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These effects occur in a minority of users and rarely require stopping

[American Journal of Physiology] Laskowska M, Oleszczuk J

For mens performance or active-lifestyle formulas, the safer B2B pathway is to build around permitted ingredients, transparent labels, third-party contaminant screening, and compliant structure/function language such as supports energy metabolism or supports exercise recovery. Avoid disease-treatment claims, steroid-like positioning, and any implication that a formula contains or replaces prohibited research chemicals

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Principal effect modifiers are speculated to be differences in patient populations (peri-operative CABG vs PCI vs medically managed acute myocardial infarction) as well as resultant ischemic burden (Furat et al