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MDH experiments with alternative substrates showed a high degree of substrate specificity

In the liver, heptanoate can form the C5 ketones, -ketopentanoate and -hydroxypentanoate, which are released into the blood and can be taken up by neuronal and other cells through monocarboxylate transporters

doi: 10.1016/j.clnu.2019.12.006 96

The tablets come in 3mg, 7mg, and 14mg doses, but given the ~0.4-1% absorption, a 14mg oral dose delivers roughly equivalent semaglutide exposure to a 0.5mg injection. Insurance coverage varies dramatically between brands

Although a recent meta-analysis by Zimmerman et al