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In addition to direct effects on ion channels, neurotransmitters may bind to G-protein coupled receptors, thereby eliciting cell-signaling effects that could result in metabolic changes (e.g., alterations in activity of various enzymes) within a postsynaptic cell (14)

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This has driven patients to seek unregulated gray-market sources, exposing them to preventable risks. It is true that Americans have been buying risky, research-grade peptides, including from China, that could contain toxins and poor quality peptide fragments