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Various strategies are used to extend the half-lives of these agonists compared to native GLP-1 including using a synthetic analog of Ex4 (Byetta) and the addition of a fatty acid side chain to native GLP-1 to facilitate albumin binding (Liraglutide/Victoza)

Non-erythropoietic: By design it does not stimulate erythropoiesis, avoiding the hematocrit/thrombotic risks associated with EPO

Environmental pollutants, heavy metals, and chemicals can also increase the body's demand for antioxidants, including glutathione, leading to its depletion