When to Stop

• Melanoma case reports — dermatology literature documents at least 4 case reports of melanoma emerging during or shortly after MTII use, including transformation of pre-existing nevi. Causation vs. correlation is unproven (population baseline is fair-skinned tan-seeking individuals at elevated melanoma risk regardless), but the mechanistic plausibility (melanogenesis stimulation + UV exposure pairing) is high enough that the question "does MTII increase melanoma risk?" is unanswered and should be assumed yes pending data.
• Dysplastic nevus eruption with severe dysplasia — multiple case reports (Cardones 2009, Actas Dermo-Sifiliográficas 2012). 25-year-old male, 4-week MTII course, multiple new nevi, 3 with severe dysplasia on histology.
• Priapism — at least 3 published case reports; one required surgical (Winter's) shunt after failed phenylephrine intracavernosal injection. Often associated with overdose (>1 mg single injection) or stacking with PDE5 inhibitor.
• Rhabdomyolysis + sympathomimetic toxicity — Nelson 2012 case report: 39M, 6 mg single SC injection (6× recommended starting dose), CK >17,000 IU/L at 12h, ICU 3 days, recovered.
• Posterior Reversible Encephalopathy Syndrome (PRES) — Annals of Internal Medicine 2013 case report: seizures, visual disturbance, MRI findings of bilateral posterior white matter abnormalities. Reversible. Mechanism unclear (possible BP-mediated or direct CNS melanocortin effect).
• Renal infarction — single case report in literature.
• FAMMM syndrome accelerated nevus change — case report of teenage girl with familial atypical mole and melanoma syndrome who used MTII and tanning beds, developed multiple darkened nevi with one biopsy-confirmed dysplastic.
• Pre-treatment baseline (mandatory, not optional): full-body skin examination by dermatologist, total-body photography ("mole mapping"), dermoscopy of any nevus >2 mm or with prior atypia. This baseline is the only way to monitor for change during use.
• First 4 weeks: assess nausea tolerance, BP changes (some users report transient elevation), spontaneous erection pattern.
• 3 months and ongoing every 3-6 months: full-body re-exam comparing to baseline photos. Any nevus changing in color, size, shape, or border = excisional biopsy threshold.
• Stop immediately: any seizure, severe headache + visual disturbance (PRES rule-out), priapism >2 hours (urological emergency), painful nevus change, or systemic toxicity (muscle pain + dark urine = rhabdo workup).
• Most "research peptide" vendors source from Chinese contract manufacturers, repackage in EU or US "labs," and sell with widely variable purity, sterility, and actual peptide content (Dr. Gerstman 2024 substack analysis). Independent third-party testing is rare. Some vials contain <50% labeled peptide; others contain endotoxin contamination. This is not a moralistic warning — it's the documented baseline reality of the gray peptide market.
• No GMP, no cold-chain guarantee, no recall mechanism — if a batch is contaminated, there is no regulatory infrastructure to know.