DoseLogDan said:

Resolution therefore closed the doors unevenly, and the asymmetry follows from the bulks lists.

Vendor communication red flags for compounded supply:

• Won't provide COA before purchase — walk away
• Claims "100% pure" without analytical data — unrealistic
• No physical address or phone number — accountability matters
• Pushes you to buy more than you need — pressure tactics
• Won't answer questions about their compounding process — transparency is key
• Payment only via crypto or wire transfer — legitimate pharmacies accept cards

A legitimate compounding pharmacy operates like a healthcare business, not a gray market dealer.

One thing that is still open after LindaRN_retired’s answer:

Why a shortage listing created a legal pathway at all, since a shortage is a supply fact rather than a permission?

Dr.GutHealth said:

Vendor communication red flags for compounded supply: Won't provide COA before purchase — walk away Claims "100% pure" without analytical data —…

Regarding compounded supply compounding legality: compounding pharmacies can legally produce semaglutide and tirzepatide while these drugs remain on the FDA shortage list. If/when the shortage resolves, the legal landscape may change.

Stay informed. The FDA shortage list is updated regularly. Current status as of my last check: semaglutide shortage ongoing, tirzepatide partially resolved. This directly impacts compounding availability.

Reporting back.

The bulks-list asymmetry was the piece I had missed entirely. It explains why one of my two pharmacies is still arguing it can supply and the other simply stopped.

Dr.LipidDallas said:

Regarding compounded supply compounding legality: compounding pharmacies can legally produce semaglutide and tirzepatide while these drugs remain on…

Agreed, and the enforcement dates were staggered by category — 503A first, 503B a few weeks later — because outsourcing facilities have manufactured inventory and clinic contracts to unwind while a 503A makes to order.