james_edin said:

The shortage clause is the answer to the second question and it is a subtraction rather than an addition.

That reframing is the part I needed. Taking it to my next appointment.

Adding the clinical framing, because it changes how the question reads.

FDA inspection results for compounding pharmacies selling compounded supply: you can look up any 503B facility's FDA inspection history on the FDA website.

Check for: Form 483 observations (violations), warning letters, and recall history. A clean inspection record is a strong indicator of quality. My pharmacy has had 0 Form 483 observations in their last 3 inspections.

This is public information. Use it. Link: fda.gov/inspections-compliance-enforcement-and-criminal-investigations

Dr.ObesityMed said:

Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five.

This is where I part company with the consensus forming above. The "tirzepatide is simply better" summary irritates me. It is better on mean weight loss, and the cardiovascular outcome evidence is far thinner than semaglutide's. If the reason for treating is cardiovascular risk rather than weight, the evidence base points the other way.

nick_newbie said:

They are two different exemptions from the same federal requirements and they buy different things.

Vendor communication red flags for compounded supply:

• Won't provide COA before purchase — walk away
• Claims "100% pure" without analytical data — unrealistic
• No physical address or phone number — accountability matters
• Pushes you to buy more than you need — pressure tactics
• Won't answer questions about their compounding process — transparency is key
• Payment only via crypto or wire transfer — legitimate pharmacies accept cards

A legitimate compounding pharmacy operates like a healthcare business, not a gray market dealer.

Moderator note: the sourcing question belongs in the vendor section and has been split out.