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However, serotonin can affect both vagus nerve and BBB permeability [69], and it modulates intestinal inflammation [212] and numerous physiological processes, including gastrointestinal secretion and peristalsis, vasoconstriction, behavior, and other neurological functions [177]

Fecal elimination of metabolites also occurs, particularly following oral administration, though quantitative contribution of each elimination pathway varies by route and dose

158,159,160 Additionally, other post-translational modifications, including truncation, 161,162 glycosylation, 163 glycation, 164 and sumoylation, 165 play an active role in promoting tau aggregation and increasing its toxicity

Genetic polymorphisms in genes encoding matrix metalloproteinases, collagen synthesis enzymes, or inflammatory mediators could theoretically influence GHK-Cu responsiveness, though systematic investigations of pharmacogenetic determinants remain absent from current literature

Once you start adding these up, its easy to see why 40% of you probably have some form of B12 deficiency

Healthspan 3 , 6 (2014)