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Similarly, apolipoprotein A-IV, which is synthesized and secreted exclusively by the small intestine (primarily by the jejunum, but also by the duodenum and ileum), acts as a satiety factor that is downregulated by leptin (188) and upregulated by insulin and PYY in both rodents and humans (189)

Its phase 2 obesity trial reported a mean 24.2% weight reduction at 48 weeks at the highest dose studied, against 2.1% for placebo (PMID 37366315)

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Supplied as a lyophilized powder, independently tested, and supported by a lot-specific Certificate of Analysis