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This limitation of standard lab testing approaches stems from how reference ranges are calculated

doi:10.1152/japplphysiol.00945.2010 Staresinic M, Sebecic B, Patrlj L, et al

Chronic conditions like long-standing GERD may benefit from extended 8 to 12 week protocols

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Additionally, standard injection risks (infection at injection site, vein irritation for IV, etc.) apply, though proper sterile technique makes these complications uncommon

So what I just discussed are the two major players are the two most often