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If you have a very strong inflammatory, systemic inflammatory signal, its very difficult for that little small molecule like BPC-157 or peptides in general to make a significant impact when your soil is disrupted. The framing is informally clinical rather than peer-reviewed, but it lines up with what the Vasireddi review describes as the literatures current state: signals of effect in defined research conditions, inconsistent translation to the heterogeneous population of real-world users
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