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Studies examining ergogenic supplements found concerning rates of problems: 12% to 58% contamination, 30% containing incorrect amino acid sequences, and 65% exceeding safe endotoxin thresholds

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10.1038/s41598-024-61011-8 46 GuY.XuX.WangZ.XuY.LiuX.CaoL.et al (2018)

For more difficult cases, the drug Methacholine is used to make the diagnosis
