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When the FDA places a peptide in a restricted or high-risk category [known as Category 2], it is explicitly signaling that it has identified safety concerns and that enforcement discretion does not apply. But, as Hajduczok notes, just because something is not FDA-approved doesnt mean its illegal to compound, but the restricted peptides should not be compounded

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Consistent with a inhibition at the PDH and OGDH, SLC25A39/40 double knockout cells accumulated -ketoglutarate (aKG) and displayed elevations in the aKG/succinate and pyruvate/citrate ratios (Fig 4e, Extended Data Fig