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Patient selection considerations include: Troche delivery: Appropriate for patients seeking systemic benefits without injections Convenience: Favored by those who want consistent absorption and ease of use Adjunctive use: Can be combined with topical or injectable approaches for broader results Microneedling with Copper Peptides Enhancement Microneedling combined with GHK-Cu application creates synergistic effects that enhance peptide penetration and biological activity

Haematological Isolated red cell macrocytoisis Macrocytic anaemia (especially if MCV more than 110fl) Pancytopenia (especially if MCV more than 120fl) Neurological or Psychiatric Optic neuropathy Peripheral neuropathy (sensory or motor) Symmetrical neuropathy affecting the legs more than the arms