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Many of the patients we see at our Doral clinic who self-describe peptide therapy as ineffective were under-sleeping or under-eating protein the entire time

Ethics declarations Competing Interest The authors declare no competing interest

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However, in the handful of studies that have used NaHCO 3 or citrate in hypoxic conditions, six studies have shown no ergogenic effect [131,132,133,134,135,136], while one study has shown an increase in the anaerobic ( W ) component, which would be suggestive of a performance enhancement, at simulated altitude (14.5% O 2