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Gut microbiota convert these precursor compounds into trimethylamine (TMA), which is shunted into the portal circulation by TMA lyases and then oxidized to TMAO by hepatic monoxygenases [64, 65]

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Reported Adverse Effects Reported adverse effects from online forums cited in a 2025 systematic review (PMC12313605) included: Anxiety and panic attacks Depression and anhedonia Insomnia Heart palpitations Fatigue and weakness Loss of appetite These anecdotal reports cannot be verified as directly caused by BPC-157 versus contamination, incorrect dosing, or concurrent conditions, but they raise concerns that the peptide might paradoxically worsen mental health in some individuals