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The critical constraint is maintaining the 28C storage temperature required to prevent oxidation of the reduced glutathione molecule, which begins degrading at ambient temperatures within hours

doi: 10.3390/brainsci10120964, 180

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Providers routinely encounter patients who experience severe gastrointestinal intolerance, metabolic adaptation, or frustrating weight loss plateaus that render these first-line therapies insufficient

Furthermore, the initial identification of ghrelin expression in esophageal squamous cell carcinoma was achieved through immunohistochemistry, wherein tissue ghrelin levels exhibited significant associations with the extent of differentiation, level of tumor invasion, lymph-vascular invasion, and tumor stage (154)