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The epithelium of the gastrointestinal tract is exposed to a variety of trypsin-like proteases that can activate PAR2

10.1371/journal.pone.0139593 6 ChenhuichenC.Cabello-OlmoM.BarajasM.IzquierdoM.Ramirez-VelezR.Zambom-FerraresiF.et al (2022)

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Missing one dose likely wont derail your progress, but frequently interrupting your oral semaglutide dose schedule can reduce long-term effectiveness

Your liver produces it naturally, but levels can drop due to age, environmental factors, and daily stress