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Once you begin using a semaglutide pen or vial, it remains stable at room temperature (up to 86F or 30C) for up to 28 days in most cases

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In rat experiments, a decrease in phylloquinone (vitamin K 1 ) and menaquinone-4 (a form of vitamin K 2 ) concentrations in extra-hepatic tissues was found in animals administered excess -tocopherol via the diet or by subcutaneous injection

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McClure R, Massari P (2014) TLR-dependent human mucosal epithelial cell responses to microbial pathogens

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But only the R-isomer (R-ALA) is naturally produced in the body and actively participates in mitochondrial energy metabolism.12 Some studies suggest that R-ALA may be more bioavailable than standard racemic ALA though the clinical significance of this difference is still under investigation.17 In addition, anecdotal reports and small studies indicate that R-ALA may be easier on digestion, with fewer gastrointestinal side effects than standard racemic ALA, especially at higher doses.18 However, R-ALA is chemically unstable on its own

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