He Took Retatrutide 40mg and Proved a Point

40 milligrams of retitrutide. That's right, a 32-year-old guy bought retitrutide online, injected, forgot he took it the day before, and injected it again, but here's the catch. The guy was taking 20 milligrams of retitrutide after starting himself on 10 milligrams. Of course, you can imagine how that story ended up, and we're gonna get into it, but at the same time, we're in the wake here of about one month into the Foundale launch, and we already have a report about a liver failure. And these two stories are obviously completely different stories, but if you followed On The Pen for any amount of time, you'll probably see a way in which these two stories connect. We're going to get into that as well as a new tool, a brand new tool for patients who are managing their shots and their GLP-1 journey. Really excited to bring you that, so stay tuned to the end for that. Welcome back to the Weekly Dose Podcast. Let's do it. Welcome to the On The Pen Podcast with your host, Dave Knapp. all right friends welcome back to the weekly dose podcast i'm your host dave knapp man on the manjaro that's why i'm here you are on the pen we go v saxenda victosa trulicity manjaro zet bound compound that pen is what we talk about each and every week here at on the pen is we empower you as a patient to have more competent and confident conversations with your doctor. So if that sounds like it'd be helpful for you, wherever you're watching, take a moment, pause and subscribe. Whether you're listening on Spotify, follow us there. If you're listening on YouTube, follow us there. And you're going to want to hit the bell and the thumbs up. You're going to train the algorithm to feed you more of this content, but we don't want to rely on the algorithm to make sure you get the news, right? Because right now we're facing another TikTok ban. Surprise, surprise. So what you need to do to make sure you stay in touch with our content, if it's important, is jump over to obesity.news, put your email in, and you'll stay in touch with our newsletter. That's the most important way to stay in touch with the content that we make here at On The Pen. This is an interesting week here because we had a Lilly earnings call earlier this week that we did a special podcast on actually last week. We've got the Pfizer earnings call that happened today. Wasn't a ton in there about obesity medicine. And then we've got the Novo earnings call tomorrow. the news that broke this week to me that stood out was this news about a liver failure and found ale but at the same time i read this whole write-up on a patient using research grade retitrutide and these stories probably don't connect for most people but i've been beating the drum for months and months and months about orforglopron because what i've said all along is that these drugs don't live in clinical trials. They live in the real world and the real world uses these drugs very differently than they are in these tightly controlled clinical trials. And we're starting to see that show up in very real and very frankly scary ways in the gray market, an option that patients are more and more being pushed to with every little constriction that happens in the compounding space. We'll get a little bit into that today. But before we get into all that, I want to zoom out for a second because another story that we broke here at On The Pen over the last couple of days is that we're starting to hear again that clinicians are facing state level pressure from their medical boards not to prescribe compounded GLP-1s. Now, the states specifically that I've heard so far are California, Rhode Island, and Kentucky. So, this doesn't feel like some big coordinated wave of warnings like we saw originally when the shortages ended. If you remember back then, many clinicians were receiving letters from their state pharmacy board saying you need to stop prescribing these. They're off shortage. So this doesn't feel as coordinated and widespread as that time, but it's there. It's still there. And if you remember that window. You remember how quickly things shifted for a lot of doctors who tightened access to GLP-1 compounds at the time. Options for certain patients started disappearing and people had to figure something out. Many of them moved to telehealth, but that's the part that keeps getting missed with every little piece of regulation enforcement that comes out, with every letter from the FDA, with every lawsuit that continues on about compounding. People don't just stop. The demand doesn't just go away for GLP-1s. Patients will adjust. They're going to find another way. I always say if folks thought that injecting pond water was going to give them the same result as a GLP-1 does, they would be injecting pond water. So they will go to whatever source will have them at whatever price they can afford considering their situation. So let's talk about this Reddit TrueTag case because this isn't just a random Reddit story. This was actually written up in medical literature published through the American College of Physicians. And this was a 32-year-old male with a history of hypertension, hadn't had any recent travel, no antibiotics, no obvious cause for what was about to happen as he presented himself to the ER. So he reported that he had purchased a Reddit Trutide online direct to consumer. So this is gray market, unregulated. And he did this to help with weight loss. It doesn't say anything about what this gentleman's situation was. Maybe he had access to compound and lost it through a, through a local clinic. But this was his weight management. And this is what he did as he went and he purchased done online as hundreds of thousands, maybe millions of people do with gray market GLP-1s. So there's no physician, there's no prescription involved in this process. And he started dosing himself. Now, this is the crazy part. He started at 10 milligrams weekly. Now, it doesn't say if he was on another GLP-1 prior to, but he just jumped right in at 10 milligrams. Now, in the clinical trials, 12 was the maximum dose. And then over a period of time, he increases to 20 milligrams. And then one day he forgets that he took his dose the day before and injects it again the next day just to be safe. So within hours, this guy had taken 40 milligrams of retitutide. Now what happened to him? Well, this guy became, uh, you know, uh, the, the poster child for the Hershey highway, severe diarrhea. We're talking bowel movements, like every 20 to 30 minutes, a very serious situation. If you ever find yourself with that amount of diarrhea, because it dehydrates your body very quickly. And then ultimately can be catastrophic for your kidneys. And so he ends up obviously in the emergency room. And when you read the case, what stands out wasn't just what happened here is how normal everything leading up to it. sounds because again, the story isn't this guy just made a mistake. The story is how easy it was for him to end up in this situation at all. So Reddit True Tide, obviously not approved anywhere. So he has to buy it outside of regulation. So whatever he bought, he's guessing, he's guessing on dose. He's guessing on purity. He's guessing on, on what it is that he's putting in his body, right? Presuming that he hadn't gone through the, um, the steps that many people who use gray market do and that's to get endotoxins and purity checked and all that stuff but generally what we've seen with different reporting through websites like finrick is even when all that's done oftentimes the amount that is in the vial does not match what's printed on the label because there's no one regulating that right that's what we mean by outside of regulation we've seen reports recently that there are many, many GLP-1 labeled products that are coming in from China that ultimately test with exactly zero, zero of the active ingredient. And there's nobody to hold accountable here because these are coming from Chinese folks who are connecting with people over in the United States through Telegram. So what's in his body, you know, from the get go, we're guessing any amounts we're guessing, but this is what this gentleman chose to disclose. But people go to these levels because many people, some of them go there just because that's what they've always done. They've gone to research grade websites for peptides, but many in the obesity community, sounds like this gentleman was using it for his weight. Many are pushed there because their options have run out and they choose it because the other avenues to access treatment aren't working for them. So this is where this moment here with this gentleman particularly stands apart because we've never had this many relying on compounded GLP-1s as part of their day-to-day care This is chronic use So when access gets disrupted like medical boards sending letters to doctors saying that they can prescribe compounded GLP when FDA starts to enforce and pulls 503B compounds regulated compounds off the market shifts the demand to 503As We'll see if there's enforcement against 503As because, as we know, they're not allowed by the Food, Drug, and Cosmetic Act to compound in bulk. this demand doesn't go away and we've never faced a situation in our country before where so many people faced the potential of getting rug pulled and let's face it even the potential even if there is no rug pull it's the potential for the rug pull that keeps people looking you know at their next option in their plan B, C, D, and E. So what we're talking about is, is not inconvenience for these patients. It's talking about the potential for displacement of that patient from care. And so they're going to do what they're going to do. The demand, like I say, a thousand times doesn't go away. Where do these people go? What do they do next? We don't fully know. We know that Lillian Lenovo's hope is that these people go to branded medications. But so far, it seems like many in our community tend to go the gray market route. And I think we're starting to see a glimpse at what happens to folks that end up in that channel because, again, they are shifting from regulated options and a doctor's oversight to basically a vial in a Reddit forum is their support. And that can be terrifying, you know, for a large swath of the population. So now let's shift a minute and let's look at the other end because the regulated versions aren't without risk either. They're fully approved by the FDA. They're fully regulated by the FDA. They're prescribed by a doctor and, and found a O is the latest GLP one Lily's oral to hit the market. We've been clanging the drum about potential liver issues. The FDA actually requiring basically a phase four study from Lily to make sure that there's no drug induced liver injury. So shortly after the launch, within a few days, there was a fairs report F A E R S S it's the federal FDA, sorry, adverse event reporting system. It's where anybody, anybody, and I stress anybody, that's part of the story that underscores all this. Anybody, a patient, a manufacturer, a doctor, a lawyer can go put a report in the FAIRS database that essentially says, hey, our patient is on this drug and our patient experienced this. It doesn't mean that the drug caused it. It just means that it's the sort of the drug is adjacent to the situation, but maybe not necessarily involved. Now, we had a report shortly after the launch within a few days. Now, on the FAERS database, it seems to say that this, Lilly was notified on the 15th of April. I believe that Foundale launched on the 9th. So we're talking about shortly after launch of Foundale. So not a whole lot of time. Lilly looked into this because it goes into an expedited review process where the manufacturer gets brought in the loop right away. And they said they don't believe this is related because of the timing, that it wasn't reasonable to assume that this was related to Foundale because Foundale had only been around for a very short period of time. And there were no liver failures in the, I believe these were the ATTAIN studies for Orforglupron with Lilly. So it matters, right? It matters that Lilly has that opinion. it's it's highly probable that this drug induced liver injury was a result of something that didn't have anything to do with the drug but it doesn't mean that we ignore it because i think we have to look at this in complete context and keep this whole thing grounded because we have what was the fastest drug launch in in modern history outside of the covid vaccine we had one of the fastest drug launches in history and the approval process and the speed at which it was approved is worthy of additional scrutiny i think that's why the fda is requiring oversight and drug-induced liver liver reporting um high's law level uh surveillance essentially the thing the thing to know about foundao here is that drug-induced liver injury is a big deal is a big deal to to throw a claim out and we've been warning that this um that elevated liver enzymes were to a very small extent observed and in the broader context we saw denuglapron which was a small molecule glp1 pill from pfizer get completely abandoned because of liver toxicity issues liver issues had been extremely rare with injectable glp1s Because I think that's sort of what Lily pivoted to yesterday. It's like, hey, this is a really rare phenomenon within GLP-1 medications. And you have to look at the patient as a whole in terms of what their overall liver health is going into it, type 2 diabetes, obesity, etc. But the liver issues that we've seen with injectables have been around 1 in 100,000, roughly. And so what we saw here with with more forglopron was. You know, in the last month or so, the number we got from Lily last week is about 20,000. So now we've got like one in 20,000. If if the drug injury or if the liver injury is indeed related to the drug, which a report in fairs doesn't mean that it's only meant to flag potential issues so that that things can be investigated further. So we'll have to wait for the dust to settle. So the honest answer about all that right now is it could be nothing and it could be something. We just don't know. We're in that window right now where nobody really knows what's happening. but because again the drug moves so fast and and anything moves as fast as or forglopron did we're gonna learn some things in real time in the real world that we didn't see in the studies and ultimately we'll see that so just so people understand what the fda asked that lily look at was high's law liver enzyme uh groups uh folks that have high liver enzymes bilirubin goes up it means basically the liver isn't just like irritated. It's actually struggling to function properly. It's super rare, but when it shows up, it's very important to figure out what the root cause was. And so that's the level at which the FDA is requiring them to look at or forgloprine or found a O. So, so now let's step back because we talked about this on yesterday's live. If you don't know, we're live Monday, Wednesday, Friday from 12 PM Eastern to 1 PM Eastern every day, every Monday, Wednesday, Friday on X and on YouTube. So I hope you'll join us on those platforms for that live. We have a good time. But we talked about this yesterday. So let's bring this all back together. So on one side, you have people completely operating outside of the system, like this guy on Reddit, true tide, 40 milligrams. And then you've got folks within the system, you know, on a brand new drug and still having, you know, issues on these medications or potential issues. In the middle, you've got patients who are potentially considering both of these avenues going, what makes sense and which way should I turn? Like, how does a patient even know what to trust? Because if the FDA is tightening things on or for glopron and a patient is looking at that, could it be something that they should avoid? I think the honest question is you have to discuss this with your doctor. You have to be aware that there were elevated ALT, AST enzymes in phase two across the whole trials, as Lily has pointed out, fairly so. There were no signs of liver failure and no signs that this caused liver issues. But I think what we're seeing is in the real world, not seeing necessarily with Fondeo, but we're seeing with stories like this gentleman on Reddit Trutide, people in the real world use these much differently than they do in the clinical trials. And that's what concerns me. That's what ultimately concerns me. Why does it concern me? Because even Lily, after identifying a couple of patients in phase two that had hepatic issues, super high elevated liver enzymes, it was just a couple of patients. But nonetheless, they pulled back from 45 milligrams in phase two to 36 milligrams in phase three. And so they traded off potentially a best in class drug and they could have potentially bested the Wagovi pill by upping the dose of orforglopron, but instead chose to pull back to 36 presumably for safety presumably to end up in a situation where they weren doing the same thing that that Pfizer did with the new glopron and in the real world it just totally different In fact just a couple of days ago I was scrolling through Instagram and there a big famous peptide influencer who has taken the liberty of branding his own version of research grade or for glopron. And he talks about how he fasts. And then, you know, through the middle of his fast, he'll just pop a couple of these tablets. I don't know what he called them, some nonsensical name. People may not even know they're getting or forglopron. But if you do, you should know it's metabolized by your liver and just quote popping a couple in the middle of the fast could be very bad for your health. And so at the end of the day, this has just been my concern. It's a small molecule, non-GLP1. I feel like I've exhausted this to no end. But if you look at where this is all heading, you see the FDA tightening things up. You see courts getting involved, allowing lawsuits to move forward. Lily's going after these telehealth companies and then the state licensing boards are stepping in you're seeing you know the pathways start to constrict it's not i i wouldn't think of of compounds in terms of in terms of something that's going to just turn off like a faucet but rather if you think of that faucet and just think of it slowly being turned slowly being turned and and it just restricts access and it forces patients to make a decision about their care and with that happens the demand moves it shifts and you do see some people move to these peptides type influencers. You see them going the research grade route because they trust influencers the same way that they trust their medical doctor. And in many cases, a lot of these influencers that are hawking these out of regulation peptides are just casually throwing out that you should just pop a couple research grade or forglopron pills. It's just crazy to me, the situation that we're in, but I think it underscores the importance of care, not just access to drugs, but access to care. And that's what's so important because we're going to see more and more people sourcing medications from the gray market as their access is restricted or the potential to their access is restricted. And then there's no care involved. Sure. Maybe you run the drug through testing. Maybe you get a clean peptide certificate analysis. You get what you need to feel safe, but you don't get the care. Reddit forum is not care. You just got a product at that point. And that's how you end up people with people managing a chronic condition with nothing but internet advice, which is no way to manage a chronic disease. And that's not where we want things to be headed in the long run for obesity care. And honestly, that's why I want to show you something here, because while all of this is happening while all of the access is shifting. And while people are trying to figure all of this out in real time, uh, there are also people out there who are building tools that can actually help. And one of the biggest gaps right now is tracking like what dose am I on? When do I take it? Where do I feel best at when I take my dose? So where's my optimal zone? What changed? How am responding because if you've been on a glp1 before you know that the journey is not a static journey it evolves how the medication treats you the the diets that you choose to uh to employ the the other tools in addition to glp1 that you're using to manage your chronic disease and shed has put everything together in a app a new app and i want to introduce that to you but i can't say it as well as Shed and the developers themselves can say about it. So let's hear from Shed today. There's been so much chatter in the community about tracking your GLP-1 journey, whether that's the behaviors that you're trying to reprogram or whether that's the actual GLP-1 journey and the tracking of the doses and how you're feeling. Our friends over at Shed, who have been sponsoring our podcast for the last almost eight or nine months, has actually come out with a pretty amazing, tool for those on a GLP One journey. And the good news is it's available for everyone. And today on the podcast, we have the privilege of talking with Mr. Kyler Oki. And Kyler is the chief product officer at Shed. And he's going to tell us a little bit about what went into this app design, what it is, how you can get it, and how you might benefit from it. So without further ado, I'd like to introduce you to Kyler Oki. Kyler, welcome to On The Pen. Hey, thanks, Dave. Pleasure to be here. Yeah, really glad that you made some time for us today because this, when I saw that Shed was launching an app, I thought, man, this is so timely because so many people in the community have been clamoring for an app that really was more than just a data tracking app, something that actually had a useful utility for somebody on the GLP One journey. Kyler, tell me how you and the folks at SHED kind of identified the need for this to begin with. Yeah, no, I think when looking at this, we were just looking and listening to what our patients were saying, right? You know, in that process of what are some of the struggles they're having, and when it comes to like tracking and reporting and understanding more about what their journey should look like, right? And so listening to that feedback and talking to patients and having interviews with them and then ultimately landing on the development of this app to where we wanted to be a GLP1 companion, right? A place that they could go to and have access to reporting their experiences. Yeah, that's awesome. I mean, I've heard it so much in the on-dependent community. It's not a surprise to me that that was a big area of feedback for you from patients at Shed. Now, I am curious, like throughout that journey of sort of discovering the need for something like this, what were some of the areas of deficiencies that were maybe highlighted by the patient community? Like, I wish that I had a way to track this, or I wish there was a way to know or understand or have insights into this. What were some of the kind of recurring themes that you had? Yeah, definitely. I think one of the first themes is things on a GW1 journey can move relatively quickly these days, right? From hearing about it to getting approved, and there's not a lot of time to learn for a lot of people. And so one thing was just learning more about what should that journey look like, right? And then one of the other factors was, okay, what should my experience be like? You know, I know they know that it's going to change, you know, they're going to learn about titration and they may not have a great understanding of what that is. And so then one of the things repeatedly asked was, I want a place to be able to log my dosing, right? Understand what I felt like on this dose versus this dose. And so some very common themes across all our patients of just wanting to learn about the journey, what their experience should be like. And at the same time, have a, have a kind of a journal of a place where they could look back and understand what they'd experienced over time. Yeah. It's kind of like, it's kind of like food tracking in a way, like, because it's one of those things where if you're trying to, to watch a certain macronutrient or you're trying to, to hit a certain goal and you're not tracking, you kind of think back through you. Like I was doing really good last month. What was I doing different than I was doing now? But if you weren't tracking, you don't sort of have that data to recall. Kind of the same thing on the JLP1 journey. It's like, hey, I was feeling really good at this point. Side effects were good. Appetite suppression was good. But now maybe I've moved up or maybe I've spaced my dosing differently. I don't know what the different variables could be from person to person. But if you don't sort of have that data, sometimes it's just hard to remember or hard to accurately remember exactly where you were. So this app is kind of designed to help patients kind of identify, hey, I was feeling good here and this is where I was. What are some of the other tools that are kind of built into the pivot app that might benefit somebody who's on a GLP One journey? Yeah, great, great question. So obviously there's that factor of it, of a place that they can journal their experiences, right, and log their doses. One of the other things that they probably we hear about a lot, the patient community is, okay, I know there's a couple of habit changes I need to be making. There's proteins, a buzzword, right? Understanding what's the relationship there, fiber, water intake. So then we really built a simple daily log feature where we know that people are tired of intense macro calculations or calorie calculations and really trying to have to nitpick every single detail, where it's just a place for them to say, hey, did I get enough protein today from what I felt, um, based on some simple guidelines, did I drink water today? Did I have any form of activity day? Check that off every day. And then being able to see a repeated theme of all these weeks, I did really well with those daily habits and these weeks I didn't and look at how that corresponded with my GLP one journey. Um, so that's a, that's a fun feature. And then another thing, we just expanded that a little bit further out and to kind of correlate the, Hey, this was where I'm at on my medication and titration. We have a weekly report as well where they can come in and say this week I experienced a lot of cravings or I have a lot of food noise or here kind of the emotional side of my experience was I stressed this week And then they can kind of look historically and say hey based on my weekly report and where I was titrating, this was my experience that week. It was amazing. I'm having kind of an off week. And they can kind of have a couple more things to look at aside from maybe just where their dose was, or they can understand a little bit more about maybe what was happening at their life at that time. Yeah. Having, having that kind of 360 degree perspective is really good because I always talk about how the fact, the fact that obesity is a journey that involves the mind, body and the spirit. And so all of these factors play a role in how you feel at the end of the day. And so all of those things are really important to keep track of. And I love what you said also about patients telling you that, that they were sort of sick of tracking everything from a micro level. I think that, I think that's really rings true because it's one of the biggest things that people highlight when they talk about the freedom that GLP one gave them is that for the first time in their life, without having to do that, their body has just responded to normal eating, the normal rhythm of, of eating the normal diet that they're eating and their body just responds appropriately because one of the things I always say, Kyler, is that GLP ones help to level the metabolic playing field. So a lot of people don't have to white knuckle that tracking like they once did. And that's like kind of a freeing thing when you've spent, I don't know, 20 years of your life doing just that to no avail. So I like that it's not trying to be something that's super granular, but something that's trying to give people a 360 degree view of where they were at, a snapshot in time for them to be able to go back to and say, that's what I want to replicate. What sort of needs to be corrected in my behavior or in my stress levels, or even from a dosing perspective to sort of get me back to that ideal spot. I love that. So when we talk about the app, it's called Pivot. And first of all, how'd you come up with the name Pivot? Yeah. Pivot came to us of just thinking of a slight change in direction, right? Just like being able to pivot and make a change in your life. And so realistically, when people are taking that step on a GLP one journey, they decided to pivot, they decided to make a change. And so that's really resonated with us. And we wanted to bring that to light through the name. Awesome. And the pivot app is just kind of behaves like anybody, any, any app you would get in terms of it's on the Apple and Android marketplace. So somebody wants to check out the pivot app. They just simply need to go download it. Yeah, just that simple. So they can test it out for two weeks. It's free for two weeks to test it out. See if it's something that's enjoyable to them. You can find it in the Apple or Android store. And just by searching for Pivot, it should be the first thing that pops up. Yeah, awesome. So let's talk a little bit. I want to make sure that folks remember here that Shed has been the headline sponsor of our podcast for some time now. And so we're really excited to bring this to them. But if this doesn't require you to be a patient of Shed to take advantage of the Pivot app, so you can go down there. In fact, we'll put it in the link tree at otplinks.com and make it super easy for you to find the Pivot app and to download it. But if you do decide somewhere down the line that seeking treatment through Shed might be something that you want to explore, they do offer a really generous code to OTP listeners. So you can check out tryshed.com. And if you use code OTP25, OTP for on the pen 25, you're going to save 25% off of your obesity treatment. So if you do ultimately decide that getting treatment for obesity through Shed is the route for you, you can always take advantage of that code. But you don't have to be a patient to use the Pivot app, which I think is pretty cool that you can just kind of pick it up and test it out and take it for a spin and see if it's something that might add some value to your journey. Looking forward to sort of, I know that this is like, this is launch time for the Pivot app, but just kind of dreaming into the future. how would you imagine that the Pivot app becomes in terms of like the day-to-day life of somebody who's on a GLP-1? Do you think that this is something that just about anybody who's on a GLP-1 can benefit from, from a day-to-day usage standpoint? Oh yeah, a hundred percent. And that's part of the reason, you know, we made it a separate app from Shed, right? Like we understand that there's a lot of people on a GLP-1 journey. And so we wanted to really focus on that, right? We wanted to make sure that we are building something that could benefit anyone, no matter where they're coming from or who their provider may be, that if they need that extra support, they can come here. And for us, the goal is to be that GLP-1 companion, right? Some place that they can turn that on any given day if they have questions or they want to learn or they want to, you know, record their experiences, they've got a place to turn to. You know, a support system is always really crucial for people when trying to lose weight or maintain weight loss, right? and at times it can be hard because friends or family members just don't want to hear about it anymore and so we want a place that they can just turn and feel like hey this is a place that I can turn to every day and find that support and find that guidance that I need and so we wanted to you know over time we're hoping to make it more interactive more of a place that they feel like hey this is really just something I see myself needing to do every day solely for the fact that it's a place that I feel supported on this journey. Yeah I can I can kind of like foresee like a cool feature just sort of being like having a community function sort of built in there. I know that you already have that in a way through the shed website, but having maybe just like a community page where people can post about side effects or, you know, is this normal? I think so many times people start these medications and they just want to know that what they're experiencing is normal. Like people, and I'm this way too. When I start a new medication, I get so in my head about is this a side effect is this from the medication and and so i think that just having that when you're starting something new because as you pointed out earlier is a really good point to make i feel like uh when you said like the the point of like learning about a glp1 and learning that it exists to having it at your doorstep is like lightning fast and so the education around it can certainly lag when you kind of see the flashy ads because all you have to do is think about a GLP one and you have 40 ads in your meta feed. And so from the time that it gets to, to order now and you get your doctor visit and you get the medicine in the mail, it's not a lot of time to educate yourself on what the actual journey is like. So, I would hope that you come back and, and kind of let us know as different features pop up on this pivot app, but definitely wanted to let folks know that this is out there and make them aware that this is an app that you can go download and use as a companion to your GLP one journey. I think this is a super cool tool and love that you guys made it available to the masses and that you don't necessarily have to be a shed patient to take advantage of it. Anything else that we should know about the Pivot app before we jump, Kyler? No, I mean, I think we've covered it well. I think ultimately the goal here is just to be a place that people can find support. They can find knowledge, right, with how fast this industry moves and how many changes there can be and how alone at times people can feel despite, you know, having access to these great medications. And we're trying to bridge that gap where it's like, hey, you could have it relatively quickly. You may have only had one or two conversations with somebody educating you about what the treatment is. Here's a place that you can document your journey, learn more about resources and know that there's an expert approach behind developing it, that you can trust the information that's displayed in the app. Yeah, that's another big one is to just have another trustworthy source that has input from experts in the area of obesity and obesity management. That's a big one. So I think that's excellent. Well, Kyler, certainly appreciate your time. Thank you for coming here and talking to us a little bit about the Pivot app. If you guys do make some big changes to the app and add any features and you want to come back, I hope that you will. And just really appreciate you giving some time to the channel today. Yeah, definitely appreciate it. It was a pleasure. Kyler Oki with shed. Hope that was helpful for you. I think this app is going to be a game changer for a lot of people getting on GLP ones. And perhaps even if you've been on one for a while and you've been looking for some extra support, the pivot app, you can get it to it very easily just by going to the Apple or Android marketplace and searching pivot GLP one tracker. We put that up at the bottom of the page. We'll also link it at otplinks.com for your convenience. But thank you for being here again on this Tuesday for another edition of the Weekly Dose Podcast. We'll do it again next week. Until then, have a great week, and we'll catch you on the next one.