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Additionally, gastrointestinal side effects are most pronounced during the first two weeks at a new dose and typically improve by weeks three and four

J Transl Med 2007;5:27

Study secondary end points included the comparison of ACE1 and ACE2 receptor levels between the supplement and placebo groups of Cohort 2 (analyzed at baseline and every 7 days for 21 days) and the ACE1/ACE2 ratios in both supplement and placebo groups of each cohort

The behavior of drinking water to dilute the bile and induce vomiting and hence reduce nausea is common, and should not be confused with a psychogenic cause

However, factors like muscle fatigue and exercise-induced inflammation can impact peak performance