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Online patient discussion groups often contain questions about where compounders are obtaining their starting ingredients, and they sometimes share Certificates of Analysis (COAs) to try and reassure fellow patients about the sterility and potency of the products and the starting ingredients

Others see it as an important transparency gap

When this reabsorption process is impaired, excess bile acids reach the colon, where they stimulate water and electrolyte secretion, leading to chronic watery diarrhoea

PMID 15090266

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44 year old competitive cyclist and avid mountain climber This patient came to see me three months after his initial symptoms