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Side effects, which vary by drug, include myopathy and peripheral neuropathy (telbivudine), kidney toxicity and dysfunction (tenofovir and adefovir), decreased bone mineral density (tenofovir), and lactic acidosis in patients with liver disease (entecavir) (Scaglione 2012)

So lets make this simple

The average diet supplies about 5 to 15 mcg/day of vitamin B 12in a protein-bound form that is available for absorption after normal digestion

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Baseline labs should include serum copper, ceruloplasmin, 24-hour urine copper, and a comprehensive metabolic panel

Identifying imbalances in these markers allows for targeted medical and lifestyle interventions that can enhance the effectiveness of peptide therapy while reducing the risk of adverse responses