids

• Reduces visceral fat and improves lipids (total/LDL cholesterol) in obese adults without GHD, but no net weight lossmeta-analysis of RCTs
• Long-term (5-15 yr) replacement in GHD adults linked to sustained quality-of-life gains (mostly uncontrolled studies)

Sources for this benefit 272829

01 Chronic hepatitis B

• Chronic hepatitis B: RCTs reported HBV DNA/HBeAg clearance and ALT normalization with mild side effects, though results mixedhuman RCTs12

02 Blood sugar control

• Glycemic control in type 2 diabetes: HbA1c -1.3% to -2.0% at 24 weeks with up to ~17% weight loss at 36 weeksphase 2 RCT1112

03 Less liver fat

• Liver fat reduced ~82-86% (12 mg) in MASLDphase 2a RCT
• Knee osteoarthritis pain (WOMAC) improved with 26-29% weight loss in TRIUMPH-4 (phase 3, company-reported)

Sources for this benefit 131415

03 Fatty liver, small pilot

• Fatty liver: open-label pilot (n=34) of 300 mg/day oral GSH for 4 months lowered ALT (~13%), triglycerides, free fatty acids and ferritin in NAFLDhuman, uncontrolled3031

02 Lower mortality, small Russian trials

• Mortality: parent extract epithalamin in 70 older adults with heart disease linked to 28% lower overall and 2-fold lower cardiovascular mortality over 12 years; 266-person cohort reported 1.6-1.8x lower mortalitysmall Russian human trials, not independently replicated; extract, not synthetic epitalon161718

02 Cardiac repair, preclinical

• Cardiac repair: Tβ4 reduced fibrosis/scarring after cardiac injury in mice; recombinant Tβ4 in a 96-patient STEMI RCT reduced infarct area only in the early-dosed subgroup (overall not significant)animal + human RCT, mixed192021

03 Kidney function, mice

• Kidney function: lowered plasma urea and creatinine in aged mice, indicating restored renal filtrationanimal32
• Users report subjective improvements in some, nothing in othersanecdotal33

03 Metabolic health, mice

• Obesity-related metabolic dysfunction improved with NNMT inhibition in miceanimal, 202434
• Users report modest fat loss, less hunger or alertness; others nothinganecdotal/Reddit3536

02 Liver fat handling, nutrient data only

• Liver fat handling (choline component): choline is an essential nutrient; human choline deficiency causes reversible fatty liver, corrected by repletionhuman controlled data for the nutrient, not the injection22

02 Liver fat export, choline data

• Choline supports liver fat export: choline deprivation causes reversible fatty liver, and choline repletion reversed steatosis (human controlled depletion study and TPN RCT) - relevant only if deficient2324

02 Belly fat, via tesamorelin

• See Tesamorelin: visceral fat reduction (FDA-approved in HIV), liver fat and cognition datahuman RCTs2526