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Many cyanobacteria (and microalgae broadly) are safe to eat, though not every strain of cyanobacteria has a GRAS certification.5 Under the GRAS framework, an ingredient has to be demonstrated as safe either through (1) scientific procedures or (2) in the case of a substance used in food prior to January 1, 1958, through experience based on common use in food. For cyanobacteria to be used as a platform for oral GLP-1 delivery, either a GRAS organism like spirulina must serve as the host organism or, if choosing a different species, the manufacturer must prove with adequate in vivo trial data that it is safe to eat

doi: 10.2337/db08-1475

Gastrointestinal effects and referred pain: The pronounced gastrointestinal side effects of GLP-1 therapyparticularly nausea, constipation, and abdominal distensioncan occasionally manifest as referred pain to the back

Smad-dependent and Smad-independent pathways in TGF-beta family signalling

It is therefore the synergistic actions of GLP-1 in the gut and brain, acting on both central and peripheral receptors that seem responsible for the effects of the hormone on satiety