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Maintenance visits every 36 months, strict photoprotection and topical support remain essential

Any administration in a research setting would need to be part of a carefully designed, ethically reviewed study, with meticulous monitoring for unforeseen interactions or effects

Similarly, TGR5 activation elevates intracellular cAMP levels, leading to downstream activation of protein kinase A (PKA) and exchange protein directly activated by cAMP (Epac), which suppresses NF-B signaling, inhibits NLRP3 inflammasome activation, and can promote macrophage polarization from the pro-inflammatory M1 phenotype toward the anti-inflammatory M2 phenotype 148

The FDA says there is no legal basis for selling the compound as a drug, supplement, or food (though there is evidence for its illicit sale and use) (14)