Glutathione is a tripeptide composed of glutamic acid, cysteine and glycine, and the sulfhydryl group on cysteine is its active group (so glutathione is often abbreviated as G-SH)
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Notably, reduced muscle mass is strongly predictive of radiographic progression and poorer functional outcomes (Huber et al., 2020

mechanism unexplained Relative contributions of direct peptide effects versus downstream IGF-1 actions inadequately characterized Long-term receptor sensitivity and potential for desensitization inadequately studied Individual patient variability in response not well-characterized Potential for differential effects based on endogenous growth hormone status unclear Long-Term Safety Considerations Critical safety questions remain unanswered regarding chronic peptide administration: Cardiovascular safety concerns FDA warnings cite risks of increased heart rate, systemic vasodilation, flushing, and transient hypotension Immunogenicity risks FDA identifies both peptides as potentially immunogenic with risk of serious immune reactions including anaphylaxis Cancer risk theoretical concern that chronic growth hormone/IGF-1 elevation could promote cellular proliferation
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