When to Stop

• Theoretical cancer risk from telomerase activation. Telomerase is reactivated in ~90% of human cancers — that's the basic concern. *However*, animal and observational evidence so far has shown the opposite — Anisimov mice on epitalon had *reduced* spontaneous tumor incidence, and the Khavinson elderly cohort showed no excess cancer mortality. Two non-mutually-exclusive explanations: (a) pulsed dosing produces transient telomerase activation insufficient to drive tumorigenesis from healthy somatic cells; (b) restored immune surveillance (the CD4+/CD8+ + thymic effects) clears nascent transformed cells faster, net tumor reduction. This is "the Epitalon paradox." The honest position: insufficient long-term human data to be confident either way; absolute contraindication if active cancer or strong cancer history; conservative caution otherwise.
• Allergic reaction to peptide — rare in published literature, theoretical for any injectable peptide.
• Immunogenicity — FDA's stated concern for the Category 2 listing was potential for immune response against the peptide. No documented anaphylaxis in published literature, but the theoretical concern is what placed it on the restricted list.
• First 3 days of cycle 1 — adjustment / mild flu-like symptoms most likely here.
• Bedtime sleep onset during cycle — if evening dose disrupts onset, switch to AM. If AM disrupts sleep, the compound is doing something off-spec for that user — discontinue and reassess.
• Post-cycle weeks 2-8 — if mood / sleep gets *worse* post-cycle (rebound), that's an unusual signal; not expected per the published data, but worth tracking.
• Active malignancy — absolute. Telomerase activation in transformed cells is the theoretical concern most likely to bite.
• High-risk personal cancer history — relative; would want oncology consult.
• Pregnancy / lactation — insufficient data; avoid.
• Active autoimmune disease — relative; the immune-modulating mechanism is not well-characterized in autoimmunity (could go either way).