Corrections log

• Blood Pressure: Result Moderate increase in blood pressure (harmful effect) → No effect; Size moderate → not stated. 1 study added.Why: Graded D row shows Improves (down arrow) while its own note says BP rises (harm); no study was linked. The only chronic DMAA-alone trial (23424215, 12 weeks) found no significant BP change: No effect. Acute single-dose studies fail C3c for this chronic row. One RCT: ceiling C, stored D kept.

1,3-Dimethylamylamine: the page as it is now

• No human study left after the re-check, so no grade: Blood Glucose Regulation. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Alanine: the page as it is now

• Power Output (Basketball performance): Result none shown → No effect.Why: Ungraded row shows Improves for power output, but the only study (22397703, basketball players) found no difference in peak or mean vertical jump power with alanylglutamine versus water; only shooting and reaction time improved. Now No effect; grade stays unset (ceiling C).

Alanylglutamine: the page as it is now

• Follicle-Stimulating Hormone (Hormone Health): Result Small increase in FSH → No effect; Size small → not stated. 2 studies added.Why: Graded C row shows Improves ('Small increase in FSH') with no linked study, so it would lose its grade. Re-cited with two controlled alcohol studies already read (no search needed): neither found an FSH change (2128439 mean levels and pulses unchanged; 3126515 GnRH-stimulated FSH unchanged).…
• Growth Hormone (Hormone Health): Result none shown → Decrease.Why: Ungraded row shows Improves (growth hormone up). Its only study reports the opposite: 'ethanol profoundly suppressed the pulsatile secretion of growth hormone'. Show Decrease; no size figures. Ceiling C (one small controlled study); stays ungraded.
• Luteinizing Hormone (Hormone Health): Result none shown → No effect. 3 studies added.Why: Ungraded row shows Improves (LH up) with no linked study. The three alcohol studies already read: the two controlled ones found no LH change (2128439, 3126515); the uncontrolled 894528 saw only a brief surge at peak intoxication, read by its authors as a response to suppressed testosterone.…
• Testosterone (Hormone Health): Result none shown → Mixed effect.Why: Ungraded row shows Improves (testosterone up) as a clean finding for alcohol. The studies disagree: three single-dose trials saw a brief rise after a low dose, while acute intoxication (894528) and the only multi-week trial (15166654, 3 weeks, men -6.8%) saw a fall. Mixed effect, not a benefit.

Alcohol: the page as it is now

• Canker Sores Symptoms (Canker Sores): Result Small improvement in canker sore healing → Improvement; Grade B → C; Size small → not stated. 1 study removed (not a study of this supplement).Why: One placebo-controlled RCT of aloe gel reports faster healing and less pain and ulcer size; the acemannan trial tests an isolated constituent: removed. One RCT: ceiling C, B lowered; 'Small' has no basis in the abstract: size cleared, note becomes Improvement. See flag_for_coordinator: a larger…
• Psoriasis Symptoms (Psoriasis): Result No effect → Improvement; Size none → not stated.Why: The row shows 'No effect' (no verdict label) but its only study, a meta-analysis of RCTs, reports PASI significantly lower with aloe gel in two psoriasis trials (SMD -1.32); its 'no significant difference' line is about pain, not psoriasis. Show Improvement (no size word: one pooled estimate…

Aloe Vera: the page as it is now

• Inflammation (Rheumatoid Arthritis (RA)): Result Small decrease in inflammation markers → No effect; Size small → not stated. 1 study removed (studied a different group of people).Why: Row shows Improves (small decrease in inflammation markers) under RA, but the only RA trial found no change in TNF-alpha, IL-1beta, IL-6 or CRP with alpha-lipoic acid vs placebo. The metabolic-syndrome trial fails C5: removed. Show No effect; C kept (one RCT).

Alpha-Lipoic Acid: the page as it is now

• Thromboembolic Events (Septic Shock): Effect note rewritten from its studies; Size moderate → not stated. 42 studies removed (not a study of this supplement); 1 study removed (did not measure this outcome).Why: Grade A row shows Worsens (moderate) with 'ATHOS-3: 13% vs 5% thromboembolic events'; no cited abstract has those figures. The strongest passing study, a systematic review (1461 shock patients), found thromboembolic event rates similar with angiotensin II and comparators and says the evidence…

Angiotensin II: the page as it is now

• Working Memory (Mild Cognitive Impairment (MCI)): Result none shown → No effect.Why: Ungraded row shows Improves (working memory up); its only study, a meta-analysis of RCTs in cognitively impaired and healthy adults, found no significant effect on working memory (g = -0.183, P = 0.110). Show No effect; grade left unset.

Anthocyanins: the page as it is now

• No human study left after the re-check, so no grade: Daytime Functioning (Sleep Quality). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Apigenin: the page as it is now

• Blood Flow (Intermittent Claudication): Result Small Increase → No effect; Size small → not stated. 1 study removed (not a study of this supplement); 1 study added.Why: Grade C row shows Improves (blood flow) on one study of intravenous arginine infusion, which fails C3b. Re-cited (1 PubMed search): the 6-month oral L-arginine RCT in 133 claudication patients found flow-mediated vasodilation and vascular compliance not improved vs placebo. Show No effect; C…

Arginine: the page as it is now

• Parasite Clearance: Effect note rewritten from its studies; Grade A → B; Size large → not stated. 2 studies added.Why: Grade A row (large, Improves) had no study and a note about ACT drugs (artemisinin, a different compound). Herb evidence: A. annua tea clears parasitaemia quickly but day-7 cure was lower than quinine (74% vs 91%) with high recrudescence (15109558), and a 2026 systematic review finds early…

Artemisia annua: the page as it is now

• Liver Enzymes (General Liver Health). 3 studies added.

Artichoke Extract: the page as it is now

• No human study left after the re-check, so no grade: Clinical Symptom Improvement. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Asafoetida: the page as it is now

• Aerobic Exercise Metrics: Result Moderate Improvement → Improvement; Size moderate → not stated.Why: Muscle Size & Strength is a general group. The only study, Bayesian meta-analysis 33670194 (12 trials in healthy adults, with a pre-specified cardiorespiratory-fitness subgroup), found ashwagandha beat placebo on physical-performance variables. Improves holds. The abstract gives no effect size, so…
• Aerobic Exercise Metrics (General Athletic Performance): Result Moderate Improvement → Improvement; Size moderate → not stated.Why: General Athletic Performance is a general group. The only study, Bayesian meta-analysis 33670194 (12 trials in healthy adults, with a pre-specified cardiorespiratory-fitness subgroup), found ashwagandha beat placebo on physical-performance variables. Improves holds. The abstract gives no effect…
• Aerobic Exercise Metrics (Aerobic Exercise Performance): Result Moderate Improvement → Improvement; Size moderate → not stated.Why: Aerobic Exercise Performance is a general group. The only study, Bayesian meta-analysis 33670194 (12 trials in healthy adults, with a pre-specified cardiorespiratory-fitness subgroup), found ashwagandha beat placebo on physical-performance variables. Improves holds. The abstract gives no effect…
• Aerobic Exercise Metrics (Cycling Performance): Result Moderate Improvement → Improvement; Size moderate → not stated.Why: Cycling Performance is a performance (general) group, so healthy adults count. 33670194 (systematic review + Bayesian meta-analysis of 12 trials in healthy adults) ran a pre-specified cardiorespiratory-fitness subgroup and concluded ashwagandha beat placebo on the analysed physical-performance…
• Aerobic Exercise Metrics (Muscle Recovery): Result Moderate Improvement → Improvement; Size moderate → not stated.Why: Muscle Recovery is a general goal group (not a disease), so healthy adults count. 33670194 (systematic review + Bayesian meta-analysis of 12 trials in healthy adults) ran a pre-specified cardiorespiratory-fitness subgroup and concluded ashwagandha beat placebo on the analysed physical-performance…
• Aerobic Exercise Metrics (Muscle Size & Strength): Result Moderate Improvement → Improvement; Size moderate → not stated.Why: Muscle Size & Strength is a general goal group, so healthy adults count. 33670194 (systematic review + Bayesian meta-analysis of 12 trials in healthy adults) ran a pre-specified cardiorespiratory-fitness subgroup and concluded ashwagandha beat placebo on the analysed physical-performance outcomes…
• Alertness (Insomnia): Result Small Improvement → Improvement; Grade B → C; Size small → not stated. 1 study added.Why: No linked study. Re-cited RCT 32818573, whose insomnia arm (40 patients, 8 weeks) showed significantly better mental alertness on rising vs placebo. Improves holds. One RCT in insomnia: ceiling C, B lowered; the general-adult sleep meta-analysis does not count under a disease. No effect size…
• Alertness (Cognitive Improvement): Result Small Improvement → Improvement; Size small → not stated. 3 studies added.Why: No linked study. Cognitive Improvement is a general goal group. Re-cited the sleep meta-analysis 34559859 (5 RCTs, 400 adults: better mental alertness on rising) and RCTs 32226684 (50 older adults, alertness P<0.034 vs placebo) and 32818573 (insomnia arm, alertness p 0.01). Improves holds. No…
• Anaerobic Capacity: Result Small Improvement → Improvement; Size small → not stated. 1 study added.Why: No linked study. general-cardiovascular-health is a general group. Re-cited 21170205: in 40 healthy young adults, 8 weeks of Withania root extract (vs placebo arm) increased velocity and absolute/relative power. Improves holds. One small controlled trial: ceiling C = stored C. No effect size…
• Anti-Oxidant Enzyme Profile (Metabolic Health): Result Small Increase → Increase; Grade C → D; Size small → not stated. 1 study added.Why: No linked study. Metabolic Health is a general group. The only human study whose abstract reports antioxidant enzymes is 19501822: Withania root restored seminal-plasma antioxidant enzymes in 75 infertile men (before/after, no treatment control). Increase holds. A single uncontrolled study…
• Anxiety Symptoms (Stress): Result Moderate Improvement → Improvement; Size moderate → not stated. 1 study removed (not a study of this supplement).Why: Stress is a non-disease group (r011 precedent), so populations are accepted. 19718255 tests a naturopathic package (diet counselling, breathing, multivitamin plus ashwagandha) against psychotherapy: ashwagandha not separable, removed. Meta-analysis 39083548 (5 RCTs, HAM-A MD -5.96, I2 98%)…
• Anxiety Symptoms: Result Moderate Improvement → Improvement; Size moderate → not stated. 1 study removed (not a study of this supplement); 1 study removed (studied a different group of people).Why: Anxiety-disorder group. Removed 19718255 (naturopathic package; ashwagandha not separable) and 34559859 (sleep meta-analysis in general adults; fails population under a disease). Passing: meta-analysis 39083548 in anxiety/insomnia patients (HAM-A MD -5.96, I2 98%), RCT 21407960 in ICD-10 anxiety…
• Anxiety Symptoms (Bipolar Disorder): Result Moderate Improvement → No effect; Size moderate → not stated. 1 study removed (not a study of this supplement); 4 studies removed (studied a different group of people); 1 study added.Why: Page shows Improves (Moderate) for anxiety under Bipolar Disorder, but none of the five linked studies is in bipolar patients (anxiety disorders, insomnia, general adults; 19718255 is also a multi-ingredient package): all removed. The only bipolar trial, RCT 24330893 (60 euthymic patients, 8…
• Anxiety Symptoms (Mood Improvement): Result Moderate Improvement → Improvement; Size moderate → not stated. 1 study removed (not a study of this supplement).Why: Mood Improvement is a general goal group. Removed 19718255 (naturopathic package; ashwagandha not separable). Two meta-analyses (39083548: HAM-A MD -5.96 over 5 RCTs, I2 98%; 34559859: anxiety improved) and two RCTs (21407960, 31728244) report less anxiety: Improves holds. No standardised size…
• Anxiety Symptoms (Anxiety Disorders (Other)): Result Moderate Improvement → Improvement; Size moderate → not stated. 1 study removed (not a study of this supplement); 1 study removed (studied a different group of people).Why: Anxiety-disorder group. Removed 19718255 (naturopathic package; ashwagandha not separable) and 34559859 (sleep meta-analysis in general adults; fails population under a disease). Passing: meta-analysis 39083548 in anxiety/insomnia patients (HAM-A MD -5.96, I2 98%), RCT 21407960 in ICD-10 anxiety…
• Blood glucose (Stress): Result Small Improvement → Improvement; Grade C → D; Size small → not stated.Why: Stress is a non-disease group, so the population is accepted. The only study (11116534) gave Withania root powder for 30 days to 6 mild type 2 diabetics and 6 hypercholesterolaemic adults, compared before/after with no described control group: blood glucose fell. Improves holds, but a single small…
• Blood glucose (Body Composition): Result Small Improvement → Improvement; Grade C → D; Size small → not stated.Why: Body Composition is a general group. The only study (11116534; 6 mild type 2 diabetics + 6 hypercholesterolaemic adults, 30 days, before/after, no described control) reports blood glucose fell. Improves holds; single small uncontrolled study: ceiling D, C lowered. No size given: 'Small' cleared…
• Blood glucose (Type 2 Diabetes): Result Small Improvement → Improvement; Grade C → D; Size small → not stated.Why: Type 2 Diabetes group: 11116534 treated 6 mild NIDDM subjects with Withania root powder for 30 days, before/after with no described control; 'Decrease in blood glucose was comparable to that of an oral hypoglycemic drug.' Improves holds. Single small uncontrolled study: ceiling D, C lowered (as…
• Blood Pressure (Weight Loss & Maintenance). 1 study added.
• Body Fat (Body Composition): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (body fat down) with no linked study. The flagged 2026 meta-analysis (42738987, abstract read) found no significant body-fat effect (SMD -0.32, CI -0.72 to 0.08) and 'no dependable effect on adiposity'. Body Composition accepts healthy adults. Show No effect; grade…
• Condition-Related Fatigue (Chemotherapy Side Effects): Result No effect → Improvement; Size none → not stated. 1 study removed (studied a different group of people); 1 study added.Why: Page shows 'No effect' for fatigue under Chemotherapy Side Effects. The only link (30854916) studied overweight men, not chemotherapy patients: fails population, removed. The only chemotherapy study, 23142798 (100 breast cancer patients, controlled, nonrandomized), found significantly lower…
• Fatigue Symptoms (Chemotherapy Side Effects): Result Small Improvement → Improvement; Size small → not stated. 1 study added.Why: No linked study. Re-cited 23142798, the only human chemotherapy study (100 breast cancer patients, controlled, nonrandomized): fatigue scores were significantly lower with Withania than chemotherapy alone. Improves holds. No effect size given: 'Small' cleared, note 'Improvement'. One controlled…
• Immunity (Immune Health): Result Small Improvement → Improvement; Size small → not stated. 2 studies added.Why: No linked study. Immune Health is a general group. Re-cited RCT 34441940 (healthy adults: immunoglobulins, cytokines and lymphocyte counts rose vs placebo) and the 5-person uncontrolled study 19388865 (lymphocyte activation rose), which matches the stored 5 people. Improves holds. No effect size…
• Luteinizing Hormone (Oligospermia). 2 studies added.
• Osteoarthritis Symptoms (Osteoarthritis (OA)): Result Moderate Improvement → Improvement; Size moderate → not stated. 1 study added.Why: No linked study. Osteoarthritis group. Re-cited the network meta-analysis 41126953 of knee-OA RCTs: ashwagandha extract reduced stiffness scores vs placebo (MD 4.16). Improves holds. No standardised size: 'Moderate' cleared, note 'Improvement'. Ceiling A; stored C kept.
• Osteoarthritis Symptoms (Joint Pain): Result Moderate Improvement → Improvement; Size moderate → not stated. 2 studies added.Why: No linked study. Joint Pain group. Re-cited RCT 27647541 (60 patients with knee joint pain: mWOMAC, knee swelling and VAS pain fell vs placebo at 12 weeks) and the knee-OA network meta-analysis 41126953 (ashwagandha reduced stiffness vs placebo). Improves holds. No standardised size: 'Moderate'…
• Osteoarthritis Symptoms (Chronic Nonspecific Knee Pain): Result Moderate Improvement → Improvement; Size moderate → not stated. 1 study added.Why: No linked study. Chronic Nonspecific Knee Pain group. Re-cited RCT 27647541 (60 patients with knee joint pain and discomfort, no diagnosis named): mWOMAC, knee swelling and VAS pain fell significantly vs placebo at 12 weeks. Improves holds. No standardised size: 'Moderate' cleared, note…
• Oxygen Uptake (Running Performance): Result Small Improvement → Improvement; Size small → not stated.Why: Running Performance is a performance (general) group. Two placebo-controlled 8-week trials report higher VO2 max with Withania alone: 21170205 (40 healthy young adults; a Withania-only arm of 10 vs placebo) and 23326093 (40 elite cyclists randomised to 500 mg twice daily or placebo). Improves holds.
• Serum T3 (Hypothyroidism): Result Moderate Increase → Increase; Size moderate → not stated. 1 study added.Why: No linked study. Re-cited RCT 28829155, the only hypothyroid trial found (50 subclinical hypothyroid adults): ashwagandha raised serum T3 toward normal vs placebo (p = 0.0031). Increase holds. No effect size given: 'Moderate' cleared, note 'Increase'. One RCT: ceiling C = stored C.
• Sleep Duration (Insomnia): Result none shown → Small Improvement; Grade not graded → B; Size not stated → small; Form studied not stated → oral ashwagandha root extract 300 mg twice a day (600 mg/day) for 8-10 weeks (trials used KSM-66); the 2021 meta-analysis found larger effects in diagnosed insomnia, at 600 mg/day or more and after 8 weeks or more. 2 studies added.Why: Data gap re-derived (row had no linked study). Literature checked: 2021 MA 34559859 (5 RCTs, 400 adults) found a small but significant effect on overall sleep, larger in diagnosed insomnia at >=600 mg/day for >=8 weeks (full text: total sleep time SMD -0.45, 3 trials); the 8-week RCT 32818573 (40 insomnia + 40 healthy) ranked TST among the improved parameters (p < 0.002). Sleep Duration goes up: Small Improvement, increase. Both meta-analyses pool the same small set of trials (5 RCTs each, most from one research group using one branded root extract, KSM-66), so the rubric grade is B (several smaller trials agreeing), as the auditor proposed; a mechanical C9 reading (meta-analysis pointing the same way) would allow A. Row stays ungraded (helpers never raise grades). The product form and dose pattern the supporting trials used Lead check: Cheah 2021 meta-analysis (34559859; 5 RCTs, 400 adults) found a small but significant effect on overall sleep (SMD -0.59, 95% CI -0.75 to -0.42; I2 62%), more in adults with insomnia at 600 mg/day or more for 8 weeks or more; the insomnia RCT 32818573 agrees. Small effect, heterogeneous trials: B.
• Sleep Efficiency (Insomnia): Result none shown → Small Improvement; Grade not graded → B; Size not stated → small; Form studied not stated → oral ashwagandha root extract 300 mg twice a day (600 mg/day) for 8-10 weeks (trials used KSM-66); the 2021 meta-analysis found larger effects in diagnosed insomnia, at 600 mg/day or more and after 8 weeks or more. 3 studies added.Why: Data gap re-derived (row had no linked study). Literature checked: 2021 MA 34559859 found a small but significant effect on overall sleep (full text: sleep efficiency SMD -0.68, 3 trials, sign flipped so higher efficiency); RCTs in insomnia 31728244 (SE 75.6 -> 83.5 vs 75.1 -> 79.7 on placebo, 10 weeks) and 32818573 (SE among the most improved, p < 0.0001). Small Improvement, increase. Both meta-analyses pool the same small set of trials (5 RCTs each, most from one research group using one branded root extract, KSM-66), so the rubric grade is B (several smaller trials agreeing), as the auditor proposed; a mechanical C9 reading (meta-analysis pointing the same way) would allow A. Row stays ungraded (helpers never raise grades). The product form and dose pattern the supporting trials used Lead check: Cheah 2021 meta-analysis (34559859; 5 RCTs, 400 adults): small but significant effect on overall sleep (SMD -0.59), larger in insomnia; insomnia RCTs 31728244 and 32818573 found higher sleep efficiency than placebo. B.
• Sleep Latency (Insomnia): Result none shown → Small Improvement; Grade not graded → B; Size not stated → small; Form studied not stated → oral ashwagandha root extract 300 mg twice a day (600 mg/day) for 8-10 weeks (trials used KSM-66); the 2021 meta-analysis found larger effects in diagnosed insomnia, at 600 mg/day or more and after 8 weeks or more. 4 studies added.Why: Data gap re-derived (row had no linked study). Literature checked: 2021 MA 34559859 (small effect on overall sleep; full text: sleep onset latency SMD -0.53, 3 trials, I2 0%), 2024 MA 39083548 (5 RCTs, 254 with anxiety/insomnia: SOL significantly improved), RCTs 31728244 (SOL 29.0 vs 33.9 min at 10 weeks, p = 0.019) and 32818573 (SOL most improved, p < 0.0001). Latency goes down: Small Improvement, decrease (about 5 minutes faster in the 10-week trial). Both meta-analyses pool the same small set of trials (5 RCTs each, most from one research group using one branded root extract, KSM-66), so the rubric grade is B (several smaller trials agreeing), as the auditor proposed; a mechanical C9 reading (meta-analysis pointing the same way) would allow A. Row stays ungraded (helpers never raise grades). The product form and dose pattern the supporting trials used Lead check: Cheah 2021 meta-analysis (34559859) and a 2024 meta-analysis (39083548) agree on shorter sleep onset; insomnia RCTs 31728244 and 32818573 agree. Small effect: B.
• Sleep Quality (Insomnia): Result none shown → Small Improvement; Grade not graded → B; Size not stated → small; Form studied not stated → oral ashwagandha root extract 300 mg twice a day (600 mg/day) for 8-10 weeks (trials used KSM-66); the 2021 meta-analysis found larger effects in diagnosed insomnia, at 600 mg/day or more and after 8 weeks or more. 4 studies added.Why: Data gap re-derived (row had no linked study). Literature checked: 2021 MA 34559859 (5 RCTs, 400 adults: small but significant effect on overall sleep, SMD -0.59, larger in insomnia, >=600 mg/day, >=8 weeks; full text: PSQI alone not significant in 2 trials), 2024 MA 39083548 (PSQI improved in anxiety/insomnia), RCTs 31728244 (sleep quality vs placebo p = 0.002) and 32818573 (sleep quality p < 0.05 in the insomnia arm). Small Improvement. Both meta-analyses pool the same small set of trials (5 RCTs each, most from one research group using one branded root extract, KSM-66), so the rubric grade is B (several smaller trials agreeing), as the auditor proposed; a mechanical C9 reading (meta-analysis pointing the same way) would allow A. Row stays ungraded (helpers never raise grades). The product form and dose pattern the supporting trials used Lead check: Cheah 2021 meta-analysis (34559859; small but significant effect on overall sleep, SMD -0.59) and the 2024 meta-analysis (39083548) agree; insomnia RCTs 31728244 and 32818573 found better sleep quality than placebo. B.
• Strength: Result none shown → Small Improvement; Size not stated → small; Form studied not stated → oral standardized ashwagandha root extract 300 mg twice a day (600 mg/day) for 8 weeks alongside resistance training (KSM-66 in two trials); one trial used 500 mg/day of a root-and-leaf extract (Sensoril) for 12 weeks. 6 studies added.Why: Data gap re-derived (row had no linked study). Literature checked (ashwagandha strength meta-analyses and RCTs): three small RCTs with resistance training (26609282, 57 men, bench press +46.0 vs +26.4 kg; 38988644, 80 men and women; 30463324, 38 men) all favour ashwagandha; a 2026 MA (42199854, 20 RCTs) finds muscle strength SMD 0.58, significant only in physically active people; an independently run 2026 MA (42738987, 3 trials) finds SMD 0.52-0.60 that loses significance under HKSJ, GRADE low. Small Improvement. The trials are small and used branded extracts supplied by their makers, and the STAR trial and Bayesian MA authors declare supplement-industry ties (funding is not stated in the 2015 and 2023 trial abstracts; the 2023 trial declares no grants), so the rubric grade is B (several smaller trials agreeing, low certainty) as the auditor proposed; a mechanical C9 reading (3+ controlled trials agreeing) would allow A. Row stays ungraded (helpers never raise grades). Duplicate of another finding (same supplement and outcome; condition slug "muscle-size-strength", shown only on the supplement page). The product form and dose pattern the supporting trials used
• Strength (Muscle Size & Strength): Result none shown → Small Improvement; Grade not graded → B; Size not stated → small; Form studied not stated → oral standardized ashwagandha root extract 300 mg twice a day (600 mg/day) for 8 weeks alongside resistance training (KSM-66 in two trials); one trial used 500 mg/day of a root-and-leaf extract (Sensoril) for 12 weeks. 6 studies added.Why: Data gap re-derived (row had no linked study). Literature checked (ashwagandha strength meta-analyses and RCTs): three small RCTs with resistance training (26609282, 57 men, bench press +46.0 vs +26.4 kg; 38988644, 80 men and women; 30463324, 38 men) all favour ashwagandha; a 2026 MA (42199854, 20 RCTs) finds muscle strength SMD 0.58, significant only in physically active people; an independently run 2026 MA (42738987, 3 trials) finds SMD 0.52-0.60 that loses significance under HKSJ, GRADE low. Small Improvement. The trials are small and used branded extracts supplied by their makers, and the STAR trial and Bayesian MA authors declare supplement-industry ties (funding is not stated in the 2015 and 2023 trial abstracts; the 2023 trial declares no grants), so the rubric grade is B (several smaller trials agreeing, low certainty) as the auditor proposed; a mechanical C9 reading (3+ controlled trials agreeing) would allow A. Row stays ungraded (helpers never raise grades). The product form and dose pattern the supporting trials used Lead check: Wankhede 2015 RCT (26609282; 57 men, 300 mg root extract twice daily with resistance training) found greater bench-press (+46.0 vs +26.4 kg, p = 0.001) and leg-extension gains than placebo; two later RCTs agree, and a 2026 meta-analysis (42199854; 20 RCTs) found higher muscle strength (SMD 0.58, 95% CI 0.12 to 1.04). Small trials: B.
• No human study left after the re-check, so no grade: Blood glucose (Schizophrenia), Blood glucose (High Cholesterol), Cortisol (Infertility). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Ashwagandha: the page as it is now

• Nasal Congestion (Allergic Rhinitis (Seasonal Allergies / Hay Fever)): Result Small Improvement → Mixed effect; Size small → not stated.Why: Row shows Improves 'Small Improvement'. Its only RCT found only rhinorrhea better than placebo; total symptom score and other primary variables did not differ (benefit only within-group and in a weed-pollen subgroup). A clean benefit overstates it: show Mixed effect, size cleared. One RCT: C stays.
• Telomere Length (Longer Lifespan): Result No effect → Increase; Size none → not stated.Why: Row shows 'No effect' (direction none) but its only study, a 40-person placebo-controlled RCT, reports significantly longer median and short telomeres vs placebo (no change on placebo). Show Increase, no size word (no basis in the abstract). One RCT: ceiling C; stored D is below it, kept.

Astragalus: the page as it is now

• Fat Mass (Body Composition): Effect note rewritten from its studies; Size moderate → not stated. 1 study added.Why: Graded B row with no linked study shows Improves (moderate) for fat mass while its own note says the meta-analysis found no difference. Re-cited that meta-analysis (31242624, 1 PubMed search): beef protein did not change fat mass vs no protein (SMD 0.15, p = 0.256) or vs whey (SMD 0.07, p =…

Beef Protein: the page as it is now

• Proteinuria (Diabetic Nephropathy): People studied 63 → 82.Why: 20413516 randomized 82 people (39 benfotiamine, 43 placebo).

Benfotiamine: the page as it is now

• Apolipoprotein B (Type 2 Diabetes): Form studied not stated → oral berberine 900-1,500 mg/day (e.g. 500 mg twice daily) for 4-24 weeks. 2 studies added.Why: The product form and dose pattern the supporting trials used
• Apolipoprotein B (Polycystic Ovary Syndrome (PCOS)): Form studied not stated → oral berberine 900-1,500 mg/day (e.g. 500 mg twice daily) for 4-24 weeks. 2 studies added.Why: The product form and dose pattern the supporting trials used
• Apolipoprotein B (Dyslipidemia): Form studied not stated → oral berberine 900-1,500 mg/day (e.g. 500 mg twice daily) for 4-24 weeks. 2 studies added.Why: The product form and dose pattern the supporting trials used
• Apolipoprotein B (Schizophrenia): Form studied not stated → oral berberine 900-1,500 mg/day (e.g. 500 mg twice daily) for 4-24 weeks. 2 studies added.Why: The product form and dose pattern the supporting trials used
• Blood glucose (Type 2 Diabetes): Result Large Improvement → Improvement; Size large → not stated; Form studied not stated → oral berberine 0.9-1.5 g/day in divided doses (e.g. 500 mg two or three times daily with meals), alone or with glucose-lowering drugs, for 1-3 months; larger falls when baseline glucose is higher. 5 studies added.Why: Re-derived from the literature (data gap). Four meta-analyses of T2D trials agree berberine lowers fasting glucose (-0.59 to -0.86 mmol/L) and HbA1c (-0.63 to -0.73%) (36467075, 34956436, 39640489, 23118793), backed by a 116-person placebo RCT (18397984). No abstract calls the effect large: size cleared to "Improvement". Ceiling A; stored B kept (under-graded). The product form and dose pattern the supporting trials used
• Blood glucose (Nonalcoholic Fatty Liver Disease (NAFLD)): Result Large Improvement → Mixed effect; Size large → not stated; Form studied not stated → oral berberine 1-1.5 g/day (e.g. 500 mg three times daily) for 16 weeks to 6 months; glucose fell in small pooled NAFLD trials but not in the large trial of diabetes-free people. 3 studies added.Why: Re-derived from the literature (data gap). Two small meta-analyses in NAFLD report lower HbA1c/2-h glucose (27446224) and fasting glucose (4 trials, ES 0.53; 40949129), but the largest and best-run trial (337 diabetes-free people with MASLD, 41543854) found no glucose change. "Large Improvement" overstates this: Mixed effect, size cleared. Ceiling B = stored B. The product form and dose pattern the supporting trials used
• Blood glucose (Metabolic Syndrome): Result Large Improvement → Improvement; Size large → not stated; Form studied not stated → oral berberine 500 mg three times daily before meals (about 1.5 g/day; 600-900 mg/day in the schizophrenia MetS trials) for 2-3 months. 4 studies added.Why: Re-derived from the literature (data gap). In metabolic syndrome, berberine lowers fasting glucose (-0.52 mmol/L, 40740996; -0.30 mmol/L in schizophrenia with MetS, 42433212) and glucose AUC (23808999). These falls are modest and no abstract calls them large: size cleared to "Improvement". Ceiling A; stored B kept (under-graded). The product form and dose pattern the supporting trials used
• Blood glucose (Prediabetes): Result Large Improvement → Improvement; Size large → not stated; Form studied not stated → oral berberine 1.1-1.5 g/day (500 mg three times daily, or 550 mg phytosome twice daily) for 8-12 weeks. 3 studies added.Why: Re-derived from the literature (data gap). Two small placebo RCTs in prediabetes/impaired fasting glucose (37679692, 37522683) and an adult meta-analysis (36313096, FBG -7.7 mg/dL; studied in general adults) agree berberine lowers glucose. The only large fall comes from a 34-person branded pilot; size cleared to "Improvement". Ceiling B (two small RCTs; general-adult MA lowered one level) = stored B. The product form and dose pattern the supporting trials used

Berberine: the page as it is now

• No human study left after the re-check, so no grade: Beta-cell function (Obesity), Beta-cell function (Type 2 Diabetes), Beta-cell function (Type 1 Diabetes), Beta-cell function (Overweight). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Beta-Alanine: the page as it is now

• Exercise Recovery Markers (Muscle Recovery): Effect note rewritten from its studies. 2 studies added.Why: Graded C with no linked study, and its note cites 26537365, a beetroot-juice trial (not isolated betalains; fails C3) that found CK unaffected. Re-cited two betalain-concentrate RCTs (read): CK rose less (28121183) and LDH rose less (29910288) after races. Improves holds; the prose note is…

Betalains: the page as it is now

• LDL Cholesterol (Cardiovascular Health): Result Reduced LDL-C in at-risk populations → Small Increase; Size moderate → small. 3 studies added.Why: Grade C row with no linked study shows Improves (moderate LDL reduction). Re-cited (1 PubMed search): the 2025 meta-analysis of bilberry RCTs found LDL slightly higher with bilberry (WMD +0.07 mmol/L, p = 0.01) and no lipid benefit beyond TG; two RCTs found no LDL difference. The meta-analysis…

Bilberry: the page as it is now

• Major Bleeding Reduction (Percutaneous Coronary Intervention): Effect note rewritten from its studies; Size large → not stated. 50 studies removed (not a study of this supplement); 3 studies removed (did not measure this outcome); 7 studies removed (studied a different group of people).Why: Improves (less major bleeding) holds: the broad PCI meta-analyses agree (25131979 RR 0.62, 25440505 RR 0.59, 26266343 RR 0.66, 25102830 OR 0.57), so A stands. But the effect shrinks or vanishes vs heparin alone or with radial access (VALIDATE 8.6% vs 8.6%, HEAT-PPCI, 27153137, 32091668), so…
• Net Adverse Clinical Events (Percutaneous Coronary Intervention): Effect note rewritten from its studies; Size moderate → not stated. 51 studies removed (not a study of this supplement); 12 studies removed (did not measure this outcome); 7 studies removed (studied a different group of people).Why: Improves holds on the meta-analyses that report NACE: 30-day NACE lower with bivalirudin in women (28291727, RR 0.85), the elderly (32100149, RR 0.86) and transradial PCI (32091668, RR 0.87); radial-only 27153137 NS. Trials split (BRIGHT, HORIZONS benefit; ACUITY, VALIDATE no difference; HEAT-PPCI…

Bivalirudin: the page as it is now

• Allergy Symptoms (Allergic Rhinitis (Seasonal Allergies / Hay Fever)): Result Moderate Improvement → Improvement; Grade A → B; Size moderate → not stated; People studied 257 → not stated; Form studied not stated → oral black seed (Nigella sativa) oil: 250 mg standardized oil (5% thymoquinone) twice daily for 15 days, or 40-80 mg/kg/day oil in capsules; nasal-drop products are a different route and do not count for this row. 3 studies added.Why: Literature checked (no Cochrane review). Best sources: the 2024 meta-analysis of 8 small trials (39372205) favours black seed for nasal symptoms but its authors call the trials few and of lower quality, and the pool includes a nasal-drop trial and a combination product; small oral placebo trials (39121267, 65 people; 20947211, 66 people; 14669258) agree. Several small agreeing trials plus a low-quality meta-analysis = B, not A. 'Moderate' has no basis (the symptom scales differ); size cleared. People 257 does not match the cited trial (66); cleared because the study list changed. The product form and dose pattern the supporting trials used

Black seed: the page as it is now

• Kidney Stone Symptoms (Kidney Stones): Result Small Improvement → Improvement; Size small → not stated.Why: By the linked evidence alone the row holds weakly: a 2012 letter (no abstract) reports preliminary evidence of a protective effect; C = stored C. 'Small' has no basis: size cleared, note becomes Improvement (direction left as stored). See flag_for_coordinator: a later double-blind RCT found no…

Boron: the page as it is now

• No human study left after the re-check, so no grade: Angiogenesis, Anti-Aging, Anti-Cancer Activity, Anti-Inflammatory Activity, Corneal/Ocular Health, Endothelial Function (Cardiovascular Health), Gastric Ulcer Healing (General Gut Health), Intestinal Inflammation (General Gut Health), Ligament Healing (Musculoskeletal Health), Lipid Profile, Muscle Injury Recovery (Musculoskeletal Health), Neuroprotection (Neurological Health), Tendon Healing (Musculoskeletal Health), Wound Healing Rate (Skin Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

BPC-157: the page as it is now

• No human study left after the re-check, so no grade: Anxiety Symptoms (Anxiety Disorders (Other)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Bromantane: the page as it is now

• Bone Mineral Density: Effect note rewritten from its studies; Grade C → not graded; Size moderate → not stated. 2 studies added.

Butea Monosperma: the page as it is now

• Glycemic Control (Healthy Muscle Aging): Result none shown → Mixed effect; Form studied not stated → caffeine 200 mg/day for 6 months (trial, no glucose or HbA1c change); habitual dietary caffeine intake in cohort studies. 2 studies added.Why: Literature checked (glycemic control = fasting glucose, HbA1c or new-onset diabetes). The auditor's caffeine 'harm' study (11574419) is a single-dose clamp of insulin sensitivity: acute and a different outcome, so its #79 removal stands, as does the removal of the old 'Improves'. Chronic evidence on the right outcomes is split: the one placebo RCT of caffeine itself (33838673, 200 mg/day for 6 months) found no change in fasting glucose or HbA1c, while cohort studies link higher caffeine intake with 30% less new-onset type 2 diabetes (24150256), an association also seen with decaffeinated coffee. Mixed effect, size blank. Healthy-muscle-aging is a general condition, so any adult population counts. Row stays ungraded; C9 ceiling C (one RCT plus observational data). The product form and dose pattern the supporting trials used
• Headaches (Postdural Puncture Headache): Result Small Improvement → Improvement; Size small → not stated. 1 study removed (not a study of this supplement); 1 study added.Why: Copilot-cited page (protocols/postdural-puncture-headache). The only link tested acetaminophen 500 mg + caffeine 65 mg for prevention: combination, removed. Re-cited the flagged oral-caffeine RCT (2405733, read): 300 mg relieved PDPH at 4 h vs placebo, sometimes transiently. Improves holds, C kept…
• Rating of Perceived Exertion (Pain Relief): Result none shown → Mixed effect.Why: Page shows Improves with perceived exertion going UP. One RCT found caffeine LOWERED RPE (21605608), another found no effect on RPE (21411832); the third reports no RPE result. Mixed effect; stays ungraded (ceiling B). Pain Relief read as a general goal group, so healthy exercisers accepted.

Caffeine: the page as it is now

• Depression Symptoms (Premenstrual Syndrome (PMS)): Form studied not stated → oral calcium carbonate 500-1,200 mg elemental calcium daily (e.g. 500 mg twice daily) through the cycle for 2-3 menstrual cycles. 6 studies added.Why: The product form and dose pattern the supporting trials used
• PMS Symptoms (Primary Dysmenorrhea (Menstrual Cramps)): People studied 135 → not stated; Form studied not stated → calcium carbonate 1,000-1,200 mg/day elemental (e.g. 600 mg twice daily) every day for at least 2-3 menstrual cycles; 500 mg/day was also tested. 1 study added.Why: Literature checked (no Cochrane review or meta-analysis of calcium for PMS). Several placebo RCTs, including a 466-woman multicentre trial (9731851: 48% vs 30% symptom reduction), agree that calcium lowers PMS symptoms; a pilot (23963058) found only small, non-significant effects, so 'Small' fits. Mechanically this would be A for PMS, but the row sits on the dysmenorrhea page and the trials are in PMS (indirect), so B is kept. Stored direction 'increase' corrected to decrease. People 135 cleared (study list changed). The product form and dose pattern the supporting trials used
• Pre-Eclampsia Risk (Preeclampsia): Result Moderate Improvement → No effect; Grade A → B; Size moderate → not stated; People studied 15,730 → not stated; Form studied not stated → oral calcium at least 1 g/day elemental (WHO trial 1.5 g/day) from before 20 weeks of pregnancy to delivery; the 2025 Cochrane review found little to no pre-eclampsia difference vs placebo (high certainty in the large trials), and 500 mg/day did as well as high dose. 1 study added.Why: Literature checked. The 2025 Cochrane update (41330480: 10 trustworthy RCTs, 37,504 women; GRADE) finds calcium may make little to no difference to pre-eclampsia (RR 0.83, 0.67-1.04, low certainty) and, in the large trials that hold over 95% of participants, little to no difference at high certainty (RR 0.92); the large WHO (16522392) and CPEP (9396883) trials agree. The positive pools (Cochrane 2014 RR 0.45, 24960615; 2024 MA RR 0.61, 39608269) include small and untrustworthy trials the 2025 update removed. Strongest evidence decides: 'Improves (moderate)' becomes No effect; meta-analyses disagree, grade A -> B. People 15730 cleared (study list changed). The product form and dose pattern the supporting trials used

Calcium: the page as it is now

• Dental Health Metrics (Gingivitis): Effect note rewritten from its studies; Size none → not stated.Why: Direction error: its placebo-controlled RCT (24554883, 240 people) found significant reductions; the row said No effect. Grade D kept (never raised in this pass; ceiling C).
• Dermatitis Risk (Dermatitis): Result Small Improvement → Mixed effect; Size small → not stated; People studied 756 → not stated; Form studied not stated → topical calendula cream or ointment applied to irradiated skin through radiotherapy (calendula is used on the skin, not as an oral supplement). 1 study removed (did not measure this outcome); 3 studies added.Why: Our auditor agreed on 32460565 (episiotomy pain, not dermatitis: removed) and on the topical label. Literature checked: the MASCC meta-analysis 36859690 found no significant effect of calendula on grade 2+ radiation dermatitis, and the 2024 MA 37816677 calls the calendula evidence insufficient. Against bland creams calendula did no better (23245940, 411 people; 32965030, 81 people); against other active creams it did better (15084618 vs trolamine, 254 people; 25992820 vs essential fatty acids, 51 people). A clean "Small Improvement" overstates this: "Mixed effect", size cleared. Calendula is applied to the skin, which is how the page presents it (C3b passes), so evidence_form names the form. C kept (a meta-analysis with inconsistent trials allows B: under-graded). People 756 cleared: the study list changed and no abstract sum gives it. The product form and dose pattern the supporting trials used

Calendula Officinalis: the page as it is now

• Blood Pressure (Neurological Health): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Literature checked (cannabis BP meta-analysis, systematic reviews, repeated-dose trials, cohorts). The linked study is one smoked dose in 10 healthy men and shows orthostatic hypotension with dizziness, a harm and an acute effect: fails C3c for a blood-pressure row, removed. No meta-analysis or…
• Fibromyalgia Symptoms (Fibromyalgia): Result none shown → Mixed effect.Why: Ungraded row shows Improves. Its only study found no effect beyond placebo on spontaneous or electrical pain, with some secondary gains (pressure-pain threshold, responder rate) after a single inhalation: Mixed effect. If the coordinator rules inhaled studies out for this page, ungrade instead.
• Heart Rate (Neurological Health): Result none shown → Increase.Why: Page shows Improves with heart rate going DOWN. Every study that states a direction found smoked cannabis RAISED heart rate (6438677, 1324250 placebo-controlled; 7053160 in glaucoma, with tachycardia). Inhaled cannabis accepted for the cannabis page (another finding); heart rate here is an…
• Intraocular Pressure (Glaucoma): Result none shown → Improvement. 1 study removed (studied a different group of people).Why: The page shows Improves with an up arrow (IOP rising); the glaucoma/ocular-hypertension crossover trial found 5 mg THC lowered IOP for about 2-4 hours (CBD did not lower it). Arrow set to decrease, label Improvement (no size basis). The smoking study in normal eyes is removed (population, and…
• Intraocular Pressure (Ocular Hypertension): Result Moderate Improvement → Mixed effect; Size moderate → not stated. 1 study removed (studied a different group of people).Why: Page shows Improves with eye pressure going UP and "Moderate Improvement". The only ocular-hypertension study (16988594, 6 patients, single doses) found THC lowered IOP for under 4 hours, CBD 20 mg did nothing and CBD 40 mg raised IOP. Mixed effect, size cleared; C kept (one RCT). 1089090 is…
• Pain (Opioid-Refractory Pain): Result none shown → No effect. 4 studies removed (studied a different group of people); 1 study added.Why: Ungraded row shows Improves for opioid-refractory pain. The flagged Cochrane review (37283486, read: 5 RCTs, 1539 people with pain despite opioids) found nabiximols and THC no better than placebo; it includes the one linked RCT (19896326) and outranks it and the open-label extension. Now No…
• Parkinson's Disease Symptoms (Parkinson's Disease): Result none shown → No effect.Why: Ungraded row shows Improves. The only study, a double-blind crossover RCT in Parkinson disease (15477546), found no effect on dyskinesia or parkinsonism. Now No effect; stays ungraded (ceiling C).
• Sleep Latency (Insomnia). 1 study added.
• Sleep Quality (Insomnia): Result none shown → No effect. 3 studies removed (studied a different group of people); 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row under Insomnia shows Improves. Its three sleep-benefit trials are in neuropathic-pain patients and the fourth is a cancer-pain meta-analysis with no sleep outcome: all removed. The flagged Cochrane review in adults with insomnia (read) found little to no effect on sleep quality…
• Visual acuity (VA) (Ocular Hypertension): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (visual acuity up) with no study. The flagged 6-patient crossover RCT in ocular hypertension (16988594, read) found visual acuity not significantly changed: added, now No effect. Row stays ungraded (ceiling C).

Cannabis: the page as it is now

• Diuresis (Kidney Health): Result none shown → No effect.Why: Ungraded row shows Improves (more diuresis); its only study, a placebo-controlled crossover RCT, found no influence of Orthosiphon (or the other remedies) on urine output or sodium excretion. No effect; one RCT, ceiling C, grade left unset.
• No human study left after the re-check, so no grade: Diuresis (High Blood Pressure), Diuresis (Pitting Edema). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Cat's whiskers: the page as it is now

• HDL Cholesterol. 1 study added.
• LDL Cholesterol. 1 study added.

Celery seed extract: the page as it is now

• No human study left after the re-check, so no grade: Lipofuscin Reduction. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Centrophenoxine: the page as it is now

• Toxin Absorption Prevention (Arsenic Poisoning): Effect note rewritten from its studies; Grade A → not graded; Size large → not stated; People studied 2,000 → not stated. 1 study added.

Charcoal: the page as it is now

• Body Fat: Result Small Decrease → Mixed effect; Grade B → C; Size small → not stated; People studied 103 → not stated; Form studied not stated → oral chromium picolinate 200-1,000 µg/day for 6-16 weeks, with or without resistance training; no body-fat benefit in training trials. 6 studies added.Why: Data gap re-derived (row had no linked study). Literature checked (chromium body-fat meta-analyses, Cochrane, resistance-training RCTs). muscle-size-strength is a general group (any population). In overweight/obese adults one MA (31115179, 21 trials) finds body fat % down 0.68 points (CI to -0.03… The product form and dose pattern the supporting trials used
• Muscle Mass (Body Composition): Result none shown → No effect.Why: Ungraded row shows Improves (muscle mass up); all five linked RCTs (resistance-trained men, women, older adults, athletes) found chromium picolinate did not increase lean or muscle mass vs placebo. Show No effect; 5 agreeing RCTs allow A, grade left unset.

Chromium: the page as it is now

• Cognitive Function in Alzheimer's (Cognitive Function): Effect note rewritten from its studies; Grade B → C; Size moderate → not stated. 2 studies added.Why: Graded B with no linked study; the note's '300mg/day' and 'Preclinical review (20 studies)' are in no cited abstract. Re-cited (1 PubMed search): a 48-week controlled study in 24 moderate AD patients found cognition better than untreated controls; the flagged open-label study (18 patients) found…

Cistanche (Cistanche tubulosa/deserticola): the page as it is now

• No human study left after the re-check, so no grade: Body Length/Growth (Growth Hormone Deficiency), Fat Mass (Body Composition), GH Pulse Amplitude (Growth Hormone Deficiency), Growth Hormone Levels (Growth Hormone Deficiency), IGF-1 Levels (Growth Hormone Deficiency), Lean Body Mass (Body Composition), Slow-Wave Sleep Duration (Sleep Quality). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

CJC-1295: the page as it is now

• Bone Mineral Density: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 3 studies added.

Cnidium monnieri: the page as it is now

• Blood Flow (Obesity): Form studied not stated → cocoa flavanols about 500-900 mg a day (high-flavanol cocoa drink or extract) for 4-12 weeks; the dose-response is an inverted U with the largest effect near 710 mg. 2 studies added.Why: The product form and dose pattern the supporting trials used

Cocoa Extract: the page as it is now

• Anti-Oxidant Enzyme Profile (Autism Spectrum Disorder (ASD)): Result Small Increase → none shown; Size small → not stated. 2 studies removed (studied a different group of people); 1 study added.Why: Only autism study (29684771) reports SOD/GPx activity fell with CoQ10; the authors read it as less oxidative stress, so no better/worse label (shows 'Changes; see studies').
• Autism Symptoms (Autism Spectrum Disorder (ASD)). 2 studies added.
• Depression Symptoms (Depression): Result Moderate Improvement → Improvement; Size moderate → not stated; People studied 137 → not stated; Form studied not stated → CoQ10 (ubiquinone) 200 mg/day added to standard mood medication for 8 weeks (bipolar depression); trials in depression with medical illness used up to 500 mg/day for 8-12 weeks. 1 study added.Why: Literature checked. Two small meta-analyses (41294251: SMD -0.68, 5 RCTs; 40833470: MADRS SMD -0.97 but BDI -0.12, not significant) and one bipolar-depression RCT (30106880) point to some benefit, mostly as an add-on and often in depression linked to medical illness; a published letter cautions against the 2026 MA's conclusions. Improvement and B kept; 'Moderate' is not reliable when estimates range from null (BDI) to large (MADRS), so size is cleared. People 137 cleared (study list changed). The product form and dose pattern the supporting trials used
• Erections (Peyronie's Disease). 1 study added.
• Oxidative Stress Biomarkers (Autism Spectrum Disorder (ASD)). 8 studies removed (studied a different group of people).

Coenzyme Q10: the page as it is now

• No human study left after the re-check, so no grade: Pediatric/Neonatal Infections (Multidrug-Resistant Bacterial Infections). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Colistin (Polymyxin E): the page as it is now

• Skin Elasticity (Skin Health): Result Small Improvement → Mixed effect; Size small → not stated.Why: Row shows Improves 'Small Improvement' (B). Its only study, a 23-RCT meta-analysis, found a pooled benefit on elasticity that disappears in independently funded and high-quality trials, and concludes there is no clinical evidence for collagen in skin aging. A clean benefit overstates it: Mixed…

Collagen Peptides: the page as it is now

• CD4 Lymphocytes (Immune Health): Result none shown → No effect.Why: Ungraded row shows Improves for CD4 count; its only study, a double-blind RCT, found no significant CD4 change with hyperimmune bovine colostrum vs placebo (9.43 cells/uL, P = .279). Show No effect; grade stays unset (ceiling C).
• CD4 Lymphocytes (Human Immunodeficiency Virus (HIV)): Result Small Increase → Mixed effect; Grade B → C; Size small → not stated; People studied 200 → 162; Form studied not stated → no CD4 gain when hyperimmune bovine colostrum was added to suppressive antiretroviral therapy for 24 weeks; a CD4 rise was seen only with a colostrum-based food (50 g twice daily for 4 weeks) in people with HIV-associated diarrhoea, against a no-supplement control. 1 study added.Why: Grade B row shows Improves (small increase) for CD4 in HIV; its only study, a double-blind RCT, found no significant CD4 change with hyperimmune bovine colostrum vs placebo (9.43 cells/uL, P = .279). Show No effect, size cleared; one RCT: ceiling C, B lowered. Literature checked (required before keeping 'No effect'). The double-blind placebo RCT in people on suppressive ART (21930607, 75 randomised) found no CD4 change, but a randomised controlled trial of a colostrum-based food in 87 people with HIV-associated diarrhoea (22161540) found CD4 +14% vs -12% in controls (p < 0.001); that trial was single-blind with no placebo, so the extra food is a confounder. The two controlled trials disagree, so 'No effect' is relabelled Mixed effect, C kept. People: 75 + 87 = 162 from the two abstracts (the old 200 matched nothing). The product form and dose pattern the supporting trials used
• Diarrhea Symptoms (Traveler's Diarrhea): Result none shown → No effect. 1 study removed (not a study of this supplement); 2 studies removed (studied a different group of people); 1 study added.Why: Ungraded row shows Improves for traveler's diarrhea. The two colostrum studies with a benefit are chronic diarrhea in AIDS/HIV (fail C5); the challenge study tests a hyperimmune milk product and found no difference. Added the flagged 2026 field RCT in travellers (42893120, read): hyperimmune…
• Muscle Mass (Short Bowel Syndrome (SBS)): Result Small Improvement → No effect; Size small → not stated.Why: Graded C row shows Improves (Small Improvement in muscle mass), but its only trial found lean mass rose only on the control supplement and colostrum did not improve body composition: No effect, size cleared. C = ceiling, kept.

Colostrum: the page as it is now

• Body Fat. 3 studies removed (did not support the finding).
• Body Fat (Muscle Size & Strength). 3 studies removed (did not support the finding).

Conjugated Linoleic Acid: the page as it is now

• Ceruloplasmin Levels (Copper Deficiency): Result Large Increase → Increase; Grade A → C; Size large → not stated; People studied 400 → not stated; Form studied not stated → oral copper 2-6 mg/day (copper glycinate or sulfate) for 5-8 weeks in trials; a 2.5 mg/day repletion diet raised plasma copper in experimentally depleted men within 24 days; excess zinc intake is a common cause of copper deficiency. 3 studies added.Why: Data gap re-derived; literature checked. The biomarker systematic review (19420093) finds ceruloplasmin responds only in highly depleted people; one controlled depletion-repletion study (8988916) found it rose with repletion, another (8602593, mild depletion) found no rise. Clinical copper deficiency is severe depletion, so Increase is kept, but the evidence is small, inconsistent and at high risk of bias: grade A -> C. 'Large' has no basis and is cleared. People 400 cleared. The product form and dose pattern the supporting trials used
• Serum Copper Levels (Copper Deficiency): Result Large Increase → Increase; Grade A → B; Size large → not stated; People studied 500 → not stated; Form studied not stated → oral copper 2-6 mg/day (copper glycinate or sulfate) for 5-8 weeks in trials; a 2.5 mg/day repletion diet raised plasma copper in experimentally depleted men within 24 days; excess zinc intake is a common cause of copper deficiency. 3 studies added.Why: Data gap re-derived; literature checked. No trial in patients with clinical copper deficiency was found (case series report haematological recovery, not serum copper). The systematic review of copper biomarkers (19420093) finds serum copper rises with supplementation in depleted (and less in replete) people, but all 16 studies were small and at high risk of bias; a controlled depletion-repletion study (8988916) agrees, while a mild-depletion study (8602593) found plasma copper insensitive. Direction kept (Increase); 'Large' has no basis and is cleared; grade A -> B for low certainty. People 500 cleared. The product form and dose pattern the supporting trials used

Copper: the page as it is now

• Blood Glucose Control: Effect note rewritten from its studies; Size small → not stated. 4 studies removed (did not measure this outcome).Why: Page shows Improves with a DOWN arrow (glucose lowered). The only passing study (1472747) reports cosyntropin provoked severe HYPERglycaemia in 2 diabetic patients; the others are diagnostic tests, headache, and bears. Literature check found nothing showing a fall in glucose; the ACTH 1-24…
• Kidney Function: Effect note rewritten from its studies; Grade B → C; Size moderate → not stated. 12 studies removed (did not measure this outcome); 3 studies added.Why: Graded B ('23 human trials and systematic reviews') but all 12 links are adrenal-test, diagnostic or animal papers with no kidney outcome. Literature check found real evidence: intramuscular synthetic ACTH 1-24 depot lowers proteinuria in membranous nephropathy (randomised pilot vs…
• No human study left after the re-check, so no grade: Immune Function. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Cosyntropin (Cortrosyn/Synacthen): the page as it is now

• Adrenaline (Cognitive Improvement). 1 study added.
• Adrenaline (Sleep Health). 1 study added.
• Adrenaline (Mood Improvement). 1 study added.
• Aldosterone (General Athletic Performance): Result Moderate Increase → No effect; Size moderate → not stated. 2 studies added.Why: Page shows Improves (Moderate Increase) for aldosterone. No linked study. General Athletic Performance is a general group, so trained or healthy men in heat count. Crossover RCT 17313254 found aldosterone rose similarly with creatine and placebo; RCT 11445756 reports only a 'slightly greater'…
• Aldosterone: Result Moderate Increase → No effect; Size moderate → not stated. 2 studies added.Why: Page shows Improves (Moderate Increase) for aldosterone. No linked study. Warm or hot weather exercise group (malformed slug, supplement page only); both trials were in heat. Crossover RCT 17313254 found aldosterone rose similarly with creatine and placebo; RCT 11445756 reports only a…
• Aldosterone (Warm- or Hot-Weather Exercise Performance): Result Moderate Increase → No effect; Size moderate → not stated. 2 studies added.Why: Page shows Improves (Moderate Increase) for aldosterone. No linked study. Warm- or Hot-Weather Exercise Performance group; both trials were in heat. Crossover RCT 17313254 found aldosterone rose similarly with creatine and placebo; RCT 11445756 reports only a 'slightly greater' aldosterone…
• Alertness (Rugby Performance): Result Small Improvement → Improvement; Size small → not stated. 2 studies removed (did not measure this outcome); 1 study added.Why: Rugby Performance is a performance (general) group. Both links fail outcome: 17185404 measured brain phosphates only; 21324203 (10 rugby players) measured passing-skill accuracy, not alertness. Removed. Re-cited 42075005: a single creatine dose lessened the sleep-deprivation decline on the…
• Anaerobic Capacity (Ice Hockey Performance): Result Mixed effect → Small Improvement; Size not stated → small; Form studied not stated → creatine monohydrate loading about 20 g/day (5 g four times daily) for 5-7 days, then 3-5 g/day. 5 studies added.Why: Our auditor agreed: the #79 change to "Mixed effect" weighed single trials over the meta-analyses (C7: judge on the strongest evidence). Literature checked: three meta-analyses and an NMA agree that creatine improves anaerobic / repeated-sprint performance vs placebo (30935142, 36041731, 42384726, 12945830). The linked single trials are split (4 positive or partly positive, 6 null, including the null hockey trial 16596105, kept), and the one positive hockey trial 10573659 reports within-group gains only, so the size is held at "Small" (Branch ES about 0.2; field tasks smaller) though the newer MAs show moderate SMDs. Direction increase, "Small Improvement". The wheelchair pilot 16172624 passes C5 on a *-performance row and is null, so it stays (removing a null study while adding positives would bias the row). C kept; MAs allow A/B (ceiling B given trial inconsistency: under-graded). The product form and dose pattern the supporting trials used
• Anti-Oxidant Enzyme Profile (Immune Health): Result No effect → Mixed effect; Size none → not stated. 3 studies added.Why: No linked study. Immune Health is a general group. The 25-player RCT 23800565 (the stored people figure) found no difference in catalase or SOD, and 37206869 saw no creatine-specific effect on GPX; but the larger 2026 RCT 41941966 (103 older adults) found creatine plus exercise raised GPx. A clean…
• Blood Flow (Body Composition): Result Small Increase → Increase; Size small → not stated. 2 studies added.Why: No linked study. Body Composition is a general group. Re-cited RCT 11735088 (30 men; the stored people figure): limb blood flow rose 30-38% with creatine + resistance training but not with placebo + training (creatine alone: unchanged), and the pilot 40447849 (postprandial muscle blood flow rose…
• Blood Pressure (Warm- or Hot-Weather Exercise Performance). 3 studies added.
• Body Fat (Weight Loss & Maintenance). 2 studies added.
• Creatinine (Martial Arts Performance): Result none shown → No effect. 2 studies removed (did not measure this outcome).Why: Ungraded row shows Improves (creatinine up). The only study reporting serum creatinine (12500988) found no difference between long-term creatine users and non-users. The other two do not report creatinine: removed. Show No effect. Ceiling C (observational); stays ungraded.
• Fatigue Symptoms (Amyotrophic Lateral Sclerosis): Result none shown → No effect. 1 study added.Why: Direction error: the row shows Improves (fatigue down) with no linked study. The ALS trial that measured fatigue (18608103, 107 patients, the row's own figure) found no significant improvement. 'No effect'. One RCT: ceiling C; stays ungraded.
• Huntington's Disease Symptoms (Huntington's Disease): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves for Huntington's symptoms. Both linked studies found no clinical effect, and the flagged CREST-E trial (28701493, 553 people, read) stopped for futility with no slowing of decline. Show No effect. Ceiling B (two controlled trials); stays ungraded.
• Jump Height (Anaerobic Exercise Performance). 1 study added.
• Lung Function (Amyotrophic Lateral Sclerosis): Result none shown → No effect. 2 studies added.Why: Direction error: the row shows Improves (lung function up) with no linked study. The Cochrane review of the three ALS trials (386 patients) found no significant effect on percent predicted FVC (trend slightly worse, P = 0.054), and the 107-patient trial found no respiratory improvement. 'No effect'.
• Mitochondrial Cytopathies Symptoms (Kearns-Sayre Syndrome (KSS)): Direction goes down → not set. 1 study removed (did not measure this outcome).Why: Literature checked (pubmed.py 'creatine Kearns-Sayre mitochondrial myopathy trial'): the RCT in single mtDNA deletion patients (15804248) found creatine had no beneficial effect. The row's off-topic link was removed (092): direction cleared; data gap.
• Muscular Dystrophy Symptoms (Proximal Myotonic Myopathy): Result none shown → Mixed effect. 3 studies removed (studied a different group of people).Why: Ungraded row shows Improves. The Cochrane review finds strength gains across muscular dystrophies, but the only trial in this population (DM2/PROMM, 12578937) found no significant difference in strength or Neuromuscular Symptom Score. Duchenne and DM1 trials fail C5. A clean benefit overstates it…
• Oxygen Uptake (Fibromyalgia): Result none shown → No effect. 1 study removed (studied a different group of people).Why: Ungraded row shows Improves (oxygen uptake up). The fibromyalgia RCT found no change in aerobic conditioning: No effect. The other study is in healthy men (and also found no effect): removed.
• Pain (Fibromyalgia): Result none shown → No effect. 1 study added.Why: Ungraded row with no linked study shows Improves for pain. The flagged placebo-controlled creatine trial in fibromyalgia (read) found no change in pain: added, No effect. The open-label study behind the people figure has no control group (not added).
• Power Output (Kearns-Sayre Syndrome (KSS)): Direction goes up → not set. 44 studies removed (studied a different group of people).Why: Literature checked (pubmed.py 'creatine Kearns-Sayre mitochondrial myopathy trial'): the RCT in single mtDNA deletion patients (15804248) found creatine had no beneficial effect. The row's off-topic links were removed (092): direction cleared; data gap.
• Power Output (Proximal Myotonic Myopathy): Direction goes up → not set. 1 study removed (did not measure this outcome); 43 studies removed (studied a different group of people).Why: Literature checked (pubmed.py 'creatine myotonic dystrophy type 2 proximal myotonic myopathy trial'): the double-blind RCT in DM2/PROMM (12578937) and Cochrane 2013 (23740606) do not support a strength gain in myotonic dystrophy. The row's off-topic links were removed (091): direction cleared; data gap.
• Quality of Life (Fibromyalgia): Result none shown → No effect. 1 study added.Why: Ungraded row with no linked study shows Improves for quality of life. The flagged placebo-controlled creatine trial in fibromyalgia (read) found no change in quality of life: added, No effect. The open-label study behind the people figure has no control group (not added).
• Sleep Quality (Fibromyalgia): Result none shown → No effect. 1 study added.Why: Ungraded row with no linked study shows Improves for quality of sleep. The flagged placebo-controlled creatine trial in fibromyalgia (read) found no change in quality of sleep: added, No effect. The open-label study behind the people figure has no control group (not added).
• Subjective Well-Being (Amyotrophic Lateral Sclerosis): Direction goes up → not set. 3 studies removed (studied a different group of people).Why: Literature checked (pubmed.py 'creatine amyotrophic lateral sclerosis randomized trial'): Cochrane 2010/2012 (20556761, 23235621) found no benefit of creatine in ALS. The row's off-topic links were removed (095), so nothing supports the stored 'increase': direction cleared; data gap.
• Total cholesterol (Martial Arts Performance): Result none shown → No effect. 1 study removed (did not measure this outcome).Why: Ungraded row shows Improves (total cholesterol down). The only trial measuring it (18831767) found no difference between creatine and placebo: 'Cr supplementation does not exert any additional effect on the improvement in the plasma lipid profile'. 11224803 names no cholesterol result: removed.
• Weight (Body Composition): Result none shown → Small Increase; Size not stated → small. 2 studies removed (did not measure this outcome).Why: Page shows Improves with a down arrow (weight falls). No linked study shows a fall: 5 trials report weight gain on creatine (about 1-1.7 kg; 14636103, 16248471, 18458358, 18039377 controlled; 17530953 uncontrolled) and 3 short or low-dose trials report no significant change. Show Small Increase.
• Weight (Amyotrophic Lateral Sclerosis): Direction goes down → not set. 8 studies removed (studied a different group of people); 2 studies removed (did not measure this outcome).Why: Literature checked (pubmed.py 'creatine amyotrophic lateral sclerosis randomized trial'): Cochrane 2010/2012 (20556761, 23235621) found no benefit of creatine in ALS. The row's off-topic links were removed (095), so nothing supports the stored 'decrease': direction cleared; data gap.
• No human study left after the re-check, so no grade: Bilirubin (Myotonic Dystrophy Type 1), Body Fat (Chronic Obstructive Pulmonary Disease (COPD)), Body Fat (Osteoarthritis (OA)), Creatinine (Amyotrophic Lateral Sclerosis), Creatinine (Fibromyalgia), Fatigue Symptoms (Proximal Myotonic Myopathy), Kidney Function (Amyotrophic Lateral Sclerosis), Liver Enzymes (Amyotrophic Lateral Sclerosis), Memory (Fibromyalgia), Power Output (Amyotrophic Lateral Sclerosis), Power Output (Parkinson's Disease). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Creatine: the page as it is now

• Adiponectin (Metabolic Syndrome): People studied 1,646 → not stated; Form studied not stated → curcumin 1,000 mg/day for 8 weeks in metabolic syndrome; pooled rises were larger in trials of 10 weeks or less (31425942). 1 study removed (studied a different group of people); 4 studies added.Why: Literature checked. The linked trial is in young obese men, not metabolic syndrome, and found no adiponectin change (removed, population). In metabolic syndrome, an 8-week RCT (27297718, 1,000 mg/day) and a meta-analysis in metabolic syndrome and related disorders (31249528) found adiponectin rose; general-adult meta-analyses agree (37980942; umbrella review 40109154: GRADE moderate). Increase and B kept. Mechanical ceiling is A, but the trials are small and the pooled estimates very heterogeneous (I2 93-95%), so B is the honest grade; 'Small' does not overstate. People 1646 cleared. The product form and dose pattern the supporting trials used
• Anxiety Symptoms (Depression): Result Large Improvement → Improvement; Grade A → B; Size large → not stated; People studied 284 → not stated; Form studied not stated → curcumin extract 500-1,000 mg/day (250-500 mg twice daily) for 8-12 weeks, mostly added to antidepressants; anxiety was a secondary outcome in the depression trials. 5 studies added.Why: Data gap re-derived; literature checked. In people with depression, a meta-analysis (31423805, 5 studies, 284 people) and one RCT (27723543) found less anxiety, but the other MDD RCT (25046624) found only a non-significant trend. General-adult meta-analyses (38857152, 42859601; studied in general adults) agree in direction but with I2 about 96% and moderate-to-low GRADE certainty. Direction kept; the very large SMDs come from small heterogeneous trials and are not reliable, so 'Large' is cleared; grade A -> B. People 284 cleared. The product form and dose pattern the supporting trials used
• Blood glucose (Type 2 Diabetes): Result none shown → Small Improvement; Size not stated → small; Form studied not stated → oral curcuminoids 300-500 mg/day (often with 5 mg piperine), nano-curcumin 80 mg/day or turmeric powder about 2 g/day, for 8 weeks to 3 months (9 months in the prediabetes trial); the 2026 meta-analysis found 1 g/day or more more effective. 9 studies removed (did not measure this outcome); 3 studies removed (studied a different group of people); 2 studies added.Why: Literature checked: T2D MA 39683570 (18 RCTs, 1,382 people: fasting glucose -11.5 mg/dL, HbA1c -0.54%), prediabetes/T2D MA 42005325 (34 RCTs: fasting glucose -10.2 mg/dL) and the 103-RCT umbrella MA 39478418 (FBS evidence rated high credibility) agree; T2D RCTs 22930403 and 29458218 lowered fasting glucose, 30859660 (turmeric powder) found no glycaemic effect. Small Improvement (about 10 mg/dL fasting glucose, 0.3-0.5% HbA1c). Removed: 12 links failing C3c/C4/C5 (wrong population: impaired fasting glucose, COPD, prediabetes, healthy volunteers; no glucose result; single-dose tests) and 2 passing T2D trials as surplus (27761427, 30935539, both benefit; pooled in the MAs). Ceiling A by the rubric (several meta-analyses agree); the auditor proposes B (small heterogeneous trials, many enhanced-absorption formulations). Row stays ungraded. The product form and dose pattern the supporting trials used
• Blood glucose (Metabolic Health): Result none shown → Small Improvement; Size not stated → small; Form studied not stated → oral curcuminoids 300-500 mg/day (often with 5 mg piperine), nano-curcumin 80 mg/day or turmeric powder about 2 g/day, for 8 weeks to 3 months (9 months in the prediabetes trial); the 2026 meta-analysis found 1 g/day or more more effective. 9 studies removed (did not measure this outcome); 2 studies added.Why: General condition (any human population). Literature checked: all-adult MA 37748368 (59 RCTs: fasting blood sugar improved, about -4.6 mg/dL), umbrella MA 39478418 (103 RCTs, FBS evidence rated high credibility) and prediabetes/T2D MA 42005325 (-10.2 mg/dL) agree on a small fall in fasting glucose; RCTs: 22930403 benefit in T2D, 30859660 (turmeric powder, T2D) and 30796508 (impaired fasting glucose) no fasting-glucose effect vs placebo. Small Improvement. Removed 9 links failing C3c/C4 (single-dose postprandial tests in healthy volunteers, no glucose result) and 5 passing trials as surplus (27616885 no effect; 27761427, 29458218, 30935539, 22773702 benefit; all pooled in the MAs; cap 6). Ceiling A by the rubric; auditor proposes B. Row stays ungraded. The product form and dose pattern the supporting trials used
• Blood glucose (Metabolic Syndrome): Result none shown → Small Improvement; Size not stated → small; Form studied not stated → oral curcuminoids 300-500 mg/day (often with 5 mg piperine), nano-curcumin 80 mg/day or turmeric powder about 2 g/day, for 8 weeks to 3 months (9 months in the prediabetes trial); the 2026 meta-analysis found 1 g/day or more more effective. 9 studies removed (did not measure this outcome); 8 studies removed (studied a different group of people); 5 studies added.Why: Population check: none of the 18 linked studies was in metabolic syndrome (T2D, impaired fasting glucose, COPD, prediabetes, healthy, postmenopausal) except the all-population umbrella MA 39478418, kept as a broader population. Literature checked: metabolic-syndrome MAs 30941814 (7 RCTs: fasting glucose improved, p = 0.01, high heterogeneity), 30156145 (26 RCTs, MetS and related disorders: SMD -0.78) and nano-curcumin MA 39894187 (20 RCTs: FBS SMD -0.34) favour curcumin, but both direct MetS RCTs found no fasting-glucose difference (36192751, 88 people, 12 weeks; 33851448, 50 people, nano-curcumin 80 mg/day). Strongest evidence (MAs) shows a small fall: Small Improvement. Ceiling B (meta-analyses with inconsistent trials); mechanical C9 would allow A. Row stays ungraded. The product form and dose pattern the supporting trials used
• Blood glucose (Prediabetes): Form studied not stated → oral curcuminoids 300-500 mg/day (often with 5 mg piperine), nano-curcumin 80 mg/day or turmeric powder about 2 g/day, for 8 weeks to 3 months (9 months in the prediabetes trial); the 2026 meta-analysis found 1 g/day or more more effective. 9 studies removed (did not measure this outcome); 6 studies removed (studied a different group of people); 3 studies added.Why: The product form and dose pattern the supporting trials used
• Blood Pressure (Diabetic Nephropathy): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (studied a different group of people); 1 study removed (did not measure this outcome); 1 study added.Why: Grade C row shows Improves (small) for BP in diabetic nephropathy, but neither linked study is in that population (postmenopausal women; a single dose in healthy smokers). Re-cited (1 PubMed search) the meta-analysis of curcumin RCTs in diabetic kidney disease: systolic BP reported…
• C-Reactive Protein (CRP) (Osteoarthritis (OA)): Form studied not stated → oral curcuminoids from 80 mg/day (nano-curcumin) to 1,500 mg/day (with piperine), for 6 weeks to 3 months, in knee osteoarthritis. 4 studies added.Why: The product form and dose pattern the supporting trials used
• Cognition (Age-Associated Memory Impairment and Cognitive Decline (AAMCD)): Result Small Improvement → Mixed effect; Grade B → C; Size small → not stated.Why: The two linked meta-analyses disagree. 40308636 finds global cognition improved (SMD 0.82; significant only for >= 24 weeks, age >= 60 or Asian participants); the 2025 meta-analysis 40579315 (10 human studies, 531 people) finds no significant effect on…
• Inflammation (Diabetic Nephropathy). 1 study removed (studied a different group of people); 1 study removed (did not measure this outcome).
• Mucositis Symptoms (Mucositis): Result Moderate Improvement → Improvement; Grade A → B; Size moderate → not stated; People studied 272 → not stated; Form studied not stated → oral curcumin during radiotherapy or chemotherapy: bio-enhanced turmeric (BCM-95) capsules 1-1.5 g/day for 6 weeks, or nanomicelle curcumin 80 mg twice daily for up to 7 weeks; curcumin mouthwashes and gels are topical and are not this supplement. 1 study removed (studied a different group of people); 1 study removed (not a study of this supplement); 4 studies added.Why: Literature checked. The linked oral lichen planus trial is a different disease (fail population) and the linked 2025 meta-analysis pools capsules with mouthwash and gel (topical; oral effect not separable), so both are removed. Four small placebo-controlled trials of oral curcumin capsules in patients on radiotherapy or chemotherapy (34161952, 34521398, 30761565, 37069504; 32-60 people each) all found less severe mucositis; MASCC/ISOO made no guideline for curcumin. Several small agreeing trials = B; size cleared (no common scale). People 272 cleared. The product form and dose pattern the supporting trials used

Curcumin: the page as it is now

• Testosterone (Hormone Health): Result none shown → Mixed effect.Why: Ungraded row shows Improves (testosterone up) as a clean finding. One placebo-controlled trial (19860889) reports a rise; the other (25844073, trained men) found no effect at 3 g and a FALL at 6 g. Conflicting trials: Mixed effect. Ceiling B; stays ungraded.

D-Aspartic Acid: the page as it is now

• 15-Minute Recovery Rate: Grade B → A; Form studied not stated → single 0.6 mg subcutaneous injection (an autoinjector in one trial) given during insulin-induced hypoglycaemia in people with type 1 diabetes. 16 studies removed (not a study of this supplement); 2 studies added.Why: The product form and dose pattern the supporting trials used Lead check: Maji 2023 meta-analysis (37735694) of 5 dasiglucagon RCTs in type 1 diabetes found faster recovery from insulin-induced hypoglycaemia than placebo (MD -24.7 min, 95% CI -30.9 to -18.5); the two phase 3 RCTs agree. Several well-run trials and a meta-analysis agreeing: A.

Dasiglucagon (Zegalogue): the page as it is now

• Chronic Non-Specific Back Pain (Chronic Low Back Pain): Effect note rewritten from its studies; Size moderate → not stated. 2 studies added.Why: Graded B with no linked study. Re-cited the two flagged systematic reviews (read): the 2004 review (15369596) rates the 60 mg harpagoside vs rofecoxib non-inferiority as moderate evidence, while Cochrane 2014 (25536022) rates that single 88-person trial very low quality and the placebo trials low…
• Low Back Pain Relief (Chronic Low Back Pain): Effect note rewritten from its studies; Size moderate → not stated. 2 studies added.Why: Graded A with no linked study. Re-cited the two flagged systematic reviews (read): Cochrane 2014 (25536022) says devil's claw "may be better than placebo" for short-term pain (2 trials, 315, low quality) and the 2004 review (15369596) found strong evidence at 50 mg harpagoside. The note credits…

Devil's Claw (Harpagophytum procumbens): the page as it is now

• Cortisol (General Athletic Performance): Result Increase → Decrease. 1 study removed (did not support the finding); 2 studies added.Why: Literature checked. The meta-analysis of RCTs (34342920, 10 arms, low heterogeneity) found DHEA lowers serum cortisol (WMD -53.6 nmol/L); single trials vary (16393880 rise at some hours, 23488643 little or no change). Strongest evidence supports the stored decrease, so the arrow stays; the…
• Quality of Life (Fibromyalgia): Result none shown → No effect. 1 study added.Why: Ungraded row with no linked study shows Improves (quality of life). The flagged DHEA fibromyalgia RCT (read; already on another finding) concludes DHEA does not improve quality of life: added, No effect.

DHEA: the page as it is now

• Itch Intensity Reduction (Chronic Kidney Disease-Associated Pruritus): Effect note rewritten from its studies; Size large → moderate. 9 studies removed (not a study of this supplement); 2 studies removed (did not measure this outcome); 1 study removed (studied a different group of people).Why: Direction and grade A hold: KALM-1, the pooled KALM analysis and a 9-trial meta-analysis all show less itch than placebo. The note's '51% vs 28%' mixes figures from two analyses and its '4.2-point vs 2.5-point' decrease is in no cited abstract: replaced by a standard label. 'Large' overstates it…
• Sleep Improvement (Chronic Kidney Disease-Associated Pruritus): Effect note rewritten from its studies; Grade A → C; Size large → not stated. 9 studies removed (not a study of this supplement); 3 studies removed (did not measure this outcome); 1 study removed (studied a different group of people); 1 study added.Why: No linked abstract reports sleep in CKD-associated pruritus (reviews and the meta-analysis report itch only; the notalgia trial is another condition): all four removed. Re-cited with 37968132, a post hoc analysis of the phase 3 trials in hemodialysis patients: sleep quality improved with…

Difelikefalin (Korsuva): the page as it is now

• Quality of Life in CVD (Chronic Venous Insufficiency): Effect note rewritten from its studies; Grade B → C; Size small → not stated. 1 study added.Why: Graded B with no linked study and a prose note. Re-cited the low-dose diosmin RCT the note describes (33808784, CVD C2-C4, a population that includes CVI): QoL improved vs placebo. One RCT: grade lowered B -> C. The abstract gives p-values only, so 'small' is cleared and the note becomes…
• Venous Ulcer Healing (Skin Health): Effect note rewritten from its studies. 2 studies added.Why: Graded B with no linked study. Re-cited (1 PubMed search plus the flagged Cochrane review): two meta-analyses of the same 5 MPFF trials report more ulcers healed (RRR 32%; RR 1.36), but the Cochrane review notes the only low-risk-of-bias trial showed no benefit. Improves (small) holds with that…

Diosmin: the page as it is now

• Blood glucose (High Blood Pressure): Result No effect → Mixed effect; Size none → not stated. 2 studies added.Why: Graded D "No effect" under High Blood Pressure with no linked study (would lose its grade): re-cited. Flagged RCT 12399272 (T2D + treated hypertension): fasting glucose ROSE with DHA vs olive oil (P = 0.002), HbA1c unchanged. Systematic review 39403396: DHA effects on blood glucose inconsistent.…
• Blood glucose (Type 2 Diabetes): Result No effect → Mixed effect; Size none → not stated. 2 studies added.Why: Graded D "No effect" under Type 2 Diabetes with no linked study (would lose its grade): re-cited. Flagged RCT 12399272 (T2D + treated hypertension): fasting glucose ROSE with DHA vs olive oil (P = 0.002), HbA1c unchanged. Systematic review 39403396: DHA effects on blood glucose inconsistent. Clean…
• Insulin (High Blood Pressure): Result none shown → No effect.Why: Page shows insulin going up ("Changes; see studies", stored increase) under High Blood Pressure; the only linked RCT (59 T2D patients with treated hypertension, 4 g/d DHA, 6 wk) found no significant change in fasting insulin. Show No effect. One RCT: ceiling C; row stays ungraded.
• Insulin (Type 2 Diabetes): Result none shown → No effect.Why: Page shows insulin going up ("Changes; see studies", stored increase) under Type 2 Diabetes; the only linked RCT (59 T2D patients with treated hypertension, 4 g/d DHA, 6 wk) found no significant change in fasting insulin. Show No effect. One RCT: ceiling C; row stays ungraded.
• Low-density lipoprotein (LDL) (High Blood Pressure): Result none shown → Detriment. 2 studies added.Why: Page shows Improves (LDL down) under High Blood Pressure with no linked study. Flagged meta-analysis 21975919 (read): DHA raised LDL 7.23 mg/dL vs placebo; flagged RCT 12399272 (T2D + treated hypertension) found no significant LDL change. Strongest evidence (meta-analysis) reports a harm…
• Low-density lipoprotein (LDL) (High Cholesterol): Result none shown → Detriment. 1 study added.Why: Page shows Improves (LDL down) under High Cholesterol with no linked study. Flagged meta-analysis 21975919 (read): DHA raised LDL 7.23 mg/dL vs placebo: Detriment. Flagged RCT 12399272 not added (T2D with treated hypertension, fails C5 here). Row stays ungraded (ceiling A).
• Low-density lipoprotein (LDL) (Type 2 Diabetes): Result none shown → Detriment. 2 studies added.Why: Page shows Improves (LDL down) under Type 2 Diabetes with no linked study. Flagged meta-analysis 21975919 (read): DHA raised LDL 7.23 mg/dL vs placebo; flagged RCT 12399272 (T2D + treated hypertension) found no significant LDL change. Strongest evidence (meta-analysis) reports a harm: Detriment.
• No human study left after the re-check, so no grade: Blood Pressure (High Blood Pressure), Blood Pressure (Type 2 Diabetes), Insulin (High Cholesterol). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Docosahexaenoic Acid: the page as it is now

• Estrogenic Activity: Effect note rewritten from its studies; Size small → not stated; People studied not stated → 71. 3 studies removed (not a study of this supplement); 2 studies removed (did not measure this outcome).Why: Page shows Improves (estrogenic activity up, small) while its own note says NEGATIVE FINDING. The 24-week placebo-controlled RCT 9418683 found no estrogen-like response; lab/mouse assays found no ER activation; only a single case report suggests an effect. Strongest evidence: No effect, size… Literature checked: the only placebo-controlled human test of estrogenic activity is 9418683 (24 weeks, no effect on endometrial thickness or vaginal maturation); other trials are multi-herb products or measure hot flashes only. Removed the cell/mouse study (not human) and the single gynaecomastia case report (an adverse event, not a measure of estrogenic activity). No effect and C kept (one RCT). People set to 71 from the RCT abstract. Agrees with our auditor.

Dong Quai: the page as it is now

• 6-Minute Walk Test (Barth Syndrome) (Barth Syndrome): Effect note rewritten from its studies; Grade A → C; Size large → not stated. 3 studies removed (not a study of this supplement); 1 study removed (studied a different group of people); 2 studies removed (did not measure this outcome).Why: Graded A, clean 'Improves' (large). The only placebo-controlled evidence (TAZPOWER part 1, 33077895) missed its 6MWT endpoint; the ~96 m gains come from the open-label extensions (33077895 part 2, 38602181) with no control. Mixed effect, size cleared. One controlled trial: A to C. The note's…
• Safety and Tolerability (Barth Syndrome): Effect note rewritten from its studies; Grade A → D; Size large → not stated. 3 studies removed (not a study of this supplement); 1 study removed (studied a different group of people); 2 studies removed (did not measure this outcome).Why: Graded A (large) on safety. The only passing study is the uncontrolled 10-patient open-label extension (38602181: well tolerated, injection-site reactions most common); a single small uncontrolled study allows D. Two reviews and an AMD trial removed. Size has no basis; the note's 'no serious…

Elamipretide (Forzinity/SS-31): the page as it is now

• Weight (Obesity). 6 studies removed (not a study of this supplement).
• Weight (Overweight). 6 studies removed (not a study of this supplement).
• Weight (Digestive Health). 6 studies removed (not a study of this supplement).
• No human study left after the re-check, so no grade: Heart Rate (High Cholesterol), Nasal Congestion (Upper Respiratory Tract Infection), Subjective Well-Being, Weight (High Blood Pressure). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Ephedrine: the page as it is now

• ADHD Symptoms: Effect note rewritten from its studies; Size small → not stated. 2 studies removed (did not measure this outcome).Why: Row shows Improves (small) for ADHD symptoms, but its systematic review says RCTs 'have generally been unsuccessful in demonstrating any behavioural treatment effects' and current findings do not support EFA supplements; only open-label trials improved. The randomised evidence decides: show No…
• No human study left after the re-check, so no grade: Dry Eye Symptoms. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Essential fatty acid (EFA): the page as it is now

• No human study left after the re-check, so no grade: Kidney Function (High Blood Pressure). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Eucommia Bark: the page as it is now

• Body Mass Index (BMI) (Metabolic Health): Result none shown → No effect. 4 studies added.Why: Data gap re-derived (Metabolic Health is a general group: any population). Literature checked (fenugreek BMI meta-analyses, Cochrane: none on weight). Three meta-analyses of RCTs find BMI unchanged: 12 RCTs in adults (32087319), 29 RCTs on metabolic-syndrome components (36470549) and 10 RCTs in…
• Body Mass Index (BMI) (Weight Loss & Maintenance): Result none shown → No effect. 4 studies added.Why: Data gap re-derived (Weight Loss & Maintenance is a general group: any population). Literature checked (fenugreek BMI meta-analyses, Cochrane: none on weight). Three meta-analyses of RCTs find BMI unchanged: 12 RCTs in adults (32087319), 29 RCTs on metabolic-syndrome components (36470549) and 10…
• Weight (Metabolic Health): Result none shown → No effect. 3 studies added.Why: Data gap re-derived (Metabolic Health is a general group: any population). Literature checked (fenugreek weight meta-analyses, Cochrane: none on weight). The RCT meta-analysis in adults (32087319) and the diabetes meta-analysis (39286181) find body weight unchanged, and the 6-week RCT in…
• Weight (Weight Loss & Maintenance): Result none shown → No effect. 3 studies added.Why: Data gap re-derived (Weight Loss & Maintenance is a general group: any population). Literature checked (fenugreek weight meta-analyses, Cochrane: none on weight). The RCT meta-analysis in adults (32087319) and the diabetes meta-analysis (39286181) find body weight unchanged, and the 6-week RCT in…

Fenugreek: the page as it is now

• 5-HEPE (Immune Health): Result Moderate Increase → Increase; Size moderate → not stated. 2 studies added.Why: No linked study. Immune Health is a general group (any population). Re-cited RCT 22748976 (50 overweight adults, the stored people figure: 5-HEPE rose significantly vs olive oil, p<0.001) and RCT 21296957 (116 adults, 5 g fish oil: 5-HEPE increased with supplementation). Increase holds, but…
• 5-HEPE (Weight Loss & Maintenance): Result Moderate Increase → Increase; Size moderate → not stated. 2 studies added.Why: No linked study. Weight Loss & Maintenance is a general goal group (any population; the 50-person trial was in overweight adults). Re-cited RCT 22748976 (50 overweight adults, the stored people figure: 5-HEPE rose significantly vs olive oil, p<0.001) and RCT 21296957 (116 adults, 5 g fish oil…
• Adiponectin (High Cholesterol). 2 studies added.
• Adiponectin (Type 2 Diabetes): Result No effect → Mixed effect; Size none → not stated. 3 studies added.Why: No linked study. Type 2 Diabetes group. Three meta-analyses of RCTs in type 2 diabetes disagree: EPA/DHA raised adiponectin 0.48 ug/mL but the effect vanished in sensitivity analysis (29676540); a 10-trial analysis found a non-significant 0.17 ug/mL rise (29453672); another found a significant…
• Adiponectin (Overweight): Result No effect → Small Increase; Size none → small. 3 studies added.Why: Direction error: the page shows 'No effect' for adiponectin in overweight people, but the trial behind the stored 93-person figure (Krebs 2006, 16552404) found adiponectin rose with fish oil vs placebo oil during weight loss (P<0.01), as did placebo RCT 22260859 (+0.55 ug/mL, P = .04, 'the effect…
• Adiponectin (Nonalcoholic Fatty Liver Disease (NAFLD)): Result No effect → Mixed effect; Size none → not stated. 3 studies added.Why: No linked study. NAFLD group. Fish oil vs corn oil raised adiponectin in two adult NAFLD RCTs (26226139: +1.29 ug/mL, P<0.001; 35594631: P = 0.011), and a paediatric RCT agrees, but the largest trial (24818764, 243 NASH patients, ethyl-EPA for 12 months) found no effect on adiponectin. A clean 'No…
• Adiponectin (Polycystic Ovary Syndrome (PCOS)): Result No effect → Increase; Size none → not stated. 3 studies added.Why: Direction error: the page shows 'No effect' for adiponectin in PCOS, but two meta-analyses of RCTs in PCOS found omega-3 raised adiponectin (36932420: 11 RCTs, MD 1.46, p < 0.00001; 29580250: 9 RCTs, WMD 1.34, P = 0.002), as did placebo RCT 23017309 (p = 0.003) and two further trials. Now…
• All-Cause Mortality (Cardiovascular Disease). 2 studies added.
• Anaerobic Capacity: Result Moderate Improvement → No effect; Size moderate → not stated; People studied 26 → 54. 1 study added.Why: Our auditor agreed. The #79 change to "Moderate Improvement" rested on the within-group Yo-Yo result of 28387540; the abstract reports no between-group test (203 vs 62 m, overlapping CIs), strength/sprint/power showed no treatment effect, and the authors call the Yo-Yo finding hypothesis-generating. Literature checked: the second fish-oil RCT in soccer players (9089901) found no difference in anaerobic power vs placebo, and the 2024 SR (38999792) and 2026 NMA (41901084) report recovery-marker benefits, not anaerobic performance. Label "No effect" (no significant difference vs placebo), size cleared, D kept (two small RCTs allow C: under-graded). People re-derived from the two abstracts: 26 + 28 = 54.
• Anaerobic Capacity (Anaerobic Exercise Performance): Result No effect → Improvement; Size none → not stated.Why: General performance group. The one link, a placebo RCT in 26 soccer players (4 weeks of n-3 during training), found anaerobic endurance capacity (Yo-Yo distance) improved only with n-3 (+203 m vs +62 m, p < .01 within group, Cohen's d 0.52), though strength, power and sprint did not change; the…
• Anxiety Symptoms (Menopause): Result Small Improvement → No effect; Size small → not stated. 1 study removed (studied a different group of people); 1 study added.Why: Page shows Improves (Small Improvement) for anxiety in menopause. The only link studied medical students before exams: wrong population, removed. The menopause trial behind the stored 355-person figure (MsFLASH RCT 23982113, omega-3 1.8 g/day for 12 weeks, GAD-7 anxiety among its secondary…
• Apolipoprotein A (High Cholesterol). 1 study added.
• Apolipoprotein A (Metabolic Health). 2 studies added.
• Apolipoprotein A (Dyslipidemia). 3 studies added.
• Atrial Fibrillation Incidence (Coronary Artery Disease (CAD)): Result Mixed effect → Increase; Grade C → B; Form studied not stated → marine omega-3 supplements: AF risk higher above 1 g/day (HR 1.49) than at 1 g/day or less (HR 1.12). 1 study added.Why: CAD group. The one link, a double-blind placebo RCT in 401 patients having bypass surgery (2 g/day fish oil for at least 5 days before), found AF incidence 8.40% vs 14.07%, not significant (p = 0.07; authors: 'borderline'); only AF duration and ICU/hospital stay were significantly shorter. For the… Literature checked (34612056, Gencer, Circulation 2021): in 7 cardiovascular-outcome RCTs (81,210 people, mean age 65, 4.9 years) marine omega-3 supplements raised atrial fibrillation risk (HR 1.25), more above 1 g/day (HR 1.49) than at or below 1 g/day… The product form and dose pattern the supporting trials used Large meta-analysis of cardiovascular-outcome RCTs (34612056); raised from C on the editor's explicit instruction.
• Blood Flow (High Blood Pressure): Result No effect → Mixed effect; Size none → not stated. 1 study removed (did not measure this outcome); 1 study added.Why: High Blood Pressure group. The only link is an SLE trial (wrong population) that reports flow-mediated dilation, not blood flow: removed. Re-cited the only blood-flow trial in people with raised blood pressure, pilot RCT 30279397 (borderline hypertensives, DHA-rich fish oil 20 weeks): cerebral…
• Blood glucose (Gestational Diabetes): Result No effect → Improvement; Size none → not stated. 2 studies added.Why: Direction error: the page shows 'No effect' for blood glucose in gestational diabetes, but three meta-analyses of placebo RCTs in GDM agree omega-3 lowers fasting glucose: 36913875 (6 RCTs, WMD -0.25 mmol/L) and 30231792 (7 RCTs, SMD -0.56, p = .0005), with 30324838 concurring. Now 'Improvement'…
• Blood glucose (Cardiomyopathy). 1 study added.
• Body Fat (Aerobic Exercise Performance): Result No effect → Mixed effect; Size none → not stated. 3 studies added.Why: No linked study. Aerobic Exercise Performance is a general group. Trials combining fish oil with aerobic exercise disagree: in 17490962 fish oil reduced body fat independently of exercise, while in 2402138 (32 sedentary men) percent body fat did not differ; the likely source (2691812, 34 people)…
• Body Fat (Body Composition): Result No effect → Mixed effect; Size none → not stated. 2 studies added.Why: No linked study. Body Composition is a general group. The pooled evidence is inconsistent: meta-analysis 24891155 found body fat percentage 0.49% lower with fish oil (CI -0.97 to -0.01) but no difference in fat mass, and systematic review 34330455 found 11 of 20 trials showed no effect and 9 some…
• C-Peptide (Type 1 Diabetes): Result No effect → Increase; Size none → not stated.Why: Type 1 Diabetes group. The one link, a placebo RCT in 90 pregnant women with type 1 diabetes (EPA 120 mg + DHA 616 mg twice daily), found fasting C-peptide rose significantly from first to third trimester with EPA/DHA (P<0.001) but not with placebo; the authors conclude n-3 'stimulates the…
• C-Reactive Protein (CRP) (Human Immunodeficiency Virus (HIV)): Result No effect → Small Decrease; Size none → small. 4 studies removed (studied a different group of people); 3 studies added.Why: Direction error: the page shows 'No effect' for CRP under HIV, and none of the four links studies HIV (healthy, PAD and lung-cancer populations: removed). In HIV, the meta-analysis of 9 RCTs (32977239) found omega-3 significantly lowered CRP (SMD -0.27) and the 2026 meta-analysis of 21 trials…
• Cognitive Decline (Macular Degeneration): Result none shown → No effect. 1 study removed (studied a different group of people).Why: Ungraded row on the macular-degeneration page shows Improves for cognitive decline. The only study in people with AMD (AREDS2, 26305649) found no effect of omega-3s on cognition. The positive DHA trial (20434961) enrolled healthy adults without AMD (fails C5): removed. Show No effect. Ceiling…
• Depression Symptoms (Depression): Result Mixed effect → Small Improvement; Grade B → C; Size not stated → small; Form studied not stated → oral fish oil concentrate, EPA-predominant (EPA at least 60% of EPA+DHA), about 1 g/day EPA (trial range 0.2-2.2 g/day EPA), 8-12 weeks, mostly added to usual depression treatment; DHA-predominant products showed no benefit; omega-3 above 1 g/day raises atrial fibrillation risk (34612056). 1 study removed (not a study of this supplement); 4 studies removed (studied a different group of people); 1 study removed (did not measure this outcome); 4 studies added.Why: Literature checked (omega-3 depression meta-analyses, Cochrane, EPA meta-analyses, main RCTs). Cochrane 2021 (34817851; 33 trials, 1,848 adults with MDD): SMD -0.40, very low certainty, "unlikely to be clinically meaningful", possibly biased toward benefit, no difference in response or remission.… The product form and dose pattern the supporting trials used
• HbA1c (Type 1 Diabetes): Direction goes down → not set. 2 studies removed (studied a different group of people).Why: Literature checked (pubmed.py 'omega-3 fish oil type 1 diabetes HbA1c randomized'): no type 1 diabetes trial in the results reports a fall in HbA1c (the trials target nephropathy and lipids: 37862823, 32045421). The row's two links were type 2 diabetes trials (18065585, 19540739), removed for population (092): direction cleared; data gap.
• Infant Birth Weight (Intrauterine Growth Restriction): Result Small Increase → No effect; Size small → not stated. 2 studies added.Why: Direction error: the page shows Improves with a down arrow and the note 'Small Increase' (self-contradictory) for birth weight under IUGR, with no linked study. In women with or at risk of IUGR, the meta-analysis of 3 RCTs (26033362, 575 women with a previous IUGR pregnancy) found similar…
• Infant Birth Weight (Low Birth Weight): Form studied not stated → oral fish oil / omega-3 LCPUFA (DHA with or without EPA) taken daily from about mid-pregnancy (20 weeks or earlier) until delivery. 3 studies added.Why: The product form and dose pattern the supporting trials used
• Infant Birth Weight (Preeclampsia): Form studied not stated → oral fish oil / omega-3 LCPUFA (DHA with or without EPA) taken daily from about mid-pregnancy (20 weeks or earlier) until delivery. 3 studies added.Why: The product form and dose pattern the supporting trials used
• Infant Birth Weight (Premature Birth): Form studied not stated → oral fish oil / omega-3 LCPUFA (DHA with or without EPA) taken daily from about mid-pregnancy (20 weeks or earlier) until delivery. 3 studies added.Why: The product form and dose pattern the supporting trials used
• Oxidative Stress Biomarkers (Type 2 Diabetes): Result none shown → Mixed effect. 1 study removed (studied a different group of people); 3 studies added.Why: Linked 28651701 is in first-episode schizophrenia: removed. Literature checked: the T2DM meta-analysis 39243880 (23 trials) found omega-3 raised total antioxidant capacity but did not lower malondialdehyde or change SOD; one RCT raised antioxidant status (32194222), another found no change in…
• Postpartum Depression Symptoms (Peripartum Depression): Result none shown → No effect.Why: Ungraded row (Peripartum Depression) shows Improves. Both studies are null: the meta-analysis of 11 RCTs (33190574) found no effect of omega-3 on perinatal depression scores for prevention or treatment, and the RCT (28599630) found no prevention. Now No effect; stays ungraded (ceiling A).
• Postpartum Depression Symptoms (Perinatal Depression): Result none shown → No effect.Why: Ungraded row (Perinatal Depression) shows Improves. Both studies are null: the meta-analysis of 11 RCTs (33190574) found no effect of omega-3 on perinatal depression scores for prevention or treatment, and the RCT (28599630) found no prevention. Now No effect; stays ungraded (ceiling A).
• Sleep Duration (Sleep Health). 1 study added.
• No human study left after the re-check, so no grade: Anxiety Symptoms (Premenstrual Syndrome (PMS)), Apolipoprotein B (Stroke), Blood Flow (Systemic Lupus Erythematosus), Blood Flow (Infant Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Fish Oil: the page as it is now

• Follicle-Stimulating Hormone (Hormone Health): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (FSH up) with no linked study. The flaxseed sex-hormone meta-analysis (37927501, read) found no FSH change (p = 0.783). Added; show No effect; grade stays unset (ceiling A).
• Sex Hormone Binding Globulin (Hormone Health): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (SHBG up) with no linked study. The flaxseed sex-hormone meta-analysis (37927501, read) found no significant SHBG change (SMD 0.35, CI -0.02 to 0.72, p = 0.063). Added; show No effect; grade stays unset (ceiling A).
• Testosterone (Hormone Health): Result none shown → No effect.Why: Ungraded row shows Improves (testosterone up). Its only study, a meta-analysis of 10 RCTs, found no significant change in total testosterone (SMD 0.17, p = 0.165) and concludes 'Flaxseed supplementation had no significant effect on sex hormones in adults.' Show No effect; grade stays unset…

Flaxseed: the page as it is now

• Congenital heart defect risk (Infant Health): Result none shown → Small Improvement; Grade not graded → C; Size not stated → small. 2 studies added.Why: Page shows congenital heart defect risk going up ("Changes; see studies", stored increase) with no linked study. Flagged Cochrane review 26662928 (read): no preventive or harmful effect on congenital cardiovascular defects (RR 0.57, CI 0.24-1.33). Show No effect. Row stays ungraded. / literature checked (35346212, 2022 meta-analysis of observational studies): maternal folic acid supplementation was associated with a lower risk of congenital heart defects (OR 0.82), with very high heterogeneity and possible harm from high doses around…
• Major Adverse Cardiac Events (High Blood Pressure): Result none shown → Improvement; Form studied not stated → oral folic acid 0.8 mg/day taken with antihypertensive treatment (enalapril 10 mg single pill in CSPPT), daily for about 4.5 years; shown in Chinese adults with hypertension and low folate status (no grain fortification). 2 studies added.Why: Literature checked. In hypertension, the 20,702-person CSPPT RCT (25771069) found folic acid with enalapril cut composite CV events (HR 0.80) and the meta-analysis of 65 RCTs (28912716) found 12.9% fewer cardio-/cerebrovascular events. The stored "increase" (Changes; see studies) is the wrong way… The product form and dose pattern the supporting trials used
• Memory (Memory Improvement): Result none shown → No effect.Why: Page shows Improves (memory up); the only linked meta-analysis (9 RCTs, 641 people) found no significant change in memory vs placebo (p = 0.418); only post-hoc subgroups suggested benefit, and the authors conclude no significant effect. Show No effect. Ceiling A; row stays ungraded.
• Seizure Frequency (Epilepsy): Result none shown → No effect.Why: Page shows seizure frequency going up ("Changes; see studies", stored increase) under Epilepsy; the linked Cochrane review found folic acid had no effect on seizure frequency (2 studies, 75 people). Show No effect. Row stays ungraded.
• Stroke Risk: Result none shown → Improvement.Why: Page shows stroke risk with stored direction increase ("Changes; see studies") under general cardiovascular health; the linked meta-analysis of 21 RCTs (115,559 people, primary and secondary prevention) found folic acid cut stroke risk 10%. Set Improvement, direction decrease. Ceiling A; row…
• Stroke Risk (Stroke): Result none shown → Improvement.Why: Page shows stroke risk with stored direction increase ("Changes; see studies") under Stroke; the linked meta-analysis of 21 RCTs (115,559 people, primary and secondary prevention) found folic acid cut stroke risk 10%. Set Improvement, direction decrease. Ceiling A; row stays ungraded.
• No human study left after the re-check, so no grade: Infant Death Risk (Premature Birth). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Folic Acid (Vitamin B9): the page as it is now

• No human study left after the re-check, so no grade: Nail Strength (Nail Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Gelatin: the page as it is now

• Chemotherapy-Induced Vomiting (Digestive Health): Effect note rewritten from its studies; Size moderate → not stated; Form studied not stated → oral ginger (capsules/root powder about 0.5-1 g/day, or extract with 84 mg gingerols/shogaols) added to standard antiemetics from the chemotherapy day for 3-5 days; any benefit is mainly on acute vomiting at <=1 g/day for more than 3 days. 6 studies added.Why: Re-derived from the literature (data gap). Vomiting results conflict: two meta-analyses find benefit (acute vomiting OR 0.58, 30299420; high-grade vomiting RR 0.47 with antiemetics, 38625733) and a 103-person RCT cut delayed vomiting, but two meta-analyses find no overall effect on vomiting (31519467, 36501010) and MASCC/ESMO 2023 makes no recommendation because of conflicting evidence. "Improves / moderate" overstates this: Mixed effect, size cleared. Ceiling B (inconsistent meta-analyses) = stored B. The product form and dose pattern the supporting trials used
• Hyperemesis Gravidarum (Morning Sickness): Effect note rewritten from its studies; Grade A → C; Size moderate → not stated; Form studied not stated → oral powdered ginger root 250 mg four times daily (1 g/day) for 4 days in the only placebo-controlled hyperemesis trial; evidence for any hyperemesis treatment is very low certainty. 2 studies added.Why: Data gap re-derived; literature checked. The only placebo-controlled hyperemesis trial (1988321, 27 women, crossover) found ginger 1 g/day better than placebo. The 2025 meta-analysis (40226035) reports OR 0.41 but mixes placebo, vitamin B6 and metoclopramide comparators and does not show its trials were in hyperemesis rather than ordinary pregnancy sickness; a 2024 systematic review rates every hyperemesis treatment except acupressure as very low certainty. Improvement kept, size cleared, grade A -> C. The prose note (copied pooled OR) is replaced by the standard label. The product form and dose pattern the supporting trials used
• Motion Sickness/Seasickness (Motion Sickness): Effect note rewritten from its studies; Size moderate → not stated. 3 studies added.Why: Graded B row with no linked study shows Improves (moderate). Re-cited (2 PubMed searches; single doses fit an acute outcome): the naval-cadet RCT found less vomiting and cold sweating (nausea not significant), a vection crossover found less nausea, a rotating-chair trial found no…
• Nausea Symptoms (Morning Sickness): Grade A → B; People studied 216 → not stated; Form studied not stated → oral ginger root powder, extract or syrup about 1-1.5 g/day in divided doses (e.g. 250 mg four times daily) for 4 days to 3 weeks in early pregnancy; one meta-analysis found doses under 1.5 g/day did better; vomiting was not clearly reduced. 4 studies removed (studied a different group of people); 3 studies added.Why: Literature checked. Four pregnancy RCTs vs placebo or vitamin B6 and one hyperemesis trial pass; the postoperative and chemotherapy trials are other populations and are removed. Meta-analyses (24642205, 31937153) find ginger eases pregnancy nausea (SMD 0.82), but the Cochrane review (26348534) calls the evidence limited and inconsistent and the 2014 MA rates it low quality: grade A -> B. Stored direction 'increase' corrected to decrease (nausea goes down). People 216 cleared (study list changed). The product form and dose pattern the supporting trials used
• Nausea Symptoms (Surgical Recovery): Result Moderate Improvement → Small Improvement; Grade A → B; Size moderate → small; People studied 268 → not stated; Form studied not stated → oral ginger powder at least 1 g (e.g. 1-1.5 g in capsules) taken about 1 hour before surgery; it eased nausea severity a little but did not reliably prevent nausea, vomiting or rescue antiemetic use. 6 studies removed (studied a different group of people); 3 studies added.Why: Literature checked. The pregnancy and chemotherapy trials are other populations and are removed (the other agent's lead was right). Passing: two gynecologic-surgery RCTs and the 2006 MA (RR 0.69). Newer meta-analyses find ginger lowers postoperative nausea severity a little (oral-only MA SMD -0.25, 30466995; MD -0.71, 34312974) but not the incidence of nausea/vomiting or rescue antiemetics (34700257), and a GRADE network MA found no clear advantage for postoperative nausea. 'Moderate' overstates: Small Improvement; grade A -> B. Stored direction corrected to decrease. People 268 cleared. The product form and dose pattern the supporting trials used
• Postoperative Nausea/Vomiting (Digestive Health): Size moderate → not stated; Form studied not stated → oral ginger at least 1 g (capsules) taken before surgery; reduces nausea severity more consistently than vomiting incidence. 5 studies added.Why: Re-derived from the literature (data gap). Every meta-analysis points to less postoperative nausea with oral ginger (PONV RR 0.69, 16389016; severity MD -0.71 and fewer rescue antiemetics, 34312974; SMD -0.247, 30466995), while incidence of vomiting is not consistently reduced (34700257, 10793599). The existing note says exactly this and every claim in it is in these abstracts, so it stays. Size "moderate" has no consistent basis (SMD -0.25 to -2.0): cleared. Ceiling A; stored B kept (under-graded). The product form and dose pattern the supporting trials used
• Pregnancy Nausea (NVP) (Morning Sickness): Effect note rewritten from its studies; Grade A → B; Form studied not stated → oral ginger root powder, extract or syrup about 1-1.5 g/day in divided doses (e.g. 250 mg four times daily) for 4 days to 3 weeks in early pregnancy; one meta-analysis found doses under 1.5 g/day did better; vomiting was not clearly reduced. 6 studies added.Why: Data gap re-derived; literature checked. Two meta-analyses (24642205: 12 RCTs, nausea MD 1.20, I2 0%; 31937153: 13 studies, nausea SMD 0.82) and the placebo RCTs (11275030, 14712970, 12233808) agree that oral ginger eases pregnancy nausea, but the Cochrane review (26348534) calls the ginger evidence limited and not consistent and the 2014 MA rates it low quality; vomiting is not clearly reduced. Direction and 'Moderate' (SMD 0.82) kept; grade A -> B for low certainty. The old prose note is replaced by the standard label: its claim 'More effective than vitamin B6' is not supported (31937153 found no significant difference vs B6). The product form and dose pattern the supporting trials used

Ginger (Zingiber officinale): the page as it is now

• Acute Mountain Sickness Symptoms (Acute Mountain Sickness): Result Moderate Improvement → Mixed effect; Size moderate → not stated.Why: Row shows Moderate Improvement, but its six RCTs conflict: three small trials report fewer or milder AMS, one reports both results, and two (including the largest, PHAIT, 487 completers) found ginkgo no better than placebo. Show Mixed effect, size cleared; B = ceiling (2+ RCTs…
• Libido (Sexual Dysfunction): Result none shown → No effect. 2 studies removed (did not measure this outcome).Why: Ungraded row shows Improves (libido up). The only controlled trial that reports desire (18274887) found ginkgo alone no better than placebo; only the open uncontrolled trial was positive, and the RCT outranks it: No effect. Two placebo trials (both null) report overall sexual function, not…
• Memory (Memory Improvement): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves for memory. Linked: one 262-person RCT improved delayed recall, a single-dose RCT found 120 mg ginkgo alone no better on primary outcomes, an uncontrolled MCI study found no DemTect change. The flagged meta-analysis (13 RCTs, 1132 healthy people, read) found d =…
• Tinnitus Symptoms (Tinnitus): Result none shown → No effect.Why: Ungraded row shows Improves for tinnitus. All three studies, including the Cochrane review (23543524) and a 978-person placebo-controlled trial (11154618), found ginkgo no better than placebo or control. Show No effect; grade stays unset (ceiling A).

Ginkgo Biloba: the page as it is now

• CTX-II (Bone Health): Result none shown → Decrease.Why: Page shows Improves with an up arrow (stored increase) for CTX-II, a cartilage-breakdown marker. Its only study (pre/post in soccer players) found glucosamine lowered CTX-II, transiently. The benefit is real but the measure goes down: set Decrease. Bone Health is a general group. Ungraded…

Glucosamine: the page as it is now

• No human study left after the re-check, so no grade: Immunity (Diarrhea Predominant Irritable Bowel Syndrome (IBS-D)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Glutamine: the page as it is now

• Oxidative Stress Biomarkers (Metabolic Health): Result none shown → No effect.Why: Ungraded row shows Improves (oxidative stress markers down); its only study (RCT, 40 healthy adults; Metabolic Health is general) found no change in F2-isoprostanes, 8-OHdG or glutathione status. Show No effect; ceiling C, grade left unset.

Glutathione: the page as it is now

• Seizure Activity: Effect note rewritten from its studies; Grade C → D; Size small → not stated. 2 studies removed (did not measure this outcome).Why: Page shows Improves (seizures down, '3 preclinical studies'). No preclinical study is linked. The only link with a finding is the FDA report of spontaneous seizure reports with goserelin (harm signal; FDA later added seizure warnings to GnRH agonist labels). The two 1991-92 Lancet letters on…

Goserelin (Zoladex): the page as it is now

• Chronic Venous Insufficiency Signs (Chronic Venous Insufficiency): Grade A → C.Why: Four small single-group trials from one group on microcirculation surrogates; the rubric gives C (A needs several well-run trials).
• Chronic Venous Insufficiency Signs (Varicose Veins): Grade B → C.Why: The same four small single-group surrogate trials as another finding: C.

Gotu Kola: the page as it is now

• Blood Pressure: People studied 252 → not stated; Form studied not stated → grape seed extract 300 mg/day (capsules or in a drink) for 6-8 weeks in trials; effects larger in younger or overweight people and metabolic syndrome; blood pressure returned to baseline within 4 weeks of stopping. 4 studies added.Why: Literature checked (no Cochrane review). Three meta-analyses agree on a small fall but disagree on which number moves: 2011 systolic -1.5 mmHg only (21802563), 2016 -6.1/-2.8 mmHg (27537554), 2022 diastolic -2.2 mmHg with systolic not significant (34798267); RCTs split (26568249 positive; 23702253 not significant). Small Improvement and B kept (meta-analyses inconsistent). People 252 cleared (study list changed). The product form and dose pattern the supporting trials used
• Food Intake (Metabolic Health): Result Small Decrease → Mixed effect; Size small → not stated.Why: Row shows Improves 'Small Decrease' (grade C). Its only RCT found no difference in 24 h energy intake in the whole sample; a 4% reduction appeared only in a median-split subgroup (P=0.05). A clean benefit overstates it: Mixed effect, size cleared. One RCT: C stays.
• High-density lipoprotein (HDL): Result none shown → No effect.Why: Ungraded row shows Improves (HDL up); its only study (RCT, 24 healthy heavy smokers, general-cardiovascular-health is a general group so population passes) found no significant change in HDL-C. Show No effect; ceiling C, grade left unset.
• High-density lipoprotein (HDL) (Metabolic Health): Result none shown → No effect.Why: Ungraded row shows Improves (HDL up); its only study (RCT, 24 healthy heavy smokers, Metabolic Health is a general group so population passes) found no significant change in HDL-C. Show No effect; ceiling C, grade left unset.
• Hyperpigmentation (Skin Health): Result none shown → Decrease.Why: Ungraded row shows 'Changes; see studies' with stored direction increase (hyperpigmentation up); its only study (12-woman uncontrolled study) found pigmentation fell (melanin index down, chloasma improved in 10/12). Set direction decrease, label Decrease. Single small uncontrolled study: ceiling…
• Leg Edema: Result none shown → Decrease.Why: Ungraded row shows 'Changes; see studies' with stored direction increase (leg edema up); its only study (controlled crossover trial) found GSE significantly reduced leg swelling. Set direction decrease, label Decrease (no size basis). Ceiling C, grade left unset.
• Triglycerides: Result none shown → No effect.Why: Ungraded row shows Improves (triglycerides down); its only study (RCT in metabolic syndrome; passes C5 for general-cardiovascular-health) found no significant change in serum lipids. Show No effect; ceiling C, grade left unset.
• Triglycerides (Metabolic Health): Result none shown → No effect.Why: Ungraded row shows Improves (triglycerides down); its only study (RCT in metabolic syndrome; passes C5 for Metabolic Health) found no significant change in serum lipids. Show No effect; ceiling C, grade left unset.
• Triglycerides (Metabolic Syndrome): Result none shown → No effect.Why: Ungraded row shows Improves (triglycerides down); its only study (RCT in metabolic syndrome; passes C5 for Metabolic Syndrome) found no significant change in serum lipids. Show No effect; ceiling C, grade left unset.
• No human study left after the re-check, so no grade: High-density lipoprotein (HDL) (Cardiovascular Disease), High-density lipoprotein (HDL) (Type 2 Diabetes), High-density lipoprotein (HDL) (Metabolic Syndrome), Triglycerides (Cardiovascular Disease), Triglycerides (Type 2 Diabetes). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Grape Seed Extract: the page as it is now

• Blood Pressure: Form studied not stated → oral green tea extract or catechin-rich tea for 3-24 weeks (e.g. 379 mg green tea extract a day for 3 months in obese hypertensive adults); keep EGCG under 338 mg/day in capsule form, taken with food, never as a fasting bolus; concentrated extracts carry a liver-injury warning (safety review 29580974). 2 studies added.Why: The product form and dose pattern the supporting trials used
• Blood Pressure (High Blood Pressure): Result none shown → Small Improvement; Size not stated → small; Form studied not stated → oral green tea extract or catechin-rich tea for 3-24 weeks (e.g. 379 mg green tea extract a day for 3 months in obese hypertensive adults); keep EGCG under 338 mg/day in capsule form, taken with food, never as a fasting bolus; concentrated extracts carry a liver-injury warning (safety review 29580974). 2 studies removed (studied a different group of people); 3 studies added.Why: Population check (High Blood Pressure): 18710606 and 25479028 studied overweight/obese adults, not people with high BP: removed. Literature checked: all-adult MAs 40497293 (stronger effect with elevated baseline BP), 32028419, 24861099 (greater fall when baseline SBP >= 130), 24675010 (SBP -1.94 mm Hg, small) and Cochrane 23780706 (healthy or high-CVD-risk adults) agree; RCT 22749178 in 56 obese hypertensive adults (379 mg extract/day, 3 months) lowered SBP and DBP vs placebo. Small Improvement, decrease. Ceiling A by the rubric; the auditor proposes B (small effects, I2 up to 85%, Cochrane result unstable). Row stays ungraded. The product form and dose pattern the supporting trials used
• Low-density lipoprotein (LDL) (High Blood Pressure): Result none shown → Small Improvement; Size not stated → small; Form studied not stated → oral green tea extract or catechin-rich tea for 3-24 weeks (e.g. 379 mg green tea extract a day for 3 months in obese hypertensive adults); keep EGCG under 338 mg/day in capsule form, taken with food, never as a fasting bolus; concentrated extracts carry a liver-injury warning (safety review 29580974). 1 study removed (studied a different group of people); 6 studies added.Why: The only linked study (18356827) was in obese children with a null primary analysis: removed. Literature checked: MAs 24675010 (LDL -0.19 mmol/L), 32434539 (31 trials, -4.55 mg/dL), 21715508 (14 RCTs, -2.19 mg/dL), 22027055 (catechins, -5.30 mg/dL) and Cochrane 23780706 (-0.64 mmol/L, few trials, unstable) agree, in adult populations that include people with high blood pressure; RCT 22749178 in obese hypertensive adults lowered LDL. Mostly 2-7 mg/dL: Small Improvement, decrease. Ceiling A by the rubric; the auditor proposes B. Row stays ungraded. The product form and dose pattern the supporting trials used

Green Tea Extract: the page as it is now

• No human study left after the re-check, so no grade: Eczema Symptoms (Eczema (Atopic Dermatitis)), Eczema Symptoms (Skin Health), High-density lipoprotein (HDL), High-density lipoprotein (HDL) (Metabolic Health), Low-density lipoprotein (LDL) (High Cholesterol), Low-density lipoprotein (LDL), Skin Quality (Eczema (Atopic Dermatitis)), Skin Quality (Skin Health), Triglycerides. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Hemp Protein: the page as it is now

• Blood glucose (High Cholesterol). 1 study removed (did not measure this outcome).
• Blood glucose (High Blood Pressure): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (blood glucose down) under High Blood Pressure. Linked MA 31489695 (6 RCTs, 318 adults): no effect on fasting glucose; flagged newer MA 41586243 (16 RCTs, 845 adults) agrees: added. 21068346 reports no glucose result: removed. Show No effect. Ceiling A; row stays ungraded.
• Blood glucose (Metabolic Syndrome): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (blood glucose down) under Metabolic Syndrome. Linked MA 31489695 (6 RCTs, 318 adults): no effect on fasting glucose; flagged newer MA 41586243 (16 RCTs, 845 adults) agrees: added. 21068346 reports no glucose result: removed. Show No effect. Ceiling A; row stays ungraded.
• C-Reactive Protein (CRP) (Metabolic Health): Result none shown → No effect.Why: Page shows Improves (CRP down) under Metabolic Health; the linked MA (6 RCTs, 296 adults) found no significant CRP change overall (P = 0.079; only subgroups significant) and concludes markers other than VCAM-1 might not be affected. Show No effect. Ceiling A; row stays ungraded.
• C-Reactive Protein (CRP) (High Blood Pressure): Result none shown → No effect.Why: Page shows Improves (CRP down) under High Blood Pressure; the linked MA (6 RCTs, 296 adults) found no significant CRP change overall (P = 0.079; only subgroups significant) and concludes markers other than VCAM-1 might not be affected. Show No effect. Ceiling A; row stays ungraded.
• C-Reactive Protein (CRP) (Immune Health): Result none shown → No effect.Why: Page shows Improves (CRP down) under Immune Health; the linked MA (6 RCTs, 296 adults) found no significant CRP change overall (P = 0.079; only subgroups significant) and concludes markers other than VCAM-1 might not be affected. Show No effect. Ceiling A; row stays ungraded.
• C-Reactive Protein (CRP) (Metabolic Syndrome): Result none shown → No effect.Why: Page shows Improves (CRP down) under Metabolic Syndrome; the linked MA (6 RCTs, 296 adults) found no significant CRP change overall (P = 0.079; only subgroups significant) and concludes markers other than VCAM-1 might not be affected. Show No effect. Ceiling A; row stays ungraded.
• HbA1c (Metabolic Health): Result none shown → No effect. 2 studies added.Why: Page shows Improves (HbA1c down) under Metabolic Health with no linked study. Flagged MAs 31489695 (6 RCTs) and 41586243 (16 RCTs, 845 adults), both read: no significant HbA1c effect. Show No effect. Row stays ungraded.
• HbA1c (Type 2 Diabetes): Result none shown → No effect. 2 studies added.Why: Page shows Improves (HbA1c down) under Type 2 Diabetes with no linked study. Flagged MAs 31489695 (6 RCTs) and 41586243 (16 RCTs, 845 adults), both read: no significant HbA1c effect. Show No effect. Row stays ungraded.
• HbA1c (Metabolic Syndrome): Result none shown → No effect. 2 studies added.Why: Page shows Improves (HbA1c down) under Metabolic Syndrome with no linked study. Flagged MAs 31489695 (6 RCTs) and 41586243 (16 RCTs, 845 adults), both read: no significant HbA1c effect. Show No effect. Row stays ungraded.
• High-density lipoprotein (HDL) (High Cholesterol): Result none shown → No effect. 1 study added.Why: Data gap re-derived. Literature checked (hesperidin HDL meta-analysis, Cochrane hesperidin, hypercholesterolemia RCTs). The one trial in hypercholesterolemic people (20660284, 204 adults, 800 mg/d for 4 weeks) found HDL unchanged; the general-adult meta-analyses agree (30632207, 37502716…
• High-density lipoprotein (HDL) (Metabolic Health): Result none shown → No effect. 2 studies added.Why: Ungraded row shows Improves (HDL up) with no linked study. Two meta-analyses of RCTs find no HDL change (30632207: 10 RCTs, WMD 0.16 mg/dl, CI -1.94 to 2.28; 37502716: "no significant effect was observed on high-density cholesterol"). Show No effect.
• High-density lipoprotein (HDL): Result none shown → No effect. 2 studies added.Why: Ungraded row shows Improves (HDL up) with no linked study. Two meta-analyses of RCTs find no HDL change (30632207: 10 RCTs, WMD 0.16 mg/dl, CI -1.94 to 2.28; 37502716: "no significant effect was observed on high-density cholesterol"). Show No effect.
• High-density lipoprotein (HDL) (Cardiovascular Disease): Result none shown → Mixed effect. 2 studies added.Why: Data gap re-derived. Literature checked (hesperidin HDL meta-analysis, Cochrane, coronary/CVD RCTs). Two placebo RCTs in heart disease disagree: after myocardial infarction 600 mg/d for 4 weeks raised HDL vs placebo (25757593); after CABG 200 mg/d for 12 weeks did not differ from placebo (37970430).
• Insulin (High Cholesterol): Result none shown → No effect. 2 studies added.Why: Page shows insulin going up ("Changes; see studies", stored increase) under High Cholesterol with no linked study. Flagged MAs 31489695 and 39038797 (read): no significant effect on insulin. Show No effect. Row stays ungraded.
• Insulin (Metabolic Health): Result none shown → No effect. 2 studies added.Why: Ungraded row shows "Changes; see studies" (stored increase) for insulin with no linked study. Two meta-analyses of RCTs in adults find no change in insulin (31489695: "no significant effect on ... plasma insulin", WMD -0.01 uU/mL; 39038797 likewise). Show No effect.
• Insulin: Result none shown → No effect. 2 studies added.Why: Ungraded row shows "Changes; see studies" (stored increase) for insulin with no linked study. Two meta-analyses of RCTs in adults find no change in insulin (31489695: "no significant effect on ... plasma insulin", WMD -0.01 uU/mL; 39038797 likewise). Show No effect.
• Total cholesterol (High Cholesterol): Result none shown → Mixed effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows a clean Improves (total cholesterol down) under High Cholesterol. Linked MA 30632207 (10 RCTs, 577 people): no effect on total cholesterol; the newer flagged MA 39038797 (read) found a significant TC reduction. Two meta-analyses disagree: Mixed effect. 21346065 reports no…
• Total cholesterol (Metabolic Health): Result none shown → Mixed effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows a clean Improves (total cholesterol down) under Metabolic Health. Linked MA 30632207 (10 RCTs, 577 people): no effect on total cholesterol; the newer flagged MA 39038797 (read) found a significant TC reduction. Two meta-analyses disagree: Mixed effect. 21346065 reports no…
• Total cholesterol (High Blood Pressure): Result none shown → Mixed effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows a clean Improves (total cholesterol down) under High Blood Pressure. Linked MA 30632207 (10 RCTs, 577 people): no effect on total cholesterol; the newer flagged MA 39038797 (read) found a significant TC reduction. Two meta-analyses disagree: Mixed effect. 21346065 reports no…
• Total cholesterol: Result none shown → Mixed effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows a clean Improves (total cholesterol down) under general cardiovascular health. Linked MA 30632207 (10 RCTs, 577 people): no effect on total cholesterol; the newer flagged MA 39038797 (read) found a significant TC reduction. Two meta-analyses disagree: Mixed effect. 21346065 reports…
• Total cholesterol (Cardiovascular Disease): Result none shown → Mixed effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows a clean Improves (total cholesterol down) under Cardiovascular Disease. Linked MA 30632207 (10 RCTs, 577 people): no effect on total cholesterol; the newer flagged MA 39038797 (read) found a significant TC reduction. Two meta-analyses disagree: Mixed effect. 21346065 reports no…
• Total cholesterol (Metabolic Syndrome): Result none shown → Mixed effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows a clean Improves (total cholesterol down) under Metabolic Syndrome. Linked MA 30632207 (10 RCTs, 577 people): no effect on total cholesterol; the newer flagged MA 39038797 (read) found a significant TC reduction. Two meta-analyses disagree: Mixed effect. 21346065 reports no…
• Weight (High Cholesterol): Result none shown → No effect. 1 study added.Why: Data gap re-derived. Literature checked (hesperidin weight meta-analysis, anthropometric systematic reviews, hypercholesterolemia RCTs). In the hypercholesterolemia trial (20660284) body weight did not change (<0.2 kg in all groups). General-adult evidence also shows no weight loss: 34024506 found…
• Weight (Metabolic Health): Result none shown → Increase. 1 study added.Why: Ungraded row shows Improves (weight down) with no linked study. The flagged dose-response meta-analysis of RCTs in adults (37502716) reports the opposite: "whereas weight was increased" (BMI and waist unchanged). Show Increase (no size given in the abstract).
• Weight: Result none shown → Increase. 1 study added.Why: Ungraded row shows Improves (weight down) with no linked study. The flagged dose-response meta-analysis of RCTs in adults (37502716) reports the opposite: "whereas weight was increased" (BMI and waist unchanged). Show Increase (no size given in the abstract).
• No human study left after the re-check, so no grade: High-density lipoprotein (HDL) (High Blood Pressure), High-density lipoprotein (HDL) (Metabolic Syndrome), Insulin (High Blood Pressure), Insulin (Type 2 Diabetes), Insulin (Cardiovascular Disease), Insulin (Metabolic Syndrome), Weight (Cardiovascular Disease), Weight (Metabolic Syndrome). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Hesperidin: the page as it is now

• No human study left after the re-check, so no grade: Testosterone. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Hibiscus macranthus: the page as it is now

• Body Fat (General Athletic Performance): Result none shown → No effect.Why: Ungraded row shows Improves (body fat down) under General Athletic Performance, a general group. The only linked study, a meta-analysis of 6 RCTs (39071082), found no significant fat-mass change (MD -0.18, p = 0.07). No effect; ceiling A, row stays ungraded.
• Body Fat (Body Composition): Result none shown → No effect.Why: Ungraded row shows Improves (body fat down) under Body Composition, a general group. The only linked study, a meta-analysis of 6 RCTs (39071082), found no significant fat-mass change (MD -0.18, p = 0.07). No effect; ceiling A, row stays ungraded.
• Body Fat (Football Performance): Result none shown → No effect.Why: Ungraded row shows Improves (body fat down) under Football Performance, a general group. The only linked study, a meta-analysis of 6 RCTs (39071082), found no significant fat-mass change (MD -0.18, p = 0.07). No effect; ceiling A, row stays ungraded.
• Body Fat (Metabolic Health): Result none shown → No effect; People studied 8 → not stated. 1 study removed (not a study of this supplement); 4 studies added.Why: Ungraded row shows Improves (body fat down) under Metabolic Health, a general group. The only linked study, a meta-analysis of 6 RCTs (39071082), found no significant fat-mass change (MD -0.18, p = 0.07). No effect; ceiling A, row stays ungraded. Literature checked before keeping 'No effect': an umbrella review (39797501) and meta-analyses in older adults (26169182), young adults in training (32456217) and athletes (29249685) all find no fat-mass change with HMB. No effect kept. The #79 link 39071082 pools HMB-rich multi-nutrient drinks with HMB and is replaced by the pure-HMB meta-analyses. People 8 (matched nothing) cleared, as the auditor asked. Row stays ungraded (helpers never raise); C9 ceiling A.
• Body Fat (Martial Arts Performance): Result none shown → No effect.Why: Ungraded row shows Improves (body fat down) under Martial Arts Performance, a general group. The only linked study, a meta-analysis of 6 RCTs (39071082), found no significant fat-mass change (MD -0.18, p = 0.07). No effect; ceiling A, row stays ungraded.
• Body Fat (Running Performance): Result none shown → No effect.Why: Ungraded row shows Improves (body fat down) under Running Performance, a general group. The only linked study, a meta-analysis of 6 RCTs (39071082), found no significant fat-mass change (MD -0.18, p = 0.07). No effect; ceiling A, row stays ungraded.
• Body Fat (Muscle Size & Strength): Result none shown → No effect.Why: Row stores body fat going UP ('Changes; see studies') under Muscle Size & Strength. The only linked study, a meta-analysis of 6 RCTs (39071082), found no significant fat-mass change (MD -0.18, p = 0.07), neither up nor down. No effect; ceiling A, row stays ungraded.
• High-density lipoprotein (HDL): Result none shown → No effect.Why: Page shows Improves (HDL up) but its only study, a meta-analysis of 10 RCTs (421 adults; general group muscle-size-strength), found no HDL change (WMD -0.78 mg/dL, p = 0.22). Show No effect.
• High-density lipoprotein (HDL) (General Athletic Performance): Result none shown → No effect.Why: Page shows Improves (HDL up) but its only study, a meta-analysis of 10 RCTs (421 adults; general group General Athletic Performance), found no HDL change (WMD -0.78 mg/dL, p = 0.22). Show No effect.
• High-density lipoprotein (HDL) (Metabolic Health): Result none shown → No effect.Why: Page shows Improves (HDL up) but its only study, a meta-analysis of 10 RCTs (421 adults; general group Metabolic Health), found no HDL change (WMD -0.78 mg/dL, p = 0.22). Show No effect.
• High-density lipoprotein (HDL) (Martial Arts Performance): Result none shown → No effect.Why: Page shows Improves (HDL up) but its only study, a meta-analysis of 10 RCTs (421 adults; general group Martial Arts Performance), found no HDL change (WMD -0.78 mg/dL, p = 0.22). Show No effect.
• High-density lipoprotein (HDL) (Muscle Size & Strength): Result none shown → No effect.Why: Page shows Improves (HDL up) but its only study, a meta-analysis of 10 RCTs (421 adults; general group Muscle Size & Strength), found no HDL change (WMD -0.78 mg/dL, p = 0.22). Show No effect.
• Low-density lipoprotein (LDL): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (LDL down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant LDL-C change (WMD 0.13 mg/dL, p = 0.94). General group, passes C5. Show No effect.
• Low-density lipoprotein (LDL) (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (LDL down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant LDL-C change (WMD 0.13 mg/dL, p = 0.94). General group, passes C5. Show No effect.
• Low-density lipoprotein (LDL) (Body Composition): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (LDL down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant LDL-C change (WMD 0.13 mg/dL, p = 0.94). General group, passes C5. Show No effect.
• Low-density lipoprotein (LDL) (Metabolic Health): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (LDL down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant LDL-C change (WMD 0.13 mg/dL, p = 0.94). General group, passes C5. Show No effect.
• Low-density lipoprotein (LDL) (Martial Arts Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (LDL down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant LDL-C change (WMD 0.13 mg/dL, p = 0.94). General group, passes C5. Show No effect.
• Low-density lipoprotein (LDL) (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Ungraded row shows "Changes; see studies" (stored increase) for LDL with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant LDL-C change (WMD 0.13 mg/dL, p = 0.94). General group, passes C5. Show No effect.
• Muscle Damage: Result none shown → Improvement.Why: Row stores muscle damage going UP ('Changes; see studies') under muscle-size-strength (a general group). The linked meta-analysis of RCTs (29676656) found HMB LOWERED the damage markers CK (WMD -60.71 U/L) and LDH (WMD -15.42 U/L). Set Improvement, direction decrease; no size word (no…
• Muscle Damage (General Athletic Performance): Result none shown → Improvement.Why: Row stores muscle damage going UP ('Changes; see studies') under General Athletic Performance (a general group). The linked meta-analysis of RCTs (29676656) found HMB LOWERED the damage markers CK (WMD -60.71 U/L) and LDH (WMD -15.42 U/L). Set Improvement, direction decrease; no size word (no…
• Muscle Damage (Muscle Recovery): Result none shown → Improvement.Why: Row stores muscle damage going UP ('Changes; see studies') under Muscle Recovery (a general group). The linked meta-analysis of RCTs (29676656) found HMB LOWERED the damage markers CK (WMD -60.71 U/L) and LDH (WMD -15.42 U/L). Set Improvement, direction decrease; no size word (no standardised…
• Muscle Damage (Football Performance): Result none shown → Improvement.Why: Row stores muscle damage going UP ('Changes; see studies') under Football Performance (a general group). The linked meta-analysis of RCTs (29676656) found HMB LOWERED the damage markers CK (WMD -60.71 U/L) and LDH (WMD -15.42 U/L). Set Improvement, direction decrease; no size word (no…
• Muscle Damage (Weight Loss & Maintenance): Result none shown → Improvement.Why: Row stores muscle damage going UP ('Changes; see studies') under Weight Loss & Maintenance (a general group). The linked meta-analysis of RCTs (29676656) found HMB LOWERED the damage markers CK (WMD -60.71 U/L) and LDH (WMD -15.42 U/L). Set Improvement, direction decrease; no size word (no…
• Muscle Damage (Muscle Size & Strength): Result none shown → Improvement.Why: Row stores muscle damage going UP ('Changes; see studies') under Muscle Size & Strength (a general group). The linked meta-analysis of RCTs (29676656) found HMB LOWERED the damage markers CK (WMD -60.71 U/L) and LDH (WMD -15.42 U/L). Set Improvement, direction decrease; no size word (no…
• Muscle Mass (Martial Arts Performance): Result none shown → Mixed effect.Why: Ungraded row shows Improves (muscle mass up) as a clean finding. The meta-analyses split by population: two in older adults (40248035, 33034021) find more lean/muscle mass, two in young trainees and athletes (32456217, 29249685) find none, and 3 of 4 trials in trained or older people found no…
• Total cholesterol: Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (cholesterol down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant total cholesterol change (WMD -2.26 mg/dL, p = 0.25). General group, passes C5. Show No effect.
• Total cholesterol (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (cholesterol down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant total cholesterol change (WMD -2.26 mg/dL, p = 0.25). General group, passes C5. Show No effect.
• Total cholesterol (Metabolic Health): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (cholesterol down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant total cholesterol change (WMD -2.26 mg/dL, p = 0.25). General group, passes C5. Show No effect.
• Total cholesterol (Martial Arts Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (cholesterol down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant total cholesterol change (WMD -2.26 mg/dL, p = 0.25). General group, passes C5. Show No effect.
• Total cholesterol (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Ungraded row shows "Changes; see studies" (stored increase) for total cholesterol with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant total cholesterol change (WMD -2.26 mg/dL, p = 0.25). General group, passes C5. Show No effect.
• Triglycerides (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (triglycerides down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant triglyceride change (WMD -2.83 mg/dL, p = 0.58). General group, passes C5. Show No effect.
• Triglycerides (Metabolic Health): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (triglycerides down) with no linked study. Flagged meta-analysis of 10 RCTs in 421 adults (39385778): no significant triglyceride change (WMD -2.83 mg/dL, p = 0.58). General group, passes C5. Show No effect.
• Triglycerides (Martial Arts Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (triglycerides down) with no linked study. Added the flagged meta-analysis 39385778 (10 RCTs, 421 adults): HMB did not change TG (p = 0.58). Martial Arts Performance is a general group, so any adult population fits. No effect; ceiling A, row stays ungraded.

HMB: the page as it is now

• No human study left after the re-check, so no grade: Neuroprotection (Neurological Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Humanin: the page as it is now

• Cognitive Function: Size moderate → not stated. 3 studies added.Why: Graded C row with no linked study (would lose its grade): re-cited from one search. The 2014 meta-analysis (24639880, 2 VaD trials, 92 people) and a 78-patient placebo RCT (21833673) found MMSE/ADL improved in vascular dementia; the older Cochrane review (one 14-person trial) found no significant…
• Cognitive Function (200 mcg BID) (Alzheimer’s Disease): Effect note rewritten from its studies; Size small → not stated. 1 study added.Why: Graded D row for the 200 mcg BID dose shows Improves (small) with no linked study, while its own note says no effect. Added the flagged phase II RCT 21502597 (210 AD patients): 200 μg BID did not change ADAS-Cog vs placebo ('no demonstrable cognitive effect'). No effect, size cleared. One RCT…

Huperzine A: the page as it is now

• No human study left after the re-check, so no grade: Dermatitis Severity (Dermatitis), Dermatitis Severity (Radiation Therapy Side-Effects). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Hyaluronic Acid: the page as it is now

• Cognitive Function in Dementia: Effect note rewritten from its studies; Size small → not stated. 3 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement); 3 studies added.Why: Grade C row shows Improves (small) on four links, none about cognition in dementia (cell culture, a CoQ10 review, pharmacokinetics): all removed. Re-cited (1 PubMed search plus the flagged trial): the largest RCT (536 AD patients) found no significant difference on its prespecified…

Idebenone: the page as it is now

• Anxiety Symptoms (Panic Disorder): Result Small Improvement → Improvement; Grade B → C; Size small → not stated; Form studied not stated → inositol (myo-inositol) 12-18 g/day by mouth for 4 weeks to 1 month. 1 study removed (studied a different group of people).Why: Literature checked. Only two panic-disorder trials exist, both tiny 4-week crossovers from one Israeli group: inositol 12 g/day beat placebo on panic frequency, severity and agoraphobia (7793450, 21 people), and up to 18 g/day matched fluvoxamine (11386498, 20 people, no placebo). The 2014 anxiety-disorder meta-analysis (pooling OCD, panic and PTSD) found no significant effect and the 2022 WFSBP/CANMAT guideline does not support any nutraceutical except NAC in anxiety-related disorders. Removed the bulimia trial (wrong population). Improvement kept, 'Small' cleared (no abstract gives a size basis), grade B -> C as the lead asked. People 41 = 21 + 20, matching the two remaining trials, kept. The product form and dose pattern the supporting trials used
• Anxiety Symptoms (Agoraphobia): Result Small Improvement → Improvement; Size small → not stated. 1 study removed (did not measure this outcome).Why: A placebo-controlled crossover found agoraphobia severity fell more with inositol, and an active-comparator trial found anxiety and agoraphobia improvements similar to fluvoxamine; the bulimia trial has no anxiety outcome: removed. Improves holds; no effect size in the abstracts: size cleared…
• Anxiety Symptoms (Obsessive-Compulsive disorder (OCD)): Result Small Improvement → No effect; Size small → not stated. 1 study removed (did not measure this outcome); 2 studies removed (studied a different group of people); 1 study added.Why: Graded C row shows Improves (Small Improvement) for anxiety in OCD. None of the 3 linked trials is in OCD (bulimia, panic x2: removed). Re-cited the inositol meta-analysis whose anxiety-disorder trials include two OCD trials: no significant effect on anxiety or obsessive-compulsive symptoms.…
• No human study left after the re-check, so no grade: Anxiety Symptoms (Binge Eating Disorder). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Inositol: the page as it is now

• Ghrelin (Obesity): Result none shown → Decrease. 1 study added.Why: Ungraded row under Obesity with no study shows Improves with an up arrow (ghrelin up). Flagged meta-analysis 31504857 (read; overweight/obese adults) found inulin-type fructans LOWERED ghrelin (-37.17 pg/mL). Added: Decrease; ceiling A, stays ungraded.
• Ghrelin (Overweight): Result none shown → Decrease. 1 study added.Why: Ungraded row shows Improves with ghrelin going UP and no study. The flagged meta-analysis 31504857 (RCTs in overweight/obese adults) found ghrelin went DOWN (-37.17 pg/mL) with inulin-type fructans. Added it; direction set to decrease. No size basis. Ceiling A; row stays ungraded.
• Insulin (Type 2 Diabetes): Result none shown → Decrease. 2 studies added.Why: Ungraded row under Type 2 Diabetes with no study shows 'Changes; see studies' with stored increase. Both flagged meta-analyses (read) found inulin-type fructans LOWER fasting insulin in T2DM (31805963: WMD -1.75 uU/ml with prediabetes; 27623982: MD -4.01). Added: Decrease; ceiling A, stays…
• Insulin (Prediabetes): Result none shown → Decrease. 1 study added.Why: Ungraded row under Prediabetes with no study shows 'Changes; see studies' with stored increase. Flagged meta-analysis 31805963 (read; 33 RCTs): in the prediabetes and T2DM population inulin-type fructans lowered fasting insulin (WMD -1.75 uU/ml). Added: Decrease; ceiling A, stays ungraded.
• Liver Fat (Weight Loss & Maintenance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (liver fat down) with no study. Flagged RCT 40172664 (inulin 16 g/d vs placebo with weight-loss counseling, 24 weeks; Weight Loss & Maintenance is a general goal, population fits): intrahepatic fat change did not differ. Show No effect; one RCT: ceiling C, stays…
• Total cholesterol (Type 2 Diabetes): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (total cholesterol down) with no study. Flagged meta-analysis 27623982 (populations include Type 2 Diabetes) found inulin-type fructans lowered only LDL 'without affecting the other endpoints' of the lipid profile. The 55-RCT meta-analysis 38309832 agrees (little to…
• Total cholesterol (Dyslipidemia): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (total cholesterol down) with no study. Flagged meta-analysis 27623982 (populations include Dyslipidemia) found inulin-type fructans lowered only LDL 'without affecting the other endpoints' of the lipid profile. The 55-RCT meta-analysis 38309832 agrees (little to no…

Inulin: the page as it is now

• Serum T3 (Thyroid Health): Result Small Decrease → No effect; Size small → not stated.Why: Graded C row shows Improves (Small Decrease in T3), but its only study found no change in serum T3 at any dose: No effect, size cleared. C = ceiling, kept.
• Thyroid-Stimulating Hormone (Thyroid Health): Result none shown → Mixed effect. 1 study removed (did not measure this outcome).Why: Ungraded row shows Improves (TSH up). The RCT found no TSH difference at 75-150 ug/day; the volunteer study found TSH rose only at 1500 ug/day as a compensatory sign of suppressed thyroid hormone, not an improvement: Mixed effect. The GDM cohort does not report TSH by supplement use: removed.

Iodine: the page as it is now

• Gastric Motility (Digestive Health): Effect note rewritten from its studies; Size moderate → not stated. 2 studies removed (not a study of this supplement).Why: Page shows Improves (moderate) although its own note says human trials found no difference. The only human trial (25331030, RCT, 114 patients) found no significant difference vs placebo in time to tolerate a meal (p = 0.15) or any secondary endpoint; benefit is in rats only. Now No effect…
• No human study left after the re-check, so no grade: Bone Mineral Content (Bone Health), Glucocorticoid-Induced Bone Loss (Bone Health), Longitudinal Bone Growth (Bone Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Ipamorelin: the page as it is now

• "Measures of Intelligence " (Focus & Attention): Form studied not stated → oral iron given daily to school-age children and adolescents (mostly low/middle-income settings); the IQ gain is in anaemic or iron-deficient children, little or none in iron-replete ones. 5 studies added.Why: The product form and dose pattern the supporting trials used
• "Measures of Intelligence " (Memory Improvement): Form studied not stated → oral iron given daily to school-age children and adolescents (mostly low/middle-income settings); the IQ gain is in anaemic or iron-deficient children, little or none in iron-replete ones. 5 studies added.Why: The product form and dose pattern the supporting trials used
• "Measures of Intelligence " (Cognitive Improvement): Form studied not stated → oral iron given daily to school-age children and adolescents (mostly low/middle-income settings); the IQ gain is in anaemic or iron-deficient children, little or none in iron-replete ones. 5 studies added.Why: The product form and dose pattern the supporting trials used
• Anemia Risk (Metabolic Health): Result Small Improvement → Large Improvement; Size small → large; Form studied not stated → oral iron taken daily (pregnancy trials mostly 30-60 mg elemental iron/day from the first half of pregnancy to delivery; menstruating women and school-age children for weeks to months). 4 studies added.Why: Re-derived from the literature (data gap). Two Cochrane reviews and two further meta-analyses agree daily oral iron cuts anaemia: pregnancy RR 0.30 (39145520), non-anaemic pregnancy RR 0.50 and "a large reduction" (39834271), menstruating women RR 0.39 (27087396), school-age children -50% (24130243). Metabolic Health is a general condition, so any population counts. The stored direction "increase" is wrong for a risk that falls: direction set to decrease. Size raised from small to large on the 39834271 wording and RR 0.30-0.50. Ceiling A; stored B kept (under-graded). The product form and dose pattern the supporting trials used
• Anxiety Symptoms (Fatigue): Result Small Improvement → No effect; Size small → not stated.Why: Graded C row shows Improves (Small Improvement) for anxiety; its only trial found no effect of iron on anxiety (p=0.5). No effect, size cleared, C kept.
• Ferritin (Pregnancy and Delivery Health): Form studied not stated → oral iron 30-60 mg elemental iron daily from the first half of pregnancy (<=27 weeks) to delivery; 60 mg/day raised ferritin more than 30 mg/day (39343168). 2 studies added.Why: The product form and dose pattern the supporting trials used
• Short-Term Memory (Simple) (Memory Improvement): Result none shown → Mixed effect. 4 studies added.Why: Literature checked (memory improvement is a general goal: any population). Four meta-analyses of oral iron disagree: no effect on short-term memory in 1196 children and adolescents (36558491, the source of the row's people figure) and no effect on memory in 2010 (20100340), but memory gains in…
• No human study left after the re-check, so no grade: Fibromyalgia Symptoms (Fibromyalgia). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Iron: the page as it is now

• Heart Rate (Mood Improvement): Result none shown → No effect.Why: Ungraded row shows Improves (heart rate down). Its only study, a 3-month placebo-controlled safety trial of kanna extract, found no differences in vital signs (which include heart rate) or ECG. Show No effect; one RCT: ceiling C, stays ungraded.

Kanna: the page as it is now

• Aggression (Generalized Anxiety Disorder (GAD)): Result Small Improvement → Mixed effect; Size small → not stated. 3 studies added.Why: Graded C row with no linked study shows Improves for aggression under GAD. The only human data found (1 PubMed search) are kava WS 1490 RCTs in anxiety patients that report the Erlangen Anxiety, Tension and Aggression Scale: the largest (141, includes GAD) found only minor differences…
• Anxiety Symptoms: Result Moderate Improvement → Small Improvement; Grade A → B; Size moderate → small; People studied 380 → not stated; Form studied not stated → standardized kava root extract by mouth: WS 1490 150-300 mg/day for 4 weeks, or aqueous root extract with 120-250 mg kavalactones/day for 3-16 weeks; liver injury has been reported (overdose, long use, co-medication and poor raw material: 20720265) and liver-test abnormalities were more frequent on kava in the 16-week trial, so avoid with liver disease, alcohol or other liver-toxic drugs and keep courses short. 2 studies added.Why: Literature checked. Older meta-analyses (Cochrane 12535473; 10653213) and the 2022 network MA (35378276: HAMA MD -2.46 overall) favour kava for anxiety, but in generalized anxiety disorder the largest and longest RCT (31813230, 171 people, 16 weeks) found no benefit, the GAD review (29641222) found no significant pooled effect and the network MA calls kava possibly ineffective in GAD. Benefit holds overall but is small and inconsistent: 'Moderate' -> Small Improvement (HAMA -2.46), grade A -> B. People 380 cleared (study list changed). The product form and dose pattern the supporting trials used
• Anxiety Symptoms (Stress): Result Moderate Improvement → Small Improvement; Grade A → C; Size moderate → small; People studied 198 → not stated; Form studied not stated → standardized kava root extract by mouth: WS 1490 150-300 mg/day for 4 weeks, or aqueous root extract with 120-250 mg kavalactones/day for 3-16 weeks; liver injury has been reported (overdose, long use, co-medication and poor raw material: 20720265) and liver-test abnormalities were more frequent on kava in the 16-week trial, so avoid with liver disease, alcohol or other liver-toxic drugs and keep courses short. 2 studies added.Why: Literature checked. Older meta-analyses (Cochrane 12535473; 10653213) and the 2022 network MA (35378276: HAMA MD -2.46 overall) favour kava for anxiety, but in generalized anxiety disorder the largest and longest RCT (31813230, 171 people, 16 weeks) found no benefit, the GAD review (29641222) found no significant pooled effect and the network MA calls kava possibly ineffective in GAD. Benefit holds overall but is small and inconsistent: 'Moderate' -> Small Improvement (HAMA -2.46), grade A -> C. Population: no kava trial in stressed but otherwise healthy people was found; the trials are in anxiety disorders or anxiety/tension states, so grade one level lower for indirectness (B -> C). People 198 cleared (study list changed). The product form and dose pattern the supporting trials used
• Anxiety Symptoms (Anxiety Disorders (Other)): Result Moderate Improvement → Small Improvement; Grade A → B; Size moderate → small; People studied 380 → not stated; Form studied not stated → standardized kava root extract by mouth: WS 1490 150-300 mg/day for 4 weeks, or aqueous root extract with 120-250 mg kavalactones/day for 3-16 weeks; liver injury has been reported (overdose, long use, co-medication and poor raw material: 20720265) and liver-test abnormalities were more frequent on kava in the 16-week trial, so avoid with liver disease, alcohol or other liver-toxic drugs and keep courses short. 2 studies added.Why: Literature checked. Older meta-analyses (Cochrane 12535473; 10653213) and the 2022 network MA (35378276: HAMA MD -2.46 overall) favour kava for anxiety, but in generalized anxiety disorder the largest and longest RCT (31813230, 171 people, 16 weeks) found no benefit, the GAD review (29641222) found no significant pooled effect and the network MA calls kava possibly ineffective in GAD. Benefit holds overall but is small and inconsistent: 'Moderate' -> Small Improvement (HAMA -2.46), grade A -> B. Stored direction 'increase' corrected to decrease. People 380 cleared (study list changed). The product form and dose pattern the supporting trials used

Kava: the page as it is now

• C-Reactive Protein (CRP) (Osteoarthritis (OA)). 2 studies removed (did not measure this outcome); 1 study added.
• C-Reactive Protein (CRP) (Rheumatoid Arthritis (RA)): Result none shown → Decrease. 2 studies removed (did not measure this outcome); 1 study added.Why: Literature checked. Neither linked study reports CRP (healthy-volunteer trial with unnamed inflammation markers; knee-OA pain trial): removed. The only human RCT that includes rheumatoid arthritis patients (17353582, 300 mg/day, 30 days) found CRP fell about 31% vs a rise on placebo. Improves…
• C-Reactive Protein (CRP) (Cardiovascular Disease). 2 studies removed (did not measure this outcome); 1 study added.
• C-Reactive Protein (CRP): Result none shown → Mixed effect. 2 studies removed (did not measure this outcome); 3 studies added.Why: Literature checked (general cardiovascular health: any population). Neither linked study reports CRP: removed. Placebo-controlled trials disagree: CRP fell about 31% with 300 mg/day in people with raised CRP (17353582) but did not change with 4 g/day over 6 months in healthy older adults…
• C-Reactive Protein (CRP) (Metabolic Health): Result none shown → Mixed effect. 2 studies removed (did not measure this outcome); 3 studies added.Why: Literature checked (metabolic health: any population). Neither linked study reports CRP: removed. Placebo-controlled trials disagree: CRP fell about 31% with 300 mg/day in people with raised CRP (17353582) but did not change with 4 g/day over 6 months in healthy older adults (35504165); a…

Krill Oil: the page as it is now

• Adiponectin (Type 2 Diabetes): Result Small Increase → Increase; Grade B → C; Size small → not stated. 1 study added.Why: No linked study. Type 2 Diabetes group. Re-cited RCT 20423740 (254 type 2 diabetics, 12 months): adiponectin improved more with L-carnitine added to sibutramine than with sibutramine alone. Increase holds. No size given: 'Small' cleared, note 'Increase'. The companion orlistat trial's abstract is…
• Ammonia (Hepatic Encephalopathy): Grade A → C; Form studied not stated → oral L-carnitine 2 g twice daily for 60-90 days, or 6 g/day for 4 weeks (or oral acetyl-L-carnitine), added to standard care in people with cirrhosis and hepatic encephalopathy. 1 study removed (studied a different group of people); 1 study removed (not a study of this supplement); 2 studies added.Why: Our auditor agreed in substance. Literature checked: three meta-analyses agree that carnitine lowers blood ammonia in cirrhotic hepatic encephalopathy (Cochrane 30610762, ALC, 5 RCTs; 31254469, L-carnitine, 9 RCTs/779; 24018499, oral ALC, 7 RCTs/660), and the linked RCTs agree (16437672: 4 g/day vs placebo; 23315430: 6 g/day vs no treatment, a second team). Direction and "Moderate" kept (23315430: 60 vs 1.4 umol/L fall, 14 of 16 normalised). But Cochrane rates every trial at high risk of bias and the evidence very low quality, with the ALC trials from one team: that is "studies with clear weaknesses" (published grade C), not "good human studies" (B) or "well-run trials" (A). Grade A -> C. The two meta-analyses are added so the row shows the full evidence base. The C9 count alone would allow A; C is a quality judgement. Hepatic encephalopathy is treated under medical care: no buy link on this row. The product form and dose pattern the supporting trials used
• Anaerobic Capacity: Result Small Improvement → Improvement; Size small → not stated. 2 studies added.Why: No linked study. Muscle size and strength is a general goal group. Re-cited systematic review 34959912 (11 placebo-controlled trials: oral L-carnitine improved high-intensity performance such as Wingate power, not moderate-intensity) and RCT 30661327 (resistance-trained men: mean and peak…
• Anxiety Symptoms (Dysthymia): Result Small Improvement → Improvement; Size small → not stated. 1 study added.Why: No linked study. Dysthymia group. Re-cited RCT 23428336 (80 elderly dysthymic patients, the stored people figure): with acetyl-L-carnitine HAM-A anxiety scores improved significantly, equivalent to fluoxetine. Improves holds, but there is no placebo arm and no figures, so 'Small' has no basis…
• Apolipoprotein A (Dyslipidemia). 1 study added.
• Apolipoprotein A (Coronary Artery Disease (CAD)): Result No effect → Increase; Size none → not stated. 1 study added.Why: Direction error: the page shows 'No effect' for apolipoprotein A in CAD, but the only CAD trial (RCT 27317162, 47 patients, the stored people figure) found Apo-A1 significantly higher with L-carnitine than placebo after 12 weeks (P = 0.02). Now 'Increase' (no size word: about 10%, no size basis).…
• Asthma Symptoms (Asthma): Result Small Improvement → Improvement; Size small → not stated.Why: Asthma group. The one link, a 6-month randomised placebo-controlled study in 50 children with moderate persistent asthma, found the childhood asthma control test (C-ACT) and lung function improved significantly with L-carnitine. Improves holds, but the abstract gives no figures, so 'Small' has no…
• C-Reactive Protein (CRP) (Osteoarthritis (OA)): Result Moderate Decrease → No effect; Size moderate → not stated. 1 study removed (not a study of this supplement); 2 studies added.Why: Page shows Improves (Moderate Decrease) for CRP in osteoarthritis. The only link (25424121) gave intravenous L-carnitine to metabolic-syndrome patients during fasting and reports no CRP result: wrong route and population, removed. Both OA trials found no CRP change: the 72-woman placebo RCT…
• No human study left after the re-check, so no grade: Anxiety Symptoms (Migraine Headache), Benign Prostatic Hyperplasia Symptoms (Male Sexual Dysfunction), Blood glucose (Hypothyroidism), Bone Mineral Density (Hashimoto's disease), Cortisol (Major Depressive Disorder (MDD)), Intermittent Claudication Symptoms (Intermittent Claudication). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

L-Carnitine: the page as it is now

• No human study left after the re-check, so no grade: Heart Rate (Parkinson's Disease). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

L-Tyrosine: the page as it is now

• Abdominal Pain (Lactose Intolerance). 3 studies added.
• Bloating (Lactose Intolerance): Result Moderate Improvement → Mixed effect; Grade A → B; Size moderate → not stated. 2 studies added.Why: Grade A 'Moderate Improvement' rested on no linked study (our auditor: about 66 people in small single-serving crossovers). The only abstracts that report bloating itself: one of three lactase products reduced bloating (8147360, 10 people) and no product changed bloating with a 50 g lactose load…
• Breath Hydrogen (Lactose Intolerance): Result none shown → Improvement.Why: Arrow error: the row shows Improves with the measure going UP, but every controlled trial found lactase LOWERS breath hydrogen (less undigested lactose): 82%, 62% and larger reductions vs placebo or intact milk; one uncontrolled study found a variable response. Benefit is right, direction is down…
• Diarrhea Symptoms (Lactose Intolerance). 3 studies added.
• Flatulence (Lactose Intolerance): Result none shown → Improvement. 3 studies removed (did not measure this outcome).Why: The only abstract that reports flatulence itself (25042846) found high-dose lactase significantly reduced it vs placebo. The other three report symptoms only as a total: removed. The row showed the neutral 'Changes; see studies' because Flatulence has no polarity rule; 'Improvement' with direction…
• Lactose Intolerance Symptoms (Lactose Intolerance). 3 studies added.
• Nausea Symptoms (Lactose Intolerance): Result none shown → No effect. 1 study added.Why: Direction error: the row shows Improves (down) with no linked study. The only lactase trial abstract that reports nausea itself (8223076) found nausea scores no different from control (50 g lactose; at 20 g only total symptoms were reported, and fell). 'No effect'. One RCT: ceiling C; stays…
• No human study left after the re-check, so no grade: Headaches (Lactose Intolerance), Heartburn Symptoms (Lactose Intolerance), Stool Consistency (Lactose Intolerance). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Lactase Enzyme: the page as it is now

• Stress Signs and Symptoms (Stress): Result No effect → Mixed effect; Size none → not stated. 3 studies added.Why: Graded D, 'No effect', with no linked study. Re-cited three RCTs of laughter yoga on perceived stress: two (83 nursing students, 63 ICU nurses) found no difference vs control, one (101 nurses) reports a reduction. A clean No effect understates the conflict: show Mixed effect (stored direction…

Laughter Yoga: the page as it is now

• Anxiety Symptoms (Generalized Anxiety Disorder (GAD)). 3 studies removed (not a study of this supplement).
• Anxiety Symptoms (Stress): Result Moderate Improvement → Improvement; Size moderate → not stated; Form studied not stated → oral Silexan lavender oil, 80 mg a day for about 10 weeks (inhaled lavender is not this evidence). 3 studies removed (not a study of this supplement); 1 study removed (studied a different group of people); 1 study added.Why: Our auditor / oral lavender only. The inhaled scent/aromatherapy studies (31743795, 16095639, 19968674) are removed; 19962288 is a GAD trial, not a stress population: removed. Oral Silexan in subthreshold anxiety (restlessness, agitation, mixed… The form and dose the supporting trials used.
• Anxiety Symptoms (Anxiety Disorders (Other)): Result Moderate Improvement → Improvement; Size moderate → not stated; Form studied not stated → oral Silexan lavender oil, 80 mg a day for about 10 weeks (inhaled lavender is not this evidence). 3 studies removed (not a study of this supplement); 2 studies added.Why: Our auditor / oral lavender only. Three of the four linked studies are inhaled scent or aromatherapy (31743795, 16095639, 19968674): removed. Oral Silexan in anxiety disorders: the 5-RCT meta-analysis 36717399 (n=1213) and the placebo- and paroxetine-controlled GAD… The form and dose the supporting trials used.

Lavender: the page as it is now

• Anxiety Symptoms (Stress): Result Large Improvement → Moderate Improvement; Grade B → C; Size large → moderate; Form studied not stated → oral lemon balm (Melissa officinalis) leaf extract: 300-600 mg single doses in acute studies, 400 mg/day for 3 weeks in distressed adults; pooled trials are few and highly heterogeneous. 1 study removed (not a study of this supplement); 1 study added.Why: Applied. Literature checked: the only meta-analysis (34449930, clinical trials in people with anxiety or depressive symptoms) found anxiety SMD -0.98 (95% CI -1.63 to -0.33) with high heterogeneity, few trials and mostly acute effects; RCT 37927585 (100 distressed adults, 400 mg/day for 3 weeks) reported improved anxiety and stress. Removed the four-herb lozenge EEG study 15546807 (C3/C4). "Large" overstates a heterogeneous estimate whose interval reaches -0.33: Moderate Improvement. Grade B -> C: limited, heterogeneous evidence (rubric C; a mechanical C9 reading of one MA with inconsistent results would allow B). People cleared (study list changed). The product form and dose pattern the supporting trials used
• PMS Symptoms (Premenstrual Syndrome (PMS)): Result Moderate Improvement → Improvement; Grade A → C; Size moderate → not stated; People studied 493 → not stated; Form studied not stated → lemon balm (Melissa officinalis) capsules 1,200 mg/day (two 600 mg) from the first to the last day of the menstrual cycle for 3 cycles, studied only in Iranian high-school girls. 1 study removed (did not measure this outcome).Why: Literature checked: no meta-analysis or Cochrane review of lemon balm for PMS exists. The evidence is one 100-girl placebo trial (26339667) that found lower PMS scores; the second linked paper (29369810) reports general mental-health scores, apparently from the same trial, and is removed (outcome). One small trial = C, not A. 'Moderate' has no basis (between-group difference not given) and is cleared; people 493 overstates the 100 girls studied and is cleared. The product form and dose pattern the supporting trials used

Lemon Balm: the page as it is now

• Safety/Tolerability: Effect note rewritten from its studies; Form studied not stated → injected leuprolide acetate: 3.75 mg depot monthly (adults with endometriosis) or 45 mg subcutaneously every 6 months (children with central precocious puberty). 1 study removed (studied a different group of people); 1 study added.Why: Our auditor agreed that "Improves" is unsupported. Literature checked: the controlled trial (8333471) found side effects in most patients on leuprolide or danazol, few dropouts, no serious complications, and more bone loss with leuprolide; the 2026 MA 41855532 confirms BMD loss on leuprolide even with add-back; the Cochrane GnRH-analogue review 37341141 finds more hot flushes and slightly more adverse effects than placebo. Children with CPP had only mild AEs (32738042). So tolerability is mixed: usable with few discontinuations but hypoestrogenic side effects and bone loss are expected. Label "Mixed effect: bone density falls" (standard-label prefix kept, 32 characters), direction none. Removed the dog toxicity study (not human). The template note is replaced. D kept; MA plus RCT allow B (under-graded). The product form and dose pattern the supporting trials used

Leuprolide (Lupron): the page as it is now

• Cortisol (Hormone Health): Result Small Increase → Increase; Size small → not stated. 1 study removed (did not measure this outcome).Why: Page shows Improves with a down arrow (cortisol falls) while its note says 'Small Increase'. No study shows a fall: 21184804 reports the salivary cortisol pattern of 11beta-HSD2 blockade (cortisol raised relative to cortisone), which is the mechanism of licorice's mineralocorticoid harm. Show…
• Luteinizing Hormone (Hormone Health): Result none shown → Mixed effect. 1 study added.Why: Ungraded row shows Improves (LH up) as a clean finding. Its only study (15579328, women) found LH unchanged; the flagged men's study 14520600 (read) found LH rose while testosterone fell. Two small uncontrolled studies disagree: Mixed effect, not a clean benefit. Ceiling C; stays ungraded.
• Testosterone (Hormone Health): Result none shown → Decrease. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves with an up arrow. No study shows a rise: 14520600 (men, -26%), 10515764 (title: reduction in men) and the added 15579328 (women) report LOWER testosterone; one letter (11716893) could not replicate the fall in salivary testosterone. Show Decrease (no size word given…
• Testosterone (Sexual Health): Result none shown → Mixed effect. 1 study removed (did not measure this outcome).Why: Ungraded row shows Improves (testosterone up). No study shows a rise: two reports found serum testosterone fell (14520600, 10515764) and a replication found no change (11716893), so Mixed effect. 16513152 does not measure testosterone: removed.

Licorice: the page as it is now

• No human study left after the re-check, so no grade: Autism Spectrum Disorder Symptoms (Neurological Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Luteolin: the page as it is now

• Testosterone (Sexual Health): Result none shown → No effect.Why: Ungraded row shows Improves (testosterone up); its only study, a placebo RCT, found no testosterone difference: No effect.
• No human study left after the re-check, so no grade: Estrogen (Infertility), Estrogen (Male Sexual Dysfunction). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Maca: the page as it is now

• GH Deficiency Diagnosis (Growth Hormone Deficiency): Effect note rewritten from its studies; Grade A → B; Size large → not stated. 6 studies removed (not a study of this supplement); 2 studies removed (did not measure this outcome).Why: Improves holds: the phase 3 crossover trial (29860473, with its post hoc 33320108) and the 2013 comparator-controlled validation (23559086) found accuracy comparable to ITT or arginine+GHRH. That is two distinct controlled trials, so A lowers to B. The note labels 82%/92% as phase 3 figures (they…

Macimorelin (Macrilen): the page as it is now

• Acne Symptoms (Polycystic Ovary Syndrome (PCOS)). 1 study added.
• Aerobic Exercise Metrics (General Athletic Performance): Result Moderate Improvement → Mixed effect; Size moderate → not stated. 3 studies added.Why: Direction error: no linked study and the page shows Improves (Moderate) for aerobic exercise metrics under General Athletic Performance (a performance group, any population). The stored 23 people are the triathlete RCT 9794094, which reports faster swim/cycle/run times without significance…
• Aerobic Exercise Metrics (Aerobic Exercise Performance): Result Moderate Improvement → Mixed effect; Size moderate → not stated. 3 studies added.Why: Direction error: no linked study and the page shows Improves (Moderate) for aerobic exercise metrics under Aerobic Exercise Performance (a performance group, any population). The stored 23 people are the triathlete RCT 9794094, which reports faster swim/cycle/run times without significance…
• Aerobic Exercise Metrics (Cycling Performance): Result Moderate Improvement → Mixed effect; Size moderate → not stated. 3 studies added.Why: Direction error: no linked study and the page shows Improves (Moderate) for aerobic exercise metrics under Cycling Performance (a performance group, any population). The stored 23 people are the triathlete RCT 9794094, which reports faster swim/cycle/run times without significance and…
• Aerobic Exercise Metrics (Running Performance): Result Moderate Improvement → Mixed effect; Size moderate → not stated. 3 studies added.Why: Direction error: no linked study and the page shows Improves (Moderate) for aerobic exercise metrics under Running Performance (a performance group, any population). The stored 23 people are the triathlete RCT 9794094, which reports faster swim/cycle/run times without significance and…
• Aerobic Exercise Metrics (Swimming Performance): Result Moderate Improvement → Mixed effect; Size moderate → not stated. 3 studies added.Why: Direction error: no linked study and the page shows Improves (Moderate) for aerobic exercise metrics under Swimming Performance (a performance group, any population). The stored 23 people are the triathlete RCT 9794094, which reports faster swim/cycle/run times without significance and…
• Anxiety Symptoms (Premenstrual Syndrome (PMS)): Result Small Improvement → No effect; Size small → not stated. 2 studies added.Why: Direction error: the page shows Improves (Small) for anxiety symptoms in PMS with no linked study. The two placebo-controlled crossover RCTs that measured PMS anxiety symptoms with magnesium alone (10746516, 44 women; 9861593, 38 women) found no effect; only the Mg + vitamin B6 combination…
• Arterial Stiffness (Cardiovascular Disease): Result No effect → Improvement; Size none → not stated. 1 study added.Why: Direction error: no linked study and the page shows 'No effect'. The only trial measuring arterial stiffness/compliance in people with established cardiovascular disease, the RCT 16470086 (22 heart-failure patients, MgO 800 mg/day for 3 months), found small-artery compliance improved vs placebo.…
• Asthma Symptoms (Asthma): Result Small Improvement → Mixed effect; Size small → not stated.Why: All four RCTs study asthma patients. Three small trials (37 and 89 children, 55 adults) report fewer exacerbations, less reliever use or better asthma-control scores, but the largest and only multicentre trial (14519140, 300 adults, 16 weeks) found no benefit on any measure, including symptom…
• Blood glucose (Type 2 Diabetes). 6 studies removed (did not measure this outcome); 5 studies removed (studied a different group of people).
• Blood glucose (Metabolic Health). 6 studies removed (did not measure this outcome).
• Blood glucose (High Blood Pressure): Result Small Improvement → No effect; Grade B → C; Size small → not stated. 11 studies removed (studied a different group of people); 6 studies removed (did not measure this outcome); 1 study added.Why: Direction error: the page shows Improves (Small) for blood glucose under High Blood Pressure, but none of the 17 linked studies is a hypertensive population with a glucose result (the one diabetic-hypertensive trial, 19020533, reports only BP). The only hypertensive trial reporting glucose…
• Blood glucose (Metabolic Syndrome). 10 studies removed (studied a different group of people); 6 studies removed (did not measure this outcome).
• Blood glucose (Overweight): Result Small Improvement → Improvement; Size small → not stated. 10 studies removed (studied a different group of people); 6 studies removed (did not measure this outcome).Why: Two links study overweight adults: the 6-month RCT 21205110 (52 overweight insulin-resistant non-diabetics) found fasting glucose improved vs placebo; the Korean RCT 19359148 (155 overweight adults, the stored people figure) reports only HOMA-IR and BP (no change), no glucose result, so it fails…
• Blood glucose (Rheumatoid Arthritis (RA)): Result Small Improvement → Improvement; Grade C → D; Size small → not stated. 10 studies removed (studied a different group of people); 6 studies removed (did not measure this outcome).Why: Only 35791617 studies RA: an uncontrolled before-after study in 35 patients found fasting blood sugar, insulin and HOMA-IR fell after 6 months of oral magnesium. Improves holds, but no FBS size is given ('Small' cleared to 'Improvement') and a single small uncontrolled study caps the grade at D…
• Blood glucose (Prediabetes): Result Small Improvement → Improvement; Size small → not stated. 9 studies removed (studied a different group of people); 6 studies removed (did not measure this outcome).Why: Two links pass: the meta-analysis of double-blind RCTs 34836329 found Mg 'significantly improved plasma glucose' in people at high risk of diabetes (which includes prediabetes); the prediabetes RCT 36307427 (86 people, the stored figure) found no glucose/HOMA-IR change. The meta-analysis outranks…
• Blood Pressure: Result Moderate Improvement → Small Improvement; Size moderate → small. 3 studies removed (did not measure this outcome).Why: Improves (lower BP) holds: the 2025 meta-analysis of 38 RCTs (41000008) found SBP -2.81 / DBP -2.05 mm Hg vs placebo, and the 2017 meta-analysis (28724644) SMD -0.20/-0.27; two hypertensive trials agree, three normotensive/overweight trials found no effect. 'Moderate' overstated: the pooled SMDs…
• Blood Pressure (High Blood Pressure): Result none shown → Small Improvement; Grade not graded → B; Size not stated → small; Form studied not stated → oral magnesium, median about 365 mg elemental a day for about 12 weeks.Why: / literature checked: the linked 2025 meta-analysis 41000008 (38 RCTs, 2,709 people) found magnesium lowered systolic BP 2.81 mm Hg vs placebo, and 7.68 mm Hg in treated hypertensives; median 365 mg elemental/day for 12 weeks. Same evidence as another finding (B).… The product form and dose pattern the supporting trials used Same ten linked studies as another finding (B), led by the 2025 38-RCT meta-analysis 41000008.
• Bone Mineral Density (Bone Health): Result Small Improvement → Improvement; Size small → not stated.Why: Bone Health is a general group. The only link, a 1-year RCT in girls (17018656, the stored 44 people), found hip bone mineral accrual significantly greater with magnesium (P = 0.05) and a non-significant trend at the spine. Improves holds, but the abstract gives no size, so 'Small' is cleared to…
• C-Reactive Protein (CRP) (Depression): Result Small Decrease → No effect; Size small → not stated. 3 studies removed (studied a different group of people); 1 study added.Why: Direction error: the page shows Improves ('Small Decrease') for CRP under Depression, but none of the three links studies depression (general, poor-sleep and MetS populations). The only trial in people with depressive symptoms, 34210242 (108 obese women, the stored people figure, with a…
• C-Reactive Protein (CRP) (Coronary Artery Disease (CAD)). 3 studies removed (studied a different group of people); 1 study added.
• Cortisol (Muscle Recovery): Result No effect → Increase; Size none → not stated. 1 study removed (studied a different group of people).Why: Muscle Recovery is read as an exercise population. The only exercise study (17999037, athletes vs sedentary men) found cortisol rose significantly in athletes given magnesium and tested at exhaustion, not with training or magnesium alone; the page's 'No effect' does not match. Plain 'Increase' (a…
• Cramps (Muscle Cramps): Result none shown → No effect. 2 studies removed (not a study of this supplement).Why: Ungraded row shows Improves for cramps. The strongest evidence, the Cochrane review and the pregnancy meta-analysis, plus three of four oral RCTs found no significant benefit; only one 2021 RCT was positive. No effect. Two IV studies removed (wrong route; one is a migraine trial).
• Cramps (Pregnancy and Delivery Health). 3 studies removed (studied a different group of people); 2 studies removed (not a study of this supplement).
• High-density lipoprotein (HDL): Result No effect → Small Increase; Size none → small. 3 studies added.Why: Direction error: no linked study and the page shows 'No effect'. The two largest and newest meta-analyses of RCTs (42588058, 78 RCTs; 39905454, 25 studies) both found a significant HDL-C rise of about 1.2-1.5 mg/dL; the older 2017 meta-analysis (28180945) found a non-significant upward trend (p = 0.
• Insomnia Signs and Symptoms (Insomnia): Result No effect → Mixed effect; Size none → not stated. 2 studies added.Why: No linked study; the page shows 'No effect'. The meta-analysis of 3 RCTs in older adults with insomnia (33865376) found sleep onset 17 minutes shorter with magnesium (p = 0.0006, total sleep time not significant), while the 2026 systematic review of 12 RCTs (42661485) calls the findings…
• Insomnia Signs and Symptoms (Restless Leg Syndrome): Result No effect → Improvement; Size none → not stated. 2 studies added.Why: Direction error: no linked study and the page shows 'No effect' for insomnia symptoms in restless legs syndrome. The open pilot (9703590, 10 patients, the stored people figure) found sleep efficiency rose from 75% to 85% (p < 0.01) and PLMS arousals fell, and a 75-patient single-blind RCT (36587225)
• No human study left after the re-check, so no grade: All-Cause Mortality (Atrial Fibrillation), Arterial Stiffness (Fibromyalgia), Bilirubin (Menopause), Cramps (Migraine Headache), Hematocrit (Iron Deficiency Anemia). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Magnesium: the page as it is now

• No human study left after the re-check, so no grade: Blood Pressure (Metabolic Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Maitake: the page as it is now

• Bone Mineral Density (Bone Health): Result Small Increase → none shown; Grade B → C; Size small → not stated. 3 studies added.Why: No manganese-alone trial; observational studies link higher blood manganese to lower bone density. C on observational data, no benefit claim.
• PMS Symptoms (Premenstrual Syndrome (PMS)): Result Moderate Decrease → none shown; Grade B → C; Size moderate → not stated. 1 study added.Why: Graded B with no studies. One small controlled feeding study (10 women with normal cycles) found low dietary manganese worsened premenstrual mood and pain vs adequate intake, consistent with the row's direction. Population passed as menstruating women (includes PMS) but flagged: no trial in…
• No human study left after the re-check, so no grade: Bone Formation Markers (Bone Health), Cartilage Health (Osteoarthritis (OA)), Joint Pain (Osteoarthritis (OA)), Seizure Frequency (Epilepsy). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Manganese: the page as it is now

• Abdominal Pain (Irritable Bowel Syndrome (IBS)). 3 studies added.
• Adiponectin (Nonalcoholic Steatohepatitis (NASH)): Result Small Increase → Mixed effect; Size small → not stated. 2 studies added.Why: No linked study. Re-cited the two human studies: 22804755 (16 NASH patients, uncontrolled) found adiponectin rose 119% from baseline, but the placebo-controlled RCT 32951715 (45 NAFLD patients, 12 weeks) measured adiponectin and lists no significant change for it while leptin and others improved.…
• Anti-Oxidant Enzyme Profile (Metabolic Syndrome): Result Small Increase → Increase; Grade C → D; Size small → not stated.Why: 21138476 treated 30 metabolic-syndrome patients with melatonin 5 mg for 2 months and compared with baseline (the 33 healthy volunteers were untreated): catalase rose (245.9 to 276.8 U/gHb) and TBARS fell. Increase holds. It is a single small uncontrolled study: ceiling D, C lowered. No effect…
• Anti-Oxidant Enzyme Profile (Soccer Performance): Result Small Increase → Increase; Grade C → D; Size small → not stated.Why: Soccer Performance is a general group, so the metabolic-syndrome study 21138476 is accepted: 30 patients, melatonin 5 mg for 2 months vs baseline, catalase rose and TBARS fell. Increase holds. Single small uncontrolled study (untreated healthy volunteers are not a treatment control): ceiling D, C…
• Blood Pressure (Body Composition): Result Small Improvement → Mixed effect; Size small → not stated; Form studied not stated → form-dependent: controlled-release (prolonged-release) melatonin 2-3 mg at bedtime for 3-4 weeks lowered night-time blood pressure (about -6/-3.5 mmHg) mostly in treated hypertension; immediate (fast)-release melatonin, even at 5 mg, did not; single 1-2 mg daytime doses lower blood pressure only for a few hours. 3 studies removed (did not measure this outcome); 2 studies added.Why: Literature checked. The three acute single-dose studies in healthy volunteers do not support a chronic blood pressure outcome and are removed. The largest recent meta-analysis (39113944, 28 RCTs) found no effect on systolic and a small daytime diastolic fall (-1.4 mmHg); an older 5-RCT MA (30861561) found -3.4/-3.3 mmHg; night-time BP falls only with controlled-release melatonin, not immediate-release (21966222, 35388609; low to very low quality). Mixed effect, size cleared, B kept (meta-analyses inconsistent). People 1543 cleared. The product form and dose pattern the supporting trials used
• Depression Symptoms (Depression): Result Small Improvement → No effect; Size small → not stated. 2 studies added.Why: Page shows Improves (Small, B) under Depression with no linked study. Both meta-analyses in people with depression find no significant benefit: 28612993 (RCTs in mood disorders, P = 0.09) and 35370838 (19 studies, 1,178 patients, SMD -0.17, CI crosses 0). Set No effect, size cleared. Stored B…
• Gastrin (H. Pylori Infection): Result Moderate Increase → No effect; Size moderate → not stated. 1 study added.Why: Seed 22204799 (H. pylori ulcer patients) found plasma gastrin rose in every arm, including omeprazole plus placebo, so the rise reflects omeprazole, not melatonin. The companion trial 21362032 (idiopathic ulcers, wrong population) says the same explicitly. 'Improves / Moderate Increase' is a…
• Heart Rate Variability (Multiple Sclerosis (MS)): Result No effect → Improvement; Size none → not stated; Form studied not stated → oral melatonin 3 mg nightly for 12 weeks.Why: Page shows 'No effect' (no verdict). The only study, an RCT in 27 MS patients (3 mg melatonin nightly, 12 weeks), found melatonin raised RMSSD (p = 0.0007) and HF power (p = 0.0016) and lowered LF vs placebo, i.e. better heart rate variability. Set Improvement, direction increase; no… Our auditor agreed: stored direction "decrease" contradicts the "Improvement" label and the study. In 39630381 melatonin raised RMSSD (p = 0.0007) and HF power (p = 0.0016) vs placebo, i.e. heart rate variability went up, which is the benefit (MS lowers HRV). Direction set to increase (as l001 intended); label, no size, D kept. One placebo RCT: ceiling C (under-graded). The product form and dose pattern the supporting trials used
• Insomnia Signs and Symptoms (Insomnia): Result Large Improvement → Small Improvement; Grade A → B; Size large → small; Form studied not stated → prolonged-release melatonin 2 mg before bedtime (trials in adults 55+); sleep onset about 5-7 minutes faster. 2 studies removed (studied a different group of people); 3 studies added.Why: Three placebo-controlled RCTs in insomnia populations (19584739, 18036082, 38816846) all report benefit: A holds. The migraine trial is the wrong population: removed. 'Large' overstates the two larger trials (9 min faster sleep onset; 6 mm on a sleep-quality scale): size cleared to Improvement.… Our auditor. Insomnia: the two placebo-controlled RCTs of 2 mg prolonged-release melatonin in primary insomnia aged 55+ (19584739, 18036082) and the COMISA trial (38816846) found benefit; the 19-trial meta-analysis 23691095 finds sleep onset 7 min sooner and 8 min… The product form and dose pattern the supporting trials used
• Insomnia Signs and Symptoms (Migraine Headache): Result Large Improvement → Improvement; Size large → not stated; Form studied not stated → the one trial reporting sleep quality used prolonged-release melatonin 2 mg 1 hour before bedtime for 8 weeks (not significant); the meta-analysis pools several doses and forms. 4 studies removed (studied a different group of people); 1 study added.Why: Page shows Improves (Large) under Migraine. The only study in migraine patients, the crossover RCT 20975054 (48 adults, prolonged-release melatonin 2 mg for 8 weeks), found the global PSQI did not improve (p = 0.09). The other four (insomnia in older adults, children, OSA) fail population and… Filing checked as the lead asked: the row's study (20975054) IS a migraine-population trial, and what it measured is sleep quality (Pittsburgh Sleep Quality Index) in people with migraine, a direct measure of insomnia symptoms; so the row is kept under migraine and re-derived on that outcome rather than cleared. Literature checked: the 2026 migraine meta-analysis (41627537) pooled PSQI and found better sleep quality with melatonin vs placebo (MD -1.64), while the one individual trial reporting it was not significant (p = 0.09). Strongest evidence is the MA: No effect -> Improvement, size blank, C kept (ceiling B: MA plus a non-significant trial). The product form and dose pattern the supporting trials used
• Insomnia Signs and Symptoms (Sleep Health): Result Large Improvement → Improvement; Size large → not stated.Why: Sleep Health is a general group, so all five studies pass on population. Three RCTs report benefit (shorter sleep onset by 9 min in 40 older insomniacs; better sleep quality in 170 older insomniacs; lower ISI in 30 OSA+insomnia patients), one RCT in migraine found PSQI unchanged, and the…
• Insomnia Signs and Symptoms (Cognitive Improvement): Result Large Improvement → Improvement; Size large → not stated.Why: Cognitive Improvement is a general goal group, so all five studies pass on population. Three RCTs report benefit (shorter sleep onset by 9 min; better sleep quality in 170 older insomniacs; lower ISI in 30 OSA+insomnia patients), one migraine RCT found PSQI unchanged, the children's follow-up has…
• Insomnia Signs and Symptoms (Obstructive Sleep Apnea (OSA)). 4 studies removed (studied a different group of people).
• Migraine Frequency (Migraine Headache): Result none shown → Improvement; Grade not graded → B; People studied 244 → not stated; Form studied not stated → melatonin 3 mg/day for 2-3 months in adults (positive trials); prolonged-release 2 mg 1 hour before bedtime for 8 weeks did not reduce attack frequency; a small, underpowered trial in children found no benefit. 5 studies added.Why: Literature checked; re-derived as the lead asked. Two meta-analyses find fewer migraine days or attacks with melatonin vs placebo (41627537: 9 RCTs, 788 people, -1.54 headache days/month; 36445912: 3 trials, -1.0 attacks/month), driven by trials of melatonin 3 mg/day (27165014; 28800342 as add-on in chronic migraine). Prolonged-release 2 mg (20975054) and a small paediatric trial (37466211) were null. Direction decrease (Improvement); size left blank (about 1-1.5 fewer days per month, no abstract labels it). People 244 (= 196 + 48, the two trials) cleared because the study list changed. Row stays ungraded (helpers never raise); C9 ceiling A. The product form and dose pattern the supporting trials used Lead check: two meta-analyses of placebo-controlled RCTs agree: Abouelmagd 2026 (41627537; 9 RCTs, 788 people) found fewer headache days (MD -1.54 days, 95% CI -2.50 to -0.58) and a higher 50% responder rate; 36445912 found fewer attacks (MD 1.00, 95% CI 0.02 to 1.98). The trials are small and the effect modest: B.
• Sleep Quality (Tinnitus): Result Small Improvement → Improvement; Grade B → C; Size small → not stated. 2 studies added.Why: No linked study. Re-cited the tinnitus crossover RCT 21859051 (61 adults: melatonin improved sleep quality) and the open-label study 16455366 (24 patients: PSQI fell significantly); together they match the stored 85 people. Improves holds. One RCT + one uncontrolled study: ceiling C, so B is…
• No human study left after the re-check, so no grade: Anti-Oxidant Enzyme Profile (High Blood Pressure), Anti-Oxidant Enzyme Profile (High Cholesterol), Breast Cancer Risk (Breast Cancer), Gastrin (Gastroesophageal Reflux Disease (GERD)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Melatonin: the page as it is now

• Mortality: Effect note rewritten from its studies. 4 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Direction right: the systematic review (28800058) finds better overall survival when IV mifamurtide is added to chemotherapy in non-metastatic osteosarcoma (not significant in metastatic), and the review reports 8-13% absolute survival gains; 'small' fits. The note ('2 preclinical studies') is…
• Safety/Tolerability: Effect note rewritten from its studies; Size small → not stated. 2 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Well tolerated is supported by human data (patient-access study of 205, a series of 18, an SR finding toxicity similar to chemotherapy alone), with infusion fever/chills in most patients. The note ('2 preclinical studies support this finding') is false: cleared (no standard label fits a safety…
• No human study left after the re-check, so no grade: GI Protection, Liver Protection. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Mifamurtide (Mepact): the page as it is now

• Aerobic Exercise Performance: Effect note rewritten from its studies; Size small → not stated. 2 studies removed (did not measure this outcome).Why: Graded C row shows a clean Improves. Of the two linked RCTs, one found a 1.3% faster 8 km time trial (34419082) and the other found 20 km time trial and VO2peak gains no different from placebo, only peak power higher (35623315), so the note's 'improved exercise performance' for both is wrong.…
• Liver Enzymes (ALT/AST): Effect note rewritten from its studies; Size moderate → not stated. 2 studies removed (did not measure this outcome).Why: Graded D row shows Improves (moderate) and its note says MitoQ "significantly reduced" ALT/AST. The phase II RCT (20492507) found within-group ALT falls and a significant iAUC difference for 40 mg, but the change from baseline vs placebo did not reach significance in either dose group. Mixed…
• Parkinson's Disease Progression: Effect note rewritten from its studies; Size small → not stated. 2 studies removed (did not measure this outcome).Why: Graded C row shows Improves (progression slowed, small) while its own note and its trial say the opposite: the 128-patient 12-month RCT (20568096) found 'no difference between MitoQ and placebo on any measure of PD progression'. No effect, size cleared. Caco-2 and toxicity links measure no PD…

Mitoquinone mesylate: the page as it is now

• No human study left after the re-check, so no grade: Neurological Symptoms (Molybdenum Deficiency), Serum Molybdenum Levels (Molybdenum Deficiency), Sulfite Levels (Molybdenum Deficiency), Xanthine Oxidase Activity (Purine Metabolism). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Molybdenum: the page as it is now

• No human study left after the re-check, so no grade: Lipid Profile, Type 2 Diabetes Risk (Type 2 Diabetes). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

MOTS-c: the page as it is now

• Bronchitis Symptoms (Acute Bronchitis): Result Small Improvement → Improvement; Grade B → C; Size small → not stated. 1 study removed (studied a different group of people); 2 studies added.Why: Flag confirmed: the only link is a chronic-bronchitis meta-analysis and fails C5 for Acute Bronchitis, so the B grade had no passing study. Re-cited one placebo-controlled trial including 84 acute-bronchitis patients (benefit reported for acute and chronic bronchitis) and one large uncontrolled…
• Cocaine Addiction Symptoms (Cocaine Abuse): Result none shown → Mixed effect. 2 studies added.Why: Ungraded row shows a clean Improves. A craving meta-analysis across substance use disorders favours NAC, but the two cocaine-specific efficacy RCTs (flagged 23952889, n=111; 40801394, n=140) found no reduction in use or abstinence overall, and the phase I trial showed only trends. Added both…
• Depression Symptoms (Bipolar Disorder): Result none shown → Mixed effect.Why: Ungraded row shows a clean Improves for depression in bipolar disorder. Its four meta-analyses conflict: two (2016; 2021, 6 trials) favour NAC, two (2020, 7 trials; 2021, 5 trials) find no improvement. Mixed effect; ceiling B (inconsistent meta-analyses).
• Depression Symptoms (Depression): Result none shown → Mixed effect.Why: Ungraded row shows a clean Improves for depression. Two meta-analyses favour NAC; two, including the largest (7 RCTs, n = 728), find no improvement in depressive symptoms. Mixed effect; ceiling B.
• Depression Symptoms (Major Depressive Disorder (MDD)): Result none shown → Mixed effect. 2 studies removed (studied a different group of people).Why: Ungraded row shows a clean Improves for MDD. The two meta-analyses that include MDD conflict (2016: benefit, SMD 0.37; 2020, 7 RCTs n = 728: no improvement). Mixed effect. Two bipolar-only meta-analyses removed.
• Marijuana Addiction (Cannabis Use Disorder): Direction goes up → not set. 1 study removed (did not measure this outcome).Why: Literature checked (pubmed.py 'N-acetylcysteine cannabis use disorder randomized'): the multicentre adult RCT (28623823) found NAC no better than placebo for abstinence; a 2025 Cochrane review (41025421) pools pharmacotherapies; the youth trial 39910268 is the positive one. The row's off-topic links were removed (091-093), so no study supports the stored 'increase': direction cleared; row stays a data gap to re-derive.
• No human study left after the re-check, so no grade: Length of hospitalization (Acute Liver Failure). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

N-Acetylcysteine: the page as it is now

• Bone Mineral Density: Effect note rewritten from its studies; Size small → not stated. 1 study removed (did not measure this outcome).Why: Page shows Improves (BMD up) with a note citing '4 preclinical studies'. The four linked human endometriosis trials all report BMD LOSS on intranasal nafarelin (about 2% lumbar, partly or fully recovering after stopping; less loss than with leuprolide). Now Detriment, BMD down; size cleared.…
• Hormone Levels: Effect note rewritten from its studies; Size small → not stated. 2 studies removed (did not measure this outcome).Why: Page shows Improves with an up arrow (hormones rising) and a note citing '3 preclinical studies'; the links are human. A single nafarelin test dose acutely raises ovarian steroids (8323171), while repeated dosing suppresses gonadotropins and sex hormones (case report 15260009: testosterone…
• Lipid Profile: Effect note rewritten from its studies; Size small → not stated. 1 study removed (did not measure this outcome).Why: Page shows Improves with a down arrow (lipids falling) and a note citing '2 preclinical studies'. The one study with a lipid result (10900577, uncontrolled, 34 women) found total cholesterol, HDL, Lp(a), apoA and remnant cholesterol all ROSE during nafarelin, returning to baseline after.…
• No human study left after the re-check, so no grade: Liver Protection. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Nafarelin (Synarel): the page as it is now

• Drug Bioavailability (CYP3A4 Inhibition): Effect note rewritten from its studies; Size large → not stated. 2 studies removed (did not measure this outcome); 2 studies removed (not a study of this supplement); 2 studies added.Why: Graded C row shows Improves (Large) and a prose note crediting naringenin with grapefruit's drug interaction. The human evidence is whole-juice (removed); the review names psoralens as the probable cause and rat microsomes clear naringenin. Re-cited two human trials of the naringenin glycoside…
• No human study left after the re-check, so no grade: Atherosclerosis Risk. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Naringenin: the page as it is now

• Blood glucose (Metabolic Health): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row under Metabolic Health (general group) shows Improves (blood glucose down). Its only study reports no glucose: removed. Added the flagged meta-analysis 32702899 (read; 8 RCTs in T2DM): no significant effect on plasma glucose. No effect; ceiling A, stays ungraded.
• Blood glucose: Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row under general-cardiovascular-health (general group) shows Improves (blood glucose down). Its only study reports no glucose: removed. Added the flagged meta-analysis 32702899 (read; 8 RCTs in T2DM): no significant effect on plasma glucose. No effect; ceiling A, stays ungraded.
• Blood glucose (Dyslipidemia): Result none shown → Detriment; Form studied not stated → nicotinic acid at lipid-lowering doses (extended-release 1-2 g a day, or immediate-release up to 4.5 g a day) for 8-24+ weeks; does not apply to nicotinamide or multivitamin amounts of niacin. 1 study removed (did not measure this outcome); 4 studies added.Why: Direction error re-derived. Page showed Improves (glucose down). Literature checked (niacin glucose meta-analyses, dyslipidemia RCTs). The linked low-HDL trial reports no glucose result: removed. In dyslipidemic patients niacin RAISES glucose: +16% mean plasma glucose in a randomised crossover… The product form and dose pattern the supporting trials used
• Blood glucose (Weight Loss & Maintenance): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row under Weight Loss & Maintenance (general group) shows Improves (blood glucose down). Its only study reports no glucose: removed. Added the flagged meta-analysis 32702899 (read; 8 RCTs in T2DM): no significant effect on plasma glucose. No effect; ceiling A, stays ungraded.
• Cardiovascular Disease Mortality: Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (CV mortality down). Its only study reports niacin for all-cause mortality only, and that risk was higher: removed. Added the flagged Cochrane review 28616955 (read): no change in CV mortality (RR 1.02, 32,966 people). General group. No effect; ceiling A, stays…
• Glycemic Control (Metabolic Health): Result none shown → Detriment. 1 study added.Why: Ungraded row under Metabolic Health (general group) with no study shows Improves (glycemic control up). Flagged meta-analysis 26370223 (read; 11 RCTs, 26,340 non-diabetic adults): niacin raised new-onset diabetes (RR 1.34). Added: Detriment (glycemic control worsens); ceiling A, stays ungraded.
• Glycemic Control (Weight Loss & Maintenance): Result none shown → Detriment. 1 study added.Why: Ungraded row under Weight Loss & Maintenance (general group) with no study shows Improves (glycemic control up). Flagged meta-analysis 26370223 (read; 11 RCTs, 26,340 non-diabetic adults): niacin raised new-onset diabetes (RR 1.34). Added: Detriment (glycemic control worsens); ceiling A, stays…
• HbA1c (Type 2 Diabetes): Result none shown → No effect. 1 study added.Why: Ungraded row under Type 2 Diabetes with no study shows Improves (HbA1c down). Flagged meta-analysis 32702899 (read; 8 RCTs, 2110 patients with T2DM): no significant effect on HbA1c (WMD 0.39, P = .158). Added: No effect; ceiling A, stays ungraded.
• Heart Attack Risk: Result none shown → No effect. 1 study added.Why: Ungraded row under general-cardiovascular-health with no study shows 'Changes; see studies' (stored increase). Flagged Cochrane review 28616955 (read): niacin did not change fatal or non-fatal heart attacks; general group. Added: No effect; ceiling A, stays ungraded.
• Heart Attack Risk (Atherosclerosis): Result none shown → No effect. 1 study added.Why: Ungraded row under Atherosclerosis with no study shows 'Changes; see studies' (stored increase). Flagged Cochrane review 28616955 (read): niacin did not change fatal or non-fatal heart attacks; its population (people with or at risk of CVD, median 48% with prior MI) clearly includes…
• Heart Attack Risk (Coronary Artery Disease (CAD)): Result none shown → No effect. 1 study added.Why: Ungraded row under Coronary Artery Disease with no study shows 'Changes; see studies' (stored increase). Flagged Cochrane review 28616955 (read): niacin did not change fatal or non-fatal heart attacks; its population (people with or at risk of CVD, median 48% with prior MI) clearly includes…
• Major Adverse Cardiac Events (Cardiovascular Disease): Result none shown → No effect. 1 study added.Why: Ungraded row under Cardiovascular Disease with no study shows 'Changes; see studies' (stored increase). Flagged AIM-HIGH RCT 22085343 (read; niacin vs placebo, both on statin) found no difference in major cardiovascular events. Added: No effect; ceiling C, stays ungraded.
• Stroke Risk: Result none shown → No effect. 1 study added.Why: Ungraded row under general-cardiovascular-health with no study shows 'Changes; see studies' (stored increase). Flagged Cochrane review 28616955 (read): niacin did not change fatal or non-fatal strokes; general group. Added: No effect; ceiling A, stays ungraded.
• Stroke Risk (Atherosclerosis): Result none shown → No effect. 1 study added.Why: Ungraded row under Atherosclerosis with no study shows 'Changes; see studies' (stored increase). Flagged Cochrane review 28616955 (read): niacin did not change fatal or non-fatal strokes; its population (people with or at risk of CVD, median 48% with prior MI) clearly includes Atherosclerosis.…
• Stroke Risk (Cardiovascular Disease): Result none shown → No effect. 1 study added.Why: Ungraded row under Cardiovascular Disease with no study shows 'Changes; see studies' (stored increase). Flagged Cochrane review 28616955 (read): niacin did not change fatal or non-fatal strokes; its population (people with or at risk of CVD, median 48% with prior MI) clearly includes…
• No human study left after the re-check, so no grade: Blood glucose (Obesity), Blood glucose (Nonalcoholic Fatty Liver Disease (NAFLD)), Glycemic Control (Obesity), Glycemic Control (Nonalcoholic Fatty Liver Disease (NAFLD)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Niacin (Vitamin B3): the page as it is now

• Blood Pressure (Type 2 Diabetes): Result Small Improvement → No effect; Size small → not stated. 6 studies removed (studied a different group of people); 1 study added.Why: Graded C row shows Improves (Small Improvement) for BP in type 2 diabetes. All six linked studies are other populations (older adults, hypertension, COPD; C5). The flagged type 2 diabetes trial found beetroot nitrate did not lower ambulatory BP. No effect, C kept.
• Exercise Capacity (Heart Failure): Result none shown → No effect. 4 studies removed (studied a different group of people); 1 study removed (not a study of this supplement); 1 study added.Why: Ungraded row shows Improves for exercise capacity in heart failure. Four linked meta-analyses are in healthy adults and the HF meta-analysis pools nitrate drugs. The flagged inorganic-nitrate HFpEF trial found no gain in peak VO2 or work. No effect.

Nitrate: the page as it is now

• No human study left after the re-check, so no grade: Urinary Incontinence Signs (Urinary Incontinence). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Octopamine: the page as it is now

• Blood Glucose Control: Effect note rewritten from its studies; Size moderate → not stated. 11 studies removed (did not measure this outcome).Why: Page shows Improves with a DOWN arrow (glucose lowered) and '9 preclinical studies'. The passing studies are human and show octreotide RAISES glucose: it keeps glucose up in congenital hyperinsulinism (22048969, 39565408) and sulfonylurea hypoglycaemia (20352540), while causing transient…

Octreotide (Sandostatin): the page as it is now

• No human study left after the re-check, so no grade: Pregnancy Complications (Premature Birth). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Omega-3 Fatty Acids: the page as it is now

• Atopic Dermatitis Symptoms: Effect note rewritten from its studies; Size small → not stated. 1 study removed (not a study of this supplement); 1 study removed (did not measure this outcome); 1 study added.Why: Graded C row shows Improves (small) with a prose note about hempseed and evening primrose oil. Neither linked study measures atopic dermatitis (uremic itch; plasma fatty acids in asthma). Re-cited the flagged Cochrane review: oral evening primrose and borage oil no better than placebo for…
• Cardiovascular Disease Risk: Effect note rewritten from its studies; Size moderate → not stated. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement); 2 studies added.Why: Graded B row shows Improves (moderate) with a prose note claiming RCTs show reduced CVD events. Neither linked study has a CVD outcome (immune review; plasma fatty acids). Re-cited the flagged Cochrane review (little or no difference in CVD events) and the Sydney trial in coronary patients…

Omega-6 Fatty Acids: the page as it is now

• Intestinal Parasites (Intestinal Parasite Infection): Result Moderate Improvement → Improvement; Grade C → D; Size moderate → not stated.Why: Benefit holds, but the only study is a single small uncontrolled trial (14 patients): ceiling D, C lowered to D. No comparator, so 'moderate' has no basis: cleared, note becomes 'Improvement'. Parasites went down, so the stored direction (up) is set to decrease.

Oregano: the page as it is now

• Anaerobic Capacity (Cycling Performance). 1 study removed (did not measure this outcome); 1 study added.
• Oxygen Uptake (Cycling Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (oxygen uptake up) with no study. The flagged cycling trial 20717126 measured maximal oxygen uptake and found no difference vs placebo. Show No effect; ceiling C, stays ungraded.

Ornithine: the page as it is now

• No human study left after the re-check, so no grade: Diarrhea Symptoms. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Paederia foetida: the page as it is now

• Pain (Primary Dysmenorrhea (Menstrual Cramps)): Result No effect → Improvement; Size none → not stated.Why: Row shows No effect; its only study (RCT, primary outcome) found PEA significantly reduced menstrual pain vs placebo at 1-2.5 h (satisfaction and rescue use did not differ). Set Improvement (pain down), no size basis. One RCT: ceiling C, stored D kept.

Palmitoylethanolamide: the page as it is now

• Anxiety Symptoms (Generalized Anxiety Disorder (GAD)): Result Moderate Improvement → Mixed effect; Grade B → C; Size moderate → not stated. 4 studies removed (studied a different group of people); 1 study removed (did not measure this outcome); 2 studies added.Why: One small passionflower trial in GAD vs oxazepam (no placebo) plus reviews that call the evidence inconclusive: C, mixed.
• Reaction Time (Generalized Anxiety Disorder (GAD)): Result none shown → No effect. 1 study added.Why: Re-cited with 27928252, the passionflower add-on trial in GAD that measured reaction time (it was wrongly linked to another finding). It found no between-group difference on any reaction-time item vs placebo; only a within-group drop in auditory omission errors. The page's 'Improves' is wrong… Re-cited trial 27928252 had 30 patients.

Passionflower: the page as it is now

• No human study left after the re-check, so no grade: Fatigue Symptoms (Cancer-Related Fatigue). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Pea Protein: the page as it is now

• Nausea Symptoms (Surgical Recovery): Result Small Improvement → Improvement; Grade B → C; Size small → not stated. 4 studies removed (not a study of this supplement); 1 study added.Why: Graded B on four aromatherapy studies (wrong route for the oral peppermint page, C3b; one tests unspecified oils in labour). Re-cited an oral peppermint RCT in surgery: less postoperative nausea. Improves holds on one trial: grade lowered B to C; the abstract gives no size, so 'Small' is cleared.
• No human study left after the re-check, so no grade: Nausea Symptoms (Pregnancy and Delivery Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Peppermint: the page as it is now

• No human study left after the re-check, so no grade: Attention and Focus, Exercise-Induced Euphoria, Mood Enhancement. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Phenylethylamine: the page as it is now

• Cognitive Decline: Result Small Improvement → Improvement; Grade B → C; Size small → not stated; People studied 92 → not stated; Form studied not stated → bovine-cortex phosphatidylserine (BC-PS) 300 mg/day (100 mg three times daily) for 8-12 weeks in mild Alzheimer's disease; gains were short-term and faded by 6 months; the soy-derived PS sold today has not been tested alone in Alzheimer's disease. 1 study added.Why: Literature checked (hero row). Both placebo-controlled Alzheimer's trials used bovine-cortex PS (BC-PS) 300 mg/day: 1609044 (51 people) improved several cognitive measures and 1633433 (33 people) improved only global impression with no change on cognitive tests; a third randomised trial (8038871, 70 people, 400 mg/day with cognitive training, source not stated) found gains at 8-16 weeks that faded by 6 months. No Alzheimer's trial of today's soy-derived PS alone exists; soy PS was null in age-associated memory impairment (11842880). Direction kept (short-term improvement), 'Small' cleared (no abstract quantifies it), grade B -> C: three small trials with inconsistent cognitive results and short-lived benefit (C9 ceiling B). People 92 (matched nothing) cleared. BC-PS source recorded in evidence_form as the lead asked. The product form and dose pattern the supporting trials used
• Cognitive Decline: Result none shown → No effect. 2 studies removed (studied a different group of people); 1 study added.Why: Ungraded row shows Improves for cognitive decline in age-associated memory impairment. Both linked trials are in Alzheimer's dementia (C5, removed). The flagged placebo-controlled trial in this population found soy phosphatidylserine had no effect on any memory or cognitive outcome. No effect…
• Cognitive Decline (Alzheimer’s Disease): Result none shown → Mixed effect; Form studied not stated → the Alzheimer's trials used bovine-cortex phosphatidylserine 300-400 mg/day for 8-12 weeks, with benefits fading by 6 months; soy-derived PS 300-600 mg/day showed no memory effect in age-associated memory impairment (11842880) and no soy-PS cognition trial in Alzheimer's was found. 2 studies added.Why: Literature checked (no Cochrane review). Small bovine-cortex PS trials in Alzheimer's found some short-term gains (1609044) but no psychometric change in another (1633433), and gains faded by 6 months (8038871); a 2026 network MA found an MMSE gain but no ADAS-Cog effect for any supplement. Mixed effect, direction none. Grade stays 'Not graded yet' (never raised); mechanical ceiling B, but if the lead grades it, C at most: the tested form (bovine PS) is not the soy PS sold today, which failed in memory impairment (11842880). The product form and dose pattern the supporting trials used

Phosphatidylserine: the page as it is now

• Cardiovascular Function: Effect note rewritten from its studies; Size small → not stated. 3 studies removed (did not measure this outcome); 2 studies added.Why: Graded D row shows Improves on cell and isolated-heart work only, so under the human-evidence rule it would lose its grade: re-cited with the two flagged human RCTs (abstracts read). 41508641 found no change in endothelial function or BP; 29057795 found BP/HR lower only in overweight men and…

Piceatannol: the page as it is now

• Neuroprotection (Neurological Health): Result Minor Effect → Improvement; Size small → not stated. 42 studies removed (not a study of this supplement).Why: The only pinealon study (26390612, 32 people, uncontrolled) reports improved CNS activity, so Improves holds at D (single small uncontrolled study). "Minor Effect"/small has no basis in the abstract: standard label, size cleared. Topical vitamin K letter removed.

Pinealon: the page as it is now

• Cognitive Decline (Organic Brain Syndrome): Result none shown → Mixed effect. 2 studies removed (studied a different group of people); 1 study added.Why: Ungraded row shows Improves for cognitive decline. Piracetam improves clinicians' global impression (12006732; Cochrane 11405971) but the Cochrane review found no benefit on any specific measure and the 1-year AD trial (8437693) found no improvement in either group. Mixed effect. AAMI and…

Piracetam: the page as it is now

• No human study left after the re-check, so no grade: Bowel Regularity. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Plantago Major Seeds: the page as it is now

• Pulmonary Function: Effect note rewritten from its studies; Size small → not stated. 4 studies removed (did not measure this outcome); 1 study added.Why: Page shows Improves ('3 human trials'); the linked 'trials' are lung-CANCER tumour-response studies and a cytokine lab paper, none measuring lung function. Literature check: the only controlled human respiratory outcome is NEPTUNO (phase III RCT), where time off supplemental oxygen did not…
• Safety/Tolerability: Effect note rewritten from its studies; Size small → not stated. 3 studies removed (did not measure this outcome); 2 studies added.Why: None of the 3 links studies tolerability in people (two leukaemia-cell papers and a bibliography list). The page would lose its grade, so re-cited the two COVID-19 trials: NEPTUNO phase III ('generally well tolerated') and the randomised phase I ('favorable safety profile'; nausea 42%, vomiting 16%)
• No human study left after the re-check, so no grade: Antimicrobial Activity, Immune Function, Kidney Function, Liver Protection. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Plitidepsin (Aplidin): the page as it is now

• High-density lipoprotein (HDL) (Intermittent Claudication). 3 studies added.
• Total cholesterol (Intermittent Claudication). 2 studies removed (studied a different group of people).
• No human study left after the re-check, so no grade: Low-density lipoprotein (LDL) (Intermittent Claudication). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Policosanol: the page as it is now

• Reaction Time (Cognitive Improvement): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (reaction time) with no linked study. Added the flagged human study 418433 (the only human PRL-8-53 trial): no significant change in visual reaction time vs placebo. Cognitive Improvement is a general group. No effect; ceiling C, row stays ungraded.

PRL-8-53: the page as it is now

• Abdominal Pain: Result Moderate Improvement → Improvement; Grade A → B; Size moderate → not stated; People studied 5,036 → not stated; Form studied not stated → probiotics (multi-strain or Lactobacillus products) taken alongside H. pylori eradication therapy, during the 7-14-day antibiotic course and often up to 4 weeks; Saccharomyces boulardii alone and add-ons to bismuth quadruple therapy did not reduce abdominal pain. 5 studies added.Why: Data gap re-derived; literature checked (supersedes g003, which kept A). The largest meta-analysis (39642994, 91 RCTs) and a 26-RCT Lactobacillus analysis (39722187) found fewer cases of abdominal pain when probiotics were added to eradication therapy, but three other meta-analyses found no significant effect on abdominal pain (S. boulardii 40012609; Lactobacillus 41327607; bismuth quadruple add-ons 41574348). Strongest evidence still favours a benefit, so Improvement is kept, but meta-analyses with inconsistent results = B, not A. 'Moderate' has no basis and is cleared; people 5036 (the null S. boulardii MA) cleared. The product form and dose pattern the supporting trials used
• Abdominal Pain (Irritable Bowel Syndrome (IBS)): Form studied not stated → specific probiotic strains or multi-strain products (Bifidobacterium, Bacillus coagulans, S. cerevisiae I-3856), about 10^10 CFU/day or more, taken daily for 4-8 weeks; benefit is strain-specific and evidence certainty low. 4 studies added.Why: The product form and dose pattern the supporting trials used
• Abdominal Pain (H. Pylori Infection): Result Moderate Improvement → Improvement; Grade A → B; Size moderate → not stated; People studied 5,036 → not stated; Form studied not stated → probiotics (multi-strain or Lactobacillus products) taken alongside H. pylori eradication therapy, during the 7-14-day antibiotic course and often up to 4 weeks; Saccharomyces boulardii alone and add-ons to bismuth quadruple therapy did not reduce abdominal pain. 5 studies added.Why: Data gap re-derived; literature checked (supersedes g003, which kept A). The largest meta-analysis (39642994, 91 RCTs) and a 26-RCT Lactobacillus analysis (39722187) found fewer cases of abdominal pain when probiotics were added to eradication therapy, but three other meta-analyses found no significant effect on abdominal pain (S. boulardii 40012609; Lactobacillus 41327607; bismuth quadruple add-ons 41574348). Strongest evidence still favours a benefit, so Improvement is kept, but meta-analyses with inconsistent results = B, not A. 'Moderate' has no basis and is cleared; people 5036 (the null S. boulardii MA) cleared. Stored direction 'increase' corrected to decrease (pain goes down). The product form and dose pattern the supporting trials used
• Appetite (Chemotherapy Side Effects): Result Moderate Increase → Improvement; Grade A → B; Size moderate → not stated; People studied 227 → not stated; Form studied not stated → oral probiotics taken through chemotherapy: a multi-strain probiotic for two chemotherapy cycles, or Bifidobacterium animalis subsp. lactis V9 2 x 10^10 CFU/day for 18 weeks. 4 studies added.Why: Literature re-checked (supersedes g003/2163, which kept A). Less appetite loss is a benefit, so the shown 'Worsens (Moderate Increase)' is a direction error: Improvement (appetite up). Evidence: two placebo RCTs (38018652, 42445733) and a diarrhoea meta-analysis reporting appetite as a secondary outcome (40629588) favour probiotics; a second meta-analysis found only a non-significant trend (40301781, P = 0.06); no GRADE or Cochrane assessment. Small, partly inconsistent evidence in different cancers and strains = B, not A. Size cleared; people 227 cleared. The product form and dose pattern the supporting trials used
• Bloating (Colorectal Cancer). 4 studies added.
• C-Reactive Protein (CRP) (Psoriasis): Result Mixed effect → Decrease. 2 studies removed (studied a different group of people); 1 study added.Why: Grade B row shows 'Mixed effect' for CRP under Psoriasis but both linked meta-analyses are in other diseases (schizophrenia, coronary artery disease) and fail C5. Re-cited the flagged psoriasis meta-analysis (39328313, abstract read): CRP significantly reduced with probiotics (MD -2.36, p <…
• Dental Health Metrics (Gingivitis): Result none shown → No effect.Why: Direction error: the gingivitis page shows Improves (measure goes up) but the only study, a meta-analysis, found plaque index and bleeding on probing lower but not significantly so in its 10 gingivitis trials; the benefit was in periodontitis only. Now 'No effect' (no arrow). Ceiling A…
• Depression Symptoms (Insomnia). 1 study removed (studied a different group of people); 2 studies added.
• Diarrhea Symptoms (Acute Gastroenteritis). 2 studies removed (studied a different group of people).
• Quality of Life (Psoriasis): Result none shown → No effect. 1 study added.Why: Ungraded row with no linked study shows Improves (quality of life). The flagged psoriasis probiotic meta-analysis (read) found no difference in DLQI: added, No effect.

Probiotics: the page as it is now

• Appetite (Weight Loss & Maintenance): Grade B → C.Why: Three small single-meal satiety studies (47 people) fit the rubric at C, not B.
• Fecal Weight (Digestive Health): Grade A → B; People studied 47 → not stated; Form studied not stated → psyllium seed husk 10-25 g/day taken with fluid (trials: 5 g twice daily for 8 weeks; 15 g/day for 7 days; 25 g/day for 3 weeks); stool weight rises with dose. 2 studies added.Why: Literature checked (no meta-analysis reports stool weight in its abstract). Every human study found psyllium raises stool weight: one placebo RCT in constipation (8824651, about +64% weekly stool weight), two controlled crossover feeding studies (2831263, 10966900), a dose study (3030900) and a 4-person balance study (465439, weight more than doubled in two). 'Large Increase' fits (+64%, doubling). The stored direction 'decrease' makes the page show the measure going down: corrected to increase. Small controlled studies agreeing = B, not A. People 47 cleared (study list changed). The product form and dose pattern the supporting trials used
• Fecal Weight (General Gut Health): Grade A → B; People studied 32 → not stated; Form studied not stated → psyllium seed husk 10-25 g/day taken with fluid (trials: 5 g twice daily for 8 weeks; 15 g/day for 7 days; 25 g/day for 3 weeks); stool weight rises with dose. 2 studies added.Why: Literature checked (no meta-analysis reports stool weight in its abstract). Every human study found psyllium raises stool weight: one placebo RCT in constipation (8824651, about +64% weekly stool weight), two controlled crossover feeding studies (2831263, 10966900), a dose study (3030900) and a 4-person balance study (465439, weight more than doubled in two). 'Large Increase' fits (+64%, doubling). The stored direction 'decrease' makes the page show the measure going down: corrected to increase. Small controlled studies agreeing = B, not A. People 32 cleared (study list changed). The product form and dose pattern the supporting trials used

Psyllium: the page as it is now

• Blood Pressure (High Cholesterol). 1 study added.

Pterostilbene: the page as it is now

• BPH Symptom Improvement: Effect note rewritten from its studies; Grade B → C; Size moderate → not stated. 1 study added.Why: Graded B row shows Improves with a note citing 'meta-analyses of multiple RCTs' but no linked study. Three searches found no pumpkin-seed meta-analysis; the largest placebo RCT (25196580, 1,431 men, 12 months) found the extract no better than placebo on IPSS response. No effect, size cleared…

Pumpkin Seed Extract: the page as it is now

• Aerobic Exercise Metrics (Aerobic Exercise Performance): Result none shown → No effect.Why: Ungraded row shows Improves. Its only study (10926637, cyclists) found no difference in time to exhaustion and concludes pyruvate 'does not enhance performance during intense exercise in well-trained cyclists'. Show No effect; ceiling C, stays ungraded.
• Aerobic Exercise Metrics (Cycling Performance): Result none shown → No effect.Why: Ungraded row shows Improves. Its only study (10926637, cyclists) found no difference in time to exhaustion and concludes pyruvate 'does not enhance performance during intense exercise in well-trained cyclists'. Show No effect; ceiling C, stays ungraded.
• High-density lipoprotein (HDL) (Weight Loss & Maintenance): Result none shown → No effect.Why: Ungraded row shows Improves (HDL up). Its only study (1345038; Weight Loss & Maintenance is a general goal, so the population fits) lowered total and LDL cholesterol 'without affecting the HDL-cholesterol concentration'. Show No effect; ceiling C, stays ungraded.
• High-density lipoprotein (HDL) (High Cholesterol): Result none shown → No effect.Why: Ungraded row shows Improves (HDL up). Its only study (1345038; hyperlipidemic patients fit High Cholesterol) lowered total and LDL cholesterol 'without affecting the HDL-cholesterol concentration'. Show No effect; ceiling C, stays ungraded.
• Power Output (Body Composition): Result none shown → No effect.Why: Ungraded row shows Improves (power output up). Its only study (10362452, football players; Body Composition (general) fits) found 'pyruvate supplementation alone was ineffective'; power gains came from creatine. Show No effect; one RCT: ceiling C, stays ungraded.
• Power Output (General Athletic Performance): Result none shown → No effect.Why: Ungraded row shows Improves (power output up). Its only study (10362452, football players; General Athletic Performance fits) found 'pyruvate supplementation alone was ineffective'; power gains came from creatine. Show No effect; one RCT: ceiling C, stays ungraded.
• Power Output (Anaerobic Exercise Performance): Result none shown → Mixed effect. 1 study added.Why: Ungraded row shows a clean Improves. Linked 10362452 (5-week calcium pyruvate, football players): no effect on power. The flagged sprint trial 35249338 (single dose sodium pyruvate, soccer players) found higher peak and mean power. Two controlled trials disagree: Mixed effect. Stays ungraded.
• Power Output (Football Performance): Result none shown → No effect.Why: Ungraded row shows Improves (power output up). Its only study (10362452, football players; Football Performance fits) found 'pyruvate supplementation alone was ineffective'; power gains came from creatine. Show No effect; one RCT: ceiling C, stays ungraded.

Pyruvate: the page as it is now

• High-density lipoprotein (HDL) (High Blood Pressure): Result none shown → No effect. 1 study removed (studied a different group of people); 1 study added.Why: Linked 22486135 is in dyslipidemia, not hypertension: removed. Literature checked: in (pre-)hypertensive adults 162 mg/day quercetin left lipid parameters unchanged (26328470); the row's 41-person trial 17951477 (730 mg/day, hypertensives) reports no lipids. General meta-analyses agree: no…
• Low-density lipoprotein (LDL) (High Blood Pressure): Result none shown → No effect. 1 study added.Why: Literature checked: in (pre-)hypertensive adults 162 mg/day quercetin left lipid parameters unchanged (26328470); the row's 41-person trial 17951477 reports no lipids. General meta-analyses agree (25897620: LDL WMD 1.43 mg/dL, p = 0.23; 31940027). 'Improves' becomes No effect; ceiling C; stays…
• Low-density lipoprotein (LDL) (High Cholesterol). 1 study added.
• Total cholesterol (High Cholesterol). 1 study added.
• No human study left after the re-check, so no grade: vLDL-C (High Blood Pressure). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Quercetin: the page as it is now

• No human study left after the re-check, so no grade: Fat Loss. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Rauwolscine: the page as it is now

• Sexual Function (Sexual Dysfunction): Result none shown → No effect.Why: Ungraded row shows Improves. Its only study, a meta-analysis in female sexual dysfunction, says red clover (Trifolium pratense) did not differ from placebo: No effect.

Red Clover Extract: the page as it is now

• Total cholesterol (Dyslipidemia): Result none shown → No effect. 2 studies removed (studied a different group of people); 3 studies added.Why: Literature checked. Both linked meta-analyses are in type 2 diabetes: removed. In dyslipidemia, a meta-analysis of 7 RCTs (40705097) and the largest RCT (36771199, 168 people, up to 600 mg/day) found no change in total cholesterol; one smaller RCT (30278430, 71 people) found a fall. Strongest…
• No human study left after the re-check, so no grade: Total cholesterol (High Blood Pressure), Total cholesterol (High Cholesterol). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Resveratrol: the page as it is now

• GI Protection: Effect note rewritten from its studies; Size small → not stated. 5 studies removed (did not measure this outcome); 2 studies removed (not a study of this supplement); 2 studies added.Why: Page shows Improves ('2 preclinical studies'), but none of the 7 links (appetite, demographics and pipeline reviews, an appetite RCT, interviews) measures the GI tract, and the two class-wide reviews are not retatrutide-specific. Literature check: no study shows GI protection; both…
• Liver Fat Reduction (Fatty Liver Disease): Effect note rewritten from its studies; Grade A → C. 8 studies removed (not a study of this supplement); 7 studies removed (did not measure this outcome).Why: Direction right: the one on-topic trial (38858523, 98 people with MASLD) cut liver fat by about 81-82% at 8-12 mg vs +0.3% on placebo at 24 weeks. The note's '82-86% at 48 weeks' and '89-93% normal liver fat' are in no cited abstract (the abstract gives 24-week figures and 79%/86%), and it states…
• Muscle Mass/Function: Effect note rewritten from its studies; Size small → not stated. 6 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement); 1 study added.Why: Page shows Improves (muscle up, '2 preclinical studies'). The passing review (40980310) says incretin drugs including retatrutide cause loss of lean mass, and the DXA substudy of the phase 2 RCT (40609566) found lean mass lost alongside fat, in the same proportion as other obesity drugs. No…
• No human study left after the re-check, so no grade: Anti-Cancer Activity. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Retatrutide (GLP-3 Triple Agonist): the page as it is now

• Attention (Fatigue): Result Small Improvement → Improvement; Size small → not stated; Form studied not stated → standardised Rhodiola rosea root extract SHR-5, 576 mg/day (four tablets) for 28 days in stress-related fatigue; low-dose regimens (one tablet daily for 2-3 weeks) in physicians on night duty and students. 3 studies added.Why: Re-derived from the literature (data gap). In stress-related fatigue, SHR-5 improved CCPT II attention indices vs placebo (19016404) and concentration-containing mental tests in fatigued night-duty physicians (11081987); a student trial found no effect on a text-correction test (10839209), and a systematic review calls rhodiola fatigue research contradictory. Direction kept; no abstract sizes the effect, so "Small" is cleared to "Improvement". Ceiling B = stored B. The product form and dose pattern the supporting trials used
• Depression Symptoms (Depression): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (did not measure this outcome); 1 study removed (studied a different group of people).Why: Two placebo-controlled RCTs in depression conflict: 17990195 (89 patients) improved HAM-D vs placebo, 25837277 (57 patients, MDD) found no difference from placebo. A clean Small Improvement overstates it: Mixed effect. Grade B (2 controlled trials) kept. Anxious-volunteer and no-abstract fatigue…

Rhodiola Rosea: the page as it is now

• C-Reactive Protein (CRP) (Rheumatoid Arthritis (RA)): Result none shown → No effect. 1 study removed (studied a different group of people); 1 study removed (did not measure this outcome).Why: Row shows Improves (CRP down) for RA, but the only study measuring CRP in RA (21420288) found CRP did not change after 28 days. Healthy-volunteer study and the RA RCT without CRP removed. Now No effect; grade stays empty (ceiling D, one small uncontrolled study).
• C-Reactive Protein (CRP) (Weight Loss & Maintenance): Result none shown → Mixed effect. 1 study removed (did not measure this outcome).Why: Ungraded row shows Improves (CRP down). Its two passing studies are small and uncontrolled and conflict: 17657440 (healthy subjects) reports lower CRP, 21420288 (RA and healthy women) reports no CRP change. Now Mixed effect; the RA RCT without CRP is removed; grade stays empty (ceiling C).
• No human study left after the re-check, so no grade: C-Reactive Protein (CRP) (Coronary Artery Disease (CAD)), C-Reactive Protein (CRP) (High Cholesterol), C-Reactive Protein (CRP) (Type 2 Diabetes). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Rose Hip: the page as it is now

• Blood Pressure (High Blood Pressure): Grade A → B; People studied 291 → not stated; Form studied not stated → hibiscus tea (three 240 mL cups/day of brewed tea for 6 weeks, or an infusion of 10 g dried calyx daily for 4 weeks) or a calyx extract (up to 250 mg anthocyanins/day); benefit mainly in raised blood pressure; not better than captopril or lisinopril. 3 studies added.Why: Literature checked. Several non-Cochrane meta-analyses (34694241: -6.7/-4.4 mmHg vs placebo in hypertension; 25875025: SBP -7.6 mmHg; 34927694, 39870328) and the linked trials agree that hibiscus tea or extract lowers blood pressure, but the Cochrane review (34837382, 2021) found only one eligible placebo trial and calls the evidence insufficient, very low certainty, and the pooled trials are heterogeneous (I2 up to 95%) and often against active or tea controls. Direction and 'Moderate' (about 7 mmHg systolic) kept; grade A -> B. People 291 cleared (study list changed). The product form and dose pattern the supporting trials used

Roselle: the page as it is now

• C-Reactive Protein (CRP) (Type 2 Diabetes): Result none shown → No effect. 1 study removed (studied a different group of people); 3 studies added.Why: Linked 30509713 is in allergic asthma: removed. Literature checked: the T2DM meta-analysis 40842498 found no CRP change (SMD 0.01, p = 0.97), and two placebo-controlled T2DM trials found no hs-CRP difference (31686882, 31516857); the all-adult meta-analysis 32525606 also found no CRP effect.…

Saffron: the page as it is now

• Schizophrenia symptoms (Schizophrenia): Result Moderate Improvement → No effect; Grade A → C; Size moderate → not stated.Why: Row shows Improves 'Moderate Improvement' at grade A (183 people) on one 20-patient RCT that found sarcosine added to clozapine was no better than placebo. Linked evidence shows No effect; one RCT caps grade at C (regrade A to C); size cleared. The flagged meta-analysis (no overall effect…

Sarcosine: the page as it is now

• Nitric Oxide (Metabolic Health): Result Small Increase → Mixed effect; Size small → not stated. 1 study added.Why: Graded C, Improves 'Small Increase', with no linked study. The only human study of Schisandra on nitric oxide found (placebo-controlled, athletes) reports NO raised at the start of testing but the exercise-induced salivary NO rise blocked after treatment: not a clean increase. Re-cited; one…

Schisandra: the page as it is now

• Bilirubin (Gestational Diabetes): Result Moderate Decrease → Decrease; Grade B → C; Size moderate → not stated; People studied 106 → not stated; Form studied not stated → oral selenium (selenium yeast or tablets) 200 µg/day for 6 weeks from about 24-28 weeks of gestation in women with gestational diabetes; the effect was on newborn jaundice, not maternal bilirubin. 2 studies added.Why: Data gap re-derived (row had no linked study). Literature checked (selenium GDM RCTs and meta-analyses, selenium hyperbilirubinemia). One small RCT (31317471; 36 women with GDM, 200 µg/day, 6 weeks) found fewer newborns with hyperbilirubinemia (5.6% vs 33.3%), and a 2025 MA of 4 small trials… The product form and dose pattern the supporting trials used
• Thyroid-Stimulating Hormone (Hashimoto's disease): Result none shown → Small Decrease; Size not stated → small.Why: The only study, a 21-RCT meta-analysis in Hashimoto thyroiditis, found TSH lower after 6 months of selenium (SMD -0.18, small). The page shows Improves with an up arrow (TSH rising): the arrow is wrong. Set to Small Decrease. Grade stays unset (ceiling A).
• No human study left after the re-check, so no grade: Serum T3 (Hashimoto's disease). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Selenium: the page as it is now

• GI Protection: Effect note rewritten from its studies; Size small → not stated. 4 studies removed (did not measure this outcome).Why: Page shows Improves (small) for GI protection with a note citing '5 preclinical studies'. The human evidence shows GI harm: pooled STEP RCTs (3,379 people) had far more nausea, diarrhoea and vomiting on semaglutide, and FAERS shows 45 GI signals; a 21-RCT meta-analysis found no rise in…
• Neuroprotection: Effect note rewritten from its studies. 5 studies removed (did not measure this outcome).Why: Improves holds: the one human study, a 1.09-million-patient target-trial emulation, found semaglutide associated with fewer first-time Alzheimer diagnoses (HR 0.33-0.59 vs other antidiabetics); mouse/organoid work agrees. Five links (pancreatitis, lean mass, PK, AF, NAION) do not measure…

Semaglutide (Ozempic/Wegovy): the page as it is now

• Blood Glucose Control: Effect note rewritten from its studies; Size small → not stated. 2 studies removed (not a study of this supplement); 2 studies added.Why: Literature checked. Both linked studies test the agonist analogue MR-409 in cells and mice (C3 fail): removed. The human trials of sermorelin itself (GHRH 1-29) in healthy older men found no change in fasting glucose (1379256) or OGTT glucose and insulin (9005976). Improves (Small) becomes No…
• No human study left after the re-check, so no grade: Anti-Cancer Activity, Anti-Inflammatory Activity, Cancer Cell Apoptosis, Cardiac Protection, Corneal/Ocular Health, Pulmonary Function. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Sermorelin: the page as it is now

• Leg Edema (Surgical Recovery): Direction goes up → goes down; Grade B → C. 1 study added.Why: Graded B row stores leg edema going UP ('Small Improvement') with no linked study. Added the flagged randomised study 2647603 (66 post-operative ankle patients): swelling fell 50% by day 3 with serrapeptase vs none in controls (p = 0.013). Direction set to decrease; the small size label does…
• Mucus Production (Chronic Pulmonary Disease): Result none shown → Improvement. 3 studies removed (did not measure this outcome).Why: Ungraded row under Chronic Pulmonary Disease stores mucus production going UP. The one study that measures the amount (12911824, chronic airway disease) found morning sputum weight significantly DECREASED. Set Improvement, direction decrease. Removed: the ENT trial (no mucus measure) and two…
• Mucus Production (Chronic Bronchitis): Result none shown → Improvement. 3 studies removed (did not measure this outcome).Why: Ungraded row under Chronic Bronchitis stores mucus production going UP. The one study that measures the amount (12911824, chronic airway disease) found morning sputum weight significantly DECREASED. Set Improvement, direction decrease. Removed: the ENT trial (no mucus measure) and two studies…
• No human study left after the re-check, so no grade: Mucus Production (Sinusitis), Pain (Inflammatory Venous Disease). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Serrapeptase: the page as it is now

• Milk Production (Lactation (Breast Milk Production)): Result No effect → Increase; Size none → not stated.Why: Row shows No effect, but the only abstract (24363697, RCT) reports a >3-fold prolactin rise and significant secondary gains incl. babies' weight; the other RCT has no abstract. Increase, no size word. One RCT with a result: ceiling C, stored D kept.

Shatavari: the page as it is now

• Cough (Respiratory Health): Result No effect → Improvement; Size none → not stated.Why: Row shows No effect, but its only study, a meta-analysis of 9 RCTs, found Shirazi thyme significantly reduced cough (WMD -0.99, P = 0.003). Improvement (cough down); WMD on an unstated scale gives no size basis. Meta-analysis pointing one way: ceiling A, stored D kept.

Shirazi thyme: the page as it is now

• No human study left after the re-check, so no grade: Cough Symptom Relief, Gastrointestinal Symptom Relief, Sore Throat Symptom Relief. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Slippery Elm: the page as it is now

• Blood Lactate (Exercise) (Martial Arts Performance): Result Small Decrease → Increase; Size small → not stated. 1 study removed (did not measure this outcome).Why: Page shows Improves with a down arrow ('Small Decrease') for blood lactate. The only study reporting lactate (1664869) found it HIGHER after bicarbonate (15.3 vs 13.6 mM, P < 0.01). Show Increase; no basis for a size word. 18458356 reports no lactate result: removed. Grade C kept (one…
• Glycemic Control: Result Small Improvement → No effect; Size small → not stated. 1 study removed (did not measure this outcome); 1 study added.Why: Row shows Small Improvement in glycemic control from a single-meal mineral-water study in which glucose did not change (fails C3c). Re-cited the flagged 3-month RCT (21046483, 153 adults): bicarbonate had no effect on fasting glucose, insulin or HOMA-IR. Now No effect; grade C (one RCT) kept.
• Glycemic Control (Menopause): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Literature checked. The linked study is a single meal with bicarbonated mineral water in healthy women (C3c fail for a chronic outcome; glucose did not change): removed. The only bicarbonate-supplement RCT on glucose (21046483, 3 months, adults 50+) found no effect on fasting glucose, insulin or…
• Rating of Perceived Exertion (Martial Arts Performance): Result none shown → No effect. 2 studies removed (did not measure this outcome).Why: Ungraded row shows Improves for perceived exertion. Both studies that measured RPE (18714219, 21465247) found bicarbonate did not change it. The other two do not report RPE: removed. Show No effect. Ceiling B (two controlled trials); stays ungraded.

Sodium Bicarbonate: the page as it is now

• Low-density lipoprotein (LDL) (High Cholesterol): Result Moderate Improvement → No effect; Grade C → D; Size moderate → not stated. 2 studies added.Why: Graded C 'Moderate Improvement' with no study. Re-cited the flagged 21490917 (hypercholesterolemic patients, soy lecithin 500 mg/day): LDL fell 42-56% in 1-2 months, but with no control group. A single small uncontrolled study allows only D: regrade C to D. Two PubMed searches found no controlled… Literature checked: no meta-analysis or Cochrane review; the one controlled trial in people with high cholesterol (9683394, double-blind, 20 g/day soy lecithin for 4 weeks, with an energy- and linoleic-acid-matched control) found no effect on LDL, and a 1989 review of 24 studies (2916447) found no specific effect of lecithin on cholesterol. The only positive study (21490917, 500 mg/day) has no control group. Strongest evidence = the controlled trial: label Moderate Improvement -> No effect, size cleared. The auditor asked to ungrade until a controlled trial is linked; one is now linked, so the row keeps D (C9 ceiling C with one controlled trial; helpers do not raise).
• Total cholesterol (High Cholesterol): Result none shown → No effect. 3 studies added.Why: Data gap re-derived. Literature checked (no meta-analysis or Cochrane review exists). The only controlled trial in hyperlipidaemic people (9683394, double-blind, 20 g/d soya lecithin with a linoleic-acid control) found no effect on total cholesterol; the drops of 15-40% come from uncontrolled…
• No human study left after the re-check, so no grade: Heart Rate (Mental Resilience). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Soy Lecithin: the page as it is now

• Cardiovascular Mortality (Cardiovascular Health): Effect note rewritten from its studies; Grade C → not graded; Size moderate → not stated. 1 study removed (did not support the finding).Why: Our auditor; literature checked before pulling: spermidine and mortality has only dietary-intake cohorts (NHANES 36249217); no supplement trial reports mortality. No grade or verdict.

Spermidine: the page as it is now

• Anti-Oxidant Enzyme Profile (Metabolic Health): Result Small Increase → Mixed effect; Size small → not stated; Form studied not stated → spirulina 8 g/day for 12-16 weeks in the main enzyme trial (healthy elderly adults). 2 studies added.Why: Re-derived from the literature (data gap). The meta-analysis of 9 trials finds no significant change in antioxidant enzymes (SOD P = .06, GPx P = .29; 34235823) and the main RCT saw SOD rise in women only (18714150). "Small Increase" overstates this: Mixed effect, size cleared. Ceiling B (inconsistent results) = stored B. The product form and dose pattern the supporting trials used

Spirulina: the page as it is now

• Cholesterol Levels: Effect note rewritten from its studies; Size small → not stated. 1 study removed (did not measure this outcome); 2 studies added.Why: Graded D row shows Improves (cholesterol down) on a review whose abstract gives no cholesterol result and a narrative review of animal data, so no human study passed and the grade would be lost: re-cited. The flagged human trial (8310985) found 1 g/day squalene RAISED total and LDL cholesterol…

Squalene: the page as it is now

• Behavioral Symptoms (ABC) (Autism Spectrum Disorder (ASD)): Result 34% improvement in Aberrant Behavior Checklist scores → Small Improvement; Grade B → C; Size moderate → small; Form studied not stated → oral sulforaphane from broccoli sprout or seed extract, 50-150 umol/day (dose by weight) for 10-18 weeks; one trial added it to risperidone. 6 studies added.Why: Literature checked. Six small RCTs exist. Two meta-analyses find a small benefit on aberrant behaviour (40458076: SMD -0.43, 95% CI -0.66 to -0.19; 39951914: irritability and hyperactivity), but the individual trials disagree: 25313065 (44 young men) and 34034808 (ABC secondary, primary missed) are positive, 32347624 is positive only on two subscales, and 36771424 (40 children) found no ABC change; the largest trial (36427174) found no caregiver-rated change. Direction kept (decrease = improvement); the 34% note (one trial in young men) is replaced by 'Small Improvement', with SMD -0.43 as the size basis. Grade B -> C: trials are small (40-60 children) and inconsistent and the MA authors urge caution (C9 ceiling B, 'meta-analysis with inconsistent results'). Agrees with our auditor. The product form and dose pattern the supporting trials used

Sulforaphane: the page as it is now

• Aerobic Exercise Metrics (Aerobic Exercise Performance): People studied 308 → not stated; Form studied not stated → taurine 1-6 g by mouth (capsule or drink), as a single dose about 1 hour before exercise or daily for up to 2 weeks; no dose-response within 1-6 g. 1 study added.Why: Literature checked. Two meta-analyses agree that taurine slightly improves endurance performance (29546641: g 0.40; 40852891: g 0.25 overall, benefits in aerobic endurance), but the newer one rates certainty low to very low, with prediction intervals that often include no effect. Single-dose use fits this acute outcome. Small Improvement and B kept (agreeing small, low-certainty evidence; not A). People 308 cleared (study list changed). The product form and dose pattern the supporting trials used

Taurine: the page as it is now

• Cardiac Protection (Cardiovascular Health): Effect note rewritten from its studies; Size moderate → not stated. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Page shows Improves (moderate) on mouse work. The only human trial (41229390, RCT in 96 STEMI patients) found no overall difference in infarct area vs placebo; a benefit appeared only in the subgroup dosed within 8 h. Human evidence outranks animal: Mixed effect, size cleared. Literature check…
• Corneal Wound Healing (Dry Eye): Effect note rewritten from its studies; Size moderate → not stated. 4 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement); 1 study added.Why: Linked papers are reviews plus skin and rat studies; no human trial was linked. Literature check: the dry-eye phase 2 RCT of Tβ4 eye drops (25826322, 9 patients) cut corneal staining 59% vs vehicle; re-cited. The neurotrophic keratopathy phase III (36613994) missed its 4-week healing endpoint (p =…
• Wound Healing (Skin Health): Result Moderate Improvement → Mixed effect; Size moderate → not stated. 6 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement); 1 study added.Why: Page shows Improves (moderate) on rat wounds. Human evidence is two phase 2 trials of TOPICAL Tβ4 in leg ulcers: the venous-ulcer RCT (20536470, 73 patients) only says 0.03% 'may have the potential' to speed healing, and the summary (23050815) reports faster healing only among patients who…
• No human study left after the re-check, so no grade: Anti-Inflammatory Activity (Inflammation), Blood Glucose Control, GI Protection, Ligament/Tendon Healing (Ligament Injury), Liver Fibrosis Protection (Liver Fibrosis), Mortality, Neuroprotection (Neurodegeneration), Tissue Repair (Musculoskeletal Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

TB-500: the page as it is now

• Anxiety Symptoms (Stress): Result Small Improvement → Mixed effect; Grade B → C; Size small → not stated; People studied 51 → not stated; Form studied not stated → L-theanine 200-400 mg/day by mouth: a single 200 mg dose 30-60 minutes before a stressor, or daily for 4 weeks; 450-900 mg/day added to antidepressants did not reduce anxiety in GAD. 1 study removed (did not measure this outcome); 2 studies added.Why: Literature checked. The largest and newest meta-analysis (42410082, 31 RCTs) found anxiety effects inconsistent and non-significant and the acute-stress benefit modest and driven by high-risk-of-bias studies; a 2020 systematic review (31758301) and a 30-person 4-week trial (31623400) were positive, and a GAD trial was null. Mixed effect, size cleared, grade B -> C. The linked lab-stress study measured heart rate and s-IgA, not anxiety (removed). People 51 cleared. The product form and dose pattern the supporting trials used
• Anxiety Symptoms (Generalized Anxiety Disorder (GAD)): Result Small Improvement → No effect; Size small → not stated. 1 study removed (did not measure this outcome); 1 study removed (studied a different group of people); 1 study added.Why: Grade C row shows Improves for anxiety in GAD, but neither linked study is in GAD (acute lab stress in 12 healthy people; a review of people under stress). The only GAD trial (30580081, read) found L-theanine no better than placebo on HAMA (p = 0.73). Show No effect; C kept (one RCT). Not…
• Anxiety Symptoms (Schizoaffective Disorder). 2 studies removed (studied a different group of people); 1 study added.
• Insomnia Signs and Symptoms (Generalized Anxiety Disorder (GAD)): Result none shown → No effect.Why: Ungraded row shows Improves for insomnia in GAD, but its only study (30580081, RCT) found theanine did not beat placebo on the Insomnia Severity Index (p = 0.35); only one item and a subgroup favoured it. Now No effect; grade stays empty (ceiling C).

Theanine: the page as it is now

• Anti-Cancer Activity: Effect note rewritten from its studies; Size small → not stated. 3 studies removed (did not measure this outcome).Why: Page shows Improves (small) with a template note claiming '2 human trials and systematic reviews'. The only study with a cancer result, a 13-RCT meta-analysis (13,761 people), found no difference in cancer risk (RR 0.78, CI 0.53-1.16). The three reviews report no cancer outcome and are removed.
• No human study left after the re-check, so no grade: Neuroprotection. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Tirzepatide (Mounjaro/Zepbound): the page as it is now

• Erections (Sexual Health): Result Small Increase → Mixed effect; Size small → not stated; People studied 128 → 139; Form studied not stated → Eurycoma longifolia water extract (Physta) 300 mg/day for 12 weeks. 1 study added.Why: Graded B row shows Improves (Small Increase), but its only study, a 2-trial meta-analysis, found no significant pooled change in IIEF-5, with benefit only in men with lower baseline scores: Mixed effect, size cleared. B = ceiling (meta-analysis with inconsistent results), kept. Literature checked. The only meta-analysis (26365449, 2 RCTs, 139 men) found no significant pooled IIEF-5 change, with high heterogeneity and benefit only in men with lower baseline scores; one of its trials (23243445, 109 men, 300 mg/day for 12 weeks) found a significant erectile-function gain, and a 2017 review counts 7 positive and 4 negative studies. Mixed effect kept. Grade: B kept; the C9 ceiling is B ('meta-analysis with inconsistent results') and, with 23243445 now linked, the row also meets the prompt rubric's 'one good RCT'. People: 139 from the MA abstract (23243445 is almost certainly inside that total). The product form and dose pattern the supporting trials used

Tongkat Ali: the page as it is now

• No human study left after the re-check, so no grade: Local Anesthetic / Analgesic Effect. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Toothache plant: the page as it is now

• Sperm Count (Oligospermia): Direction goes up → not set; People studied 63 → not stated.Why: Ungraded row shows Improves for sperm count. Its one RCT reports only a composite score (78.11% vs 70.95% with placebo, no statistics) and no sperm-count result, so no passing study supports the verdict: cleared, link kept. Not added: the flagged 27337519 (30 men with idiopathic infertility…

Tribulus Terrestris: the page as it is now

• Antioxidant Status (Immune Health): Effect note rewritten from its studies; Size moderate → not stated. 2 studies added.Why: Graded B, Improves (moderate) with no linked study and a prose note about a phase I SOD/MDA study that could not be found. Re-cited the two placebo-controlled RCTs that measured MDA, protein carbonyl and SOD: no between-group difference in either. Now No effect; grade B (2 RCTs) kept.
• Lipid Profile Improvement (High Cholesterol): Effect note rewritten from its studies; Grade A → C; Size moderate → not stated. 1 study added.Why: Graded A with no linked study and a prose note (review of 12 studies, 12-month T2DM trial, HMG-CoA mechanism) that no passing study supports. Re-cited the one RCT in hypercholesterolemia (37548212: significant lipid reduction). Grade lowered A -> C (one RCT); size cleared (no numbers); note ->…

Triphala (Emblica officinalis, Terminalia chebula, Terminalia bellirica): the page as it is now

• No human study left after the re-check, so no grade: Oropharyngeal Infections (Respiratory Health), Systemic Toxicity (General Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Tyrothricin: the page as it is now

• Bronchitis Symptoms (Acute Bronchitis): Direction goes up → goes down.Why: The page already shows Improves with a down arrow (the 'symptoms' polarity and the label drive it). Two meta-analyses (18222667, 36051888) and an RCT (22360575) find lower bronchitis symptom/cough scores; Cochrane 24146345 agrees for the liquid only, low quality. Grade A and Moderate…
• Cough: Result none shown → Improvement. 1 study removed (studied a different group of people); 1 study added.Why: Ungraded row under Acute Bronchitis stores cough going UP ('Changes; see studies'). The linked herbal-cough review covers upper respiratory infections and colds, not bronchitis: removed. Added the flagged EPs 7630 meta-analysis (36051888, abstract read): in adults with acute bronchitis…
• Cough (Common Cold): Result none shown → Improvement.Why: Ungraded row under Common Cold stores cough going UP ('Changes; see studies'). The linked meta-analysis (26840418) found Pelargonium sidoides significantly better than placebo at easing cough frequency and severity in upper respiratory infections and colds. Improvement, direction decrease.…
• Cough (Upper Respiratory Tract Infection): Result none shown → Improvement.Why: Ungraded row under Upper Respiratory Tract Infection stores cough going UP ('Changes; see studies'). The linked meta-analysis (26840418) found Pelargonium sidoides significantly better than placebo at easing cough frequency and severity in upper respiratory infections and colds. Improvement…
• Cough (Acute Bronchitis): Result none shown → Improvement. 1 study removed (studied a different group of people); 1 study added.Why: Ungraded row under Acute Bronchitis stores cough going UP ('Changes; see studies'). The linked herbal-cough review covers upper respiratory infections and colds, not bronchitis: removed. Added the flagged EPs 7630 meta-analysis (36051888, abstract read): in adults with acute bronchitis…
• Fever: Result none shown → Improvement; Form studied not stated → EPs 7630 liquid root extract (oral drops), 30 drops three times a day for 7 days from the start of acute bronchitis; the Cochrane review found the liquid, not tablets, effective in adult bronchitis. 2 studies removed (did not measure this outcome); 1 study added.Why: Data gap re-derived. Literature checked (Cochrane 24146345, bronchitis MA 18222667, paediatric IPD MA 31014293, bronchitis RCTs). Both linked studies are outside acute bronchitis (common cold; infants with hypogammaglobulinemia) and neither reports fever: removed. The 217-patient placebo RCT in… The product form and dose pattern the supporting trials used
• Fever (Common Cold): Result none shown → No effect. 2 studies removed (did not measure this outcome); 1 study added.Why: Page shows Improves with fever going up under Common Cold. Neither linked trial reports fever (18005909 only a composite cold score; 22809962 no fever measure): removed. Flagged trial 23142309 (61 children, viral URTI) found no significant difference in fever: added, No effect. Stays ungraded.
• Fever (Upper Respiratory Tract Infection): Result none shown → No effect. 2 studies removed (did not measure this outcome); 1 study added.Why: Page shows Improves with fever going up under Upper Respiratory Tract Infection. Neither linked trial reports fever (18005909 only a composite cold score; 22809962 no fever measure): removed. Flagged trial 23142309 (61 children, viral URTI) found no significant difference in fever: added, No…
• Fever (Acute Bronchitis): Result none shown → Improvement; Form studied not stated → liquid Pelargonium sidoides root extract EPs 7630 (oral drops), 30 drops three times daily for 7 days; Cochrane 24146345 found adult bronchitis benefit with the liquid but not with tablets. 2 studies removed (did not measure this outcome); 1 study added.Why: Literature checked. Neither linked study is in acute bronchitis or reports fever: removed. In 217 adults with acute bronchitis (18449849), liquid EPs 7630 improved fever along with all other bronchitis symptoms vs placebo. The stored "fever goes up" is a sign error: Improvement, direction decrease. The product form and dose pattern the supporting trials used
• Nasal Congestion (Common Cold): Result none shown → Improvement. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves with nasal congestion going up under Common Cold (stored increase). The only link, 19382496, reports a composite sinus score in rhinosinusitis, not congestion: removed. Flagged trial 23142309 (61 children, viral URTI) found a significant group difference in nasal…
• Nasal Congestion (Acute Respiratory Infection (ARI)): Result none shown → Improvement. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves with nasal congestion going up under Acute Respiratory Infection (ARI) (stored increase). The only link, 19382496, reports a composite sinus score in rhinosinusitis, not congestion: removed. Flagged trial 23142309 (61 children, viral URTI) found a significant group…
• Nasal Congestion (Upper Respiratory Tract Infection): Result none shown → Improvement. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves with nasal congestion going up under Upper Respiratory Tract Infection (stored increase). The only link, 19382496, reports a composite sinus score in rhinosinusitis, not congestion: removed. Flagged trial 23142309 (61 children, viral URTI) found a significant group…
• Nasal Congestion (Sinusitis): Result none shown → Improvement; Form studied not stated → EPs 7630 root extract tablets, 20 mg three times a day for 10 days in acute rhinosinusitis (the placebo trial 19382496 used the liquid, 60 drops three times a day, for up to 22 days). 1 study removed (did not measure this outcome); 1 study added.Why: Data gap re-derived. Literature checked (Cochrane 24146345, herbal rhinosinusitis network MA 36609950, sinusitis RCTs). The linked placebo RCT (19382496) reports only the composite sinusitis score, not congestion: removed. The randomised trial against amoxicillin in acute bacterial… The product form and dose pattern the supporting trials used
• No human study left after the re-check, so no grade: Common Cold Symptoms (Acute Bronchitis). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Umckaloabo: the page as it is now

• 6-Minute Walk Distance: Effect note rewritten from its studies; Size small → not stated. 2 studies added.Why: Graded C row with no linked study shows Improves (Small, note 'clinically meaningful but not statistically significant'). The meta-analysis 42559151 pooled 6MWT: +17 m, p = 0.135, not significant; the 4-month RCT 35050355 in 65-90-year-olds also found no significant 6MWD gain. Added both; No…
• Peak VO2: Result Clinically meaningful improvement in aerobic endurance → Mixed effect; Size small → not stated. 3 studies added.Why: Graded C row with no linked study shows Improves ('clinically meaningful improvement'). RCT 40839339 (runners) found no significant time x treatment effect on VO2max; RCT 35584623 reports a 'clinically meaningful' peak VO2 gain without stating significance; the systematic review 42559151 calls…

Urolithin A: the page as it is now

• Anxiety Symptoms (Generalized Anxiety Disorder (GAD)): Result none shown → No effect.Why: The only study (12410546, 36 GAD outpatients) found no HAM-A difference between groups; the row said Improves.
• Sleep Latency (Insomnia): Result none shown → No effect. 2 studies added.Why: Literature checked: the insomnia meta-analysis 20347389 found no difference in time to fall asleep (0.70 min, 95% CI -3.44 to 4.83) and the herbal-insomnia meta-analysis 25644982 found no difference on any efficacy measure; Taibi 2007 (17517355) and the 2024 umbrella review (38359657) agree.…

Valerian: the page as it is now

• No human study left after the re-check, so no grade: Muscle Protein Synthesis. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Valine: the page as it is now

• ARDS/Respiratory Failure (Acute Respiratory Distress Syndrome): Effect note rewritten from its studies; Grade A → B; Size none → not stated. 2 studies removed (studied a different group of people); 2 studies removed (did not measure this outcome).Why: Only 41368449 (systematic review/meta-analysis in ARDS) is on topic: pooled RCTs show no survival benefit (OR 1.01); only uncontrolled case series showed better oxygenation. The note's 'n=196', 'n=461' and '60-day survival' figures are in no cited abstract, so it becomes No effect (direction stays…

Vasoactive Intestinal Peptide (VIP/Aviptadil): the page as it is now

• Erythropoietin (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with erythropoietin going up under General Athletic Performance, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays…
• Erythropoietin (Aerobic Exercise Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with erythropoietin going up under Aerobic Exercise Performance, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays…
• Erythropoietin: Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with erythropoietin going up under muscle-size-strength, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays ungraded.
• Erythropoietin (Running Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with erythropoietin going up under Running Performance, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays ungraded.
• Erythropoietin (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with erythropoietin going up under Muscle Size & Strength, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays ungraded.
• Growth Hormone (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (growth hormone up) under General Athletic Performance (general group). Flagged RCT 16286669 (read): no difference between velvet antler and placebo in any hormonal response, growth hormone included. Added: No effect. One RCT: ceiling C, stays ungraded.
• Growth Hormone (Rowing Performance): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (growth hormone up) under Rowing Performance (rowers studied). Flagged RCT 16286669 (read): no difference between velvet antler and placebo in any hormonal response, growth hormone included. Added: No effect. One RCT: ceiling C, stays ungraded.…
• IGF-1 (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with IGF-1 going up under General Athletic Performance, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays ungraded.
• IGF-1 (Aerobic Exercise Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with IGF-1 going up under Aerobic Exercise Performance, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays ungraded.
• IGF-1: Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with IGF-1 going up under muscle-size-strength, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays ungraded.
• IGF-1 (Running Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with IGF-1 going up under Running Performance, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays ungraded.
• IGF-1 (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with IGF-1 going up under Muscle Size & Strength, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays ungraded.
• Power Output (Rowing Performance): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (rowing power up). Flagged RCT 16286669 (read; rowers): 2000 m times and strength improved similarly with velvet antler or placebo; 'does not significantly improve rowing performance'. 2000 m simulated-race time taken as the direct power/performance…
• Red Blood Cell Count (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with red blood cell count going up under General Athletic Performance, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect.…
• Red Blood Cell Count (Aerobic Exercise Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with red blood cell count going up under Aerobic Exercise Performance, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect.…
• Red Blood Cell Count: Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with red blood cell count going up under muscle-size-strength, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays…
• Red Blood Cell Count (Running Performance): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with red blood cell count going up under Running Performance, with no linked study. Flagged RCT 14669926 (38 active men, velvet extract or powder vs placebo, 10 wk) measured it and found no endocrine or red cell mass change in any group. Added; No effect. Stays…
• Red Blood Cell Count (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (red blood cells up). Flagged RCT 14669926 (read; 38 active men, Muscle Size & Strength is a general group) found no red cell mass change in any group. Added: No effect. One RCT: ceiling C, stays ungraded. 16286669 measured no red-cell outcome (not…
• Testosterone (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Page shows Improves with testosterone going up under General Athletic Performance. The linked RCT 16286669 (rowers, 10 wk) found no hormonal difference vs placebo; flagged RCT 14669926 (38 active men, 10 wk) found no endocrine change in any group. Added it; No effect. Stays ungraded.
• Testosterone (Aerobic Exercise Performance): Result none shown → No effect. 1 study added.Why: Page shows Improves with testosterone going up under Aerobic Exercise Performance. The linked RCT 16286669 (rowers, 10 wk) found no hormonal difference vs placebo; flagged RCT 14669926 (38 active men, 10 wk) found no endocrine change in any group. Added it; No effect. Stays ungraded.
• Testosterone: Result none shown → No effect. 1 study added.Why: Page shows Improves with testosterone going up under muscle-size-strength. The linked RCT 16286669 (rowers, 10 wk) found no hormonal difference vs placebo; flagged RCT 14669926 (38 active men, 10 wk) found no endocrine change in any group. Added it; No effect. Stays ungraded.
• Testosterone (Rowing Performance): Result none shown → No effect. 1 study added.Why: Page shows Improves with testosterone going up under Rowing Performance. The linked RCT 16286669 (rowers, 10 wk) found no hormonal difference vs placebo; flagged RCT 14669926 (38 active men, 10 wk) found no endocrine change in any group. Added it; No effect. Stays ungraded.
• Testosterone (Running Performance): Result none shown → No effect. 1 study added.Why: Page shows Improves with testosterone going up under Running Performance. The linked RCT 16286669 (rowers, 10 wk) found no hormonal difference vs placebo; flagged RCT 14669926 (38 active men, 10 wk) found no endocrine change in any group. Added it; No effect. Stays ungraded.
• Testosterone (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Page shows Improves with testosterone going up under Muscle Size & Strength. The linked RCT 16286669 (rowers, 10 wk) found no hormonal difference vs placebo; flagged RCT 14669926 (38 active men, 10 wk) found no endocrine change in any group. Added it; No effect. Stays ungraded.
• No human study left after the re-check, so no grade: Testosterone (Female Sexual Dysfunction), Testosterone (Male Sexual Dysfunction), Testosterone (Erectile Dysfunction). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Velvet Antler: the page as it is now

• Pneumonia Symptoms (Pneumonia): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves. Its only study is a neonatal RDS/BPD meta-analysis with no pneumonia-symptom result: removed. The flagged Cochrane review in children with pneumonia (read) found no effect on the clinical course: added, No effect.

Vitamin A: the page as it is now

• No human study left after the re-check, so no grade: Depression Symptoms (Vitamin B12 Deficiency), Depression Symptoms, Depression Symptoms (Age-Associated Memory Impairment and Cognitive Decline (AAMCD)), Schizophrenia symptoms (Schizophrenia). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Vitamin B12: the page as it is now

• Acne Lesion Count (Acne): Result Moderate Decrease → Decrease; Grade B → C; Size moderate → not stated; People studied 300 → not stated. 1 study added.Why: Our auditor; literature checked before pulling (pubmed.py "pantothenic acid acne randomized"): the only trial (24831048, 41 adults) tested a multi-ingredient pantothenic-acid-based supplement, so no study isolates vitamin B5; no grade or verdict (C3, C9). Data gap: graded B ('Moderate Decrease', 300 people) with no linked study. Literature check: the only trial is the flagged RCT 24831048 (41 evaluable; total lesions fell vs placebo, P = 0.0197); the other hit (7476595) is a 1995 hypothesis paper with no data. Flag confirmed: one RCT, 300 people…
• Sebum Production (Acne): Result Moderate Decrease → none shown; Grade B → not graded; Size moderate → not stated; People studied 200 → not stated.Why: Our auditor; literature checked before pulling (pubmed.py "pantothenic acid acne randomized"): the only trial (24831048, 41 adults) tested a multi-ingredient pantothenic-acid-based supplement, so no study isolates vitamin B5; no grade or verdict (C3, C9).
• Skin Hydration (Skin Health): Result Moderate Increase → none shown; Grade B → not graded; Size moderate → not stated; People studied 350 → not stated.Why: Our auditor; literature checked before pulling (pubmed.py "pantothenic acid acne randomized"): the only trial (24831048, 41 adults) tested a multi-ingredient pantothenic-acid-based supplement, so no study isolates vitamin B5; no grade or verdict (C3, C9).
• Skin Roughness (Skin Health): Result Moderate Decrease → none shown; Grade B → not graded; Size moderate → not stated; People studied 280 → not stated.Why: Our auditor; literature checked before pulling (pubmed.py "pantothenic acid acne randomized"): the only trial (24831048, 41 adults) tested a multi-ingredient pantothenic-acid-based supplement, so no study isolates vitamin B5; no grade or verdict (C3, C9).
• No human study left after the re-check, so no grade: Blood Pantothenic Acid (B5 Deficiency), Deficiency Symptoms (B5 Deficiency). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Vitamin B5 (Pantothenic Acid): the page as it is now

• Breast Tenderness (Breast Pain): Result none shown → No effect. 1 study added.Why: Complaint confirmed. The only linked trial compared B6 with vitamin E and had no placebo or untreated arm; both groups improved equally, which cannot show that B6 works (cyclic breast pain often eases with placebo or time). The placebo-controlled evidence (2025 meta-analysis 40898150) found no…
• PMS Symptoms (Premenstrual Syndrome (PMS)): Result Mixed effect → Small Improvement; Grade B → C; Size not stated → small; Form studied not stated → oral pyridoxine up to 100 mg a day (long-term higher doses can cause nerve damage). 1 study added.Why: / literature checked (10334745, BMJ 1999 systematic review, 9 trials, 940 women): vitamin B6 improved overall premenstrual symptoms (OR 2.32) and premenstrual depression, but most trials were low quality. Small Improvement, grade B -> C. The product form and dose pattern the supporting trials used

Vitamin B6: the page as it is now

• Blood Flow (High Blood Pressure): Result Small Increase → none shown; Grade C → not graded; Size small → not stated. 2 studies removed (did not support the finding).Why: No oral vitamin C study left for this row (the linked ones infused vitamin C into an artery or vein: C3b). Literature checked before pulling (pubmed.py "oral vitamin C forearm blood flow hypertension", "ascorbic acid oral postural tachycardia syndrome"): no oral trial of blood flow in this population; the oral trial in type 2 diabetes found no effect on endothelial function (12241530). No grade or verdict.
• Blood Flow (Postural Orthostatic Tachycardia syndrome (POTS)): Result Small Increase → none shown; Grade C → not graded; Size small → not stated. 1 study removed (did not support the finding).Why: No oral vitamin C study left for this row (the linked ones infused vitamin C into an artery or vein: C3b). Literature checked before pulling (pubmed.py "oral vitamin C forearm blood flow hypertension", "ascorbic acid oral postural tachycardia syndrome"): no oral trial of blood flow in this population; the oral trial in type 2 diabetes found no effect on endothelial function (12241530). No grade or verdict.
• Length of hospitalization (Pneumonia): Result none shown → Mixed effect. 1 study added.Why: Literature checked. Cochrane (34791642, oral 125-200 mg/day adjunct trials) is uncertain about any effect on hospitalisation (very low certainty). The seed meta-analysis 38783029 (6 RCTs in community-acquired pneumonia) reports 'mixed results' for hospital stay with heterogeneity and publication…
• No human study left after the re-check, so no grade: Preterm Birth Risk (Premature Birth). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Vitamin C: the page as it is now

• 6-Minute Walking Test Performance (Parkinson's Disease): Result Small Improvement → Improvement; Size small → not stated. 1 study added.Why: Graded B with no linked study. Re-cited the meta-analysis of 8 RCTs in Parkinson disease (40551732): vitamin D lengthened 6-minute walk distance (WMD 24.85 m). Improves holds; B kept (ceiling A: undergraded). The abstract gives no size word, so "Small" is dropped.
• Acute Respiratory Tract Infection Symptoms (Asthma). 2 studies added.
• All-Cause Mortality (COVID-19): Result No effect → Mixed effect; Size none → not stated. 1 study removed (studied a different group of people); 3 studies added.Why: COVID-19 group. The only link (Cochrane 2011, mortality in mostly elderly women) predates COVID and fails population. Re-cited three meta-analyses of RCTs in COVID-19 patients: the largest (37802017, 25 trials) and 39764224 (14 trials) found no significant mortality effect, while the newest…
• Anxiety Symptoms (Premenstrual Syndrome (PMS)): Result Small Improvement → Mixed effect; Size small → not stated.Why: Two placebo-controlled trials in young women with PMS disagree: 31104056 (130 vitamin D-deficient women, 2000 IU every other day for 12 weeks) found no between-group difference in any PMS symptom including anxiety; 26724745 (158 girls with 25-OH-D <=10 ng/mL, high-dose D for 4 months) found…
• Aromatase-Inhibitor Related Joint Pain (Breast Cancer): Result Small Improvement → Improvement; Grade C → D; Size small → not stated.Why: Breast Cancer group: 19655244 followed 60 women starting letrozole; those with 25OHD <=40 ng/ml got 50,000 IU D3 weekly for 12 weeks with no control arm, and women who reached higher 25OHD reported less joint-pain disability (52 vs 19%). The authors conclude it 'may reduce disability'. Improves…
• Arterial Stiffness (Obesity): Result No effect → Mixed effect; Size none → not stated. 3 studies added.Why: No linked study. Obesity group (overweight/obese adults include the obese). Re-cited the stored 225-child source 31950134 (no effect on arterial stiffness) plus the two placebo-controlled trials in overweight/obese people that a search found: 35451536 (55 men, no PWV change) and 29216203 (70…
• Arterial Stiffness (Overweight): Result No effect → Mixed effect; Size none → not stated. 3 studies added.Why: No linked study. Overweight group. Re-cited the stored 225-child source 31950134 (no effect on arterial stiffness) plus the two placebo-controlled trials in overweight/obese people that a search found: 35451536 (55 men, no PWV change) and 29216203 (70 deficient adults, PWV fell dose-dependently, -0.
• Asthma Symptoms (Acute Respiratory Infection (ARI)). 2 studies removed (studied a different group of people); 3 studies added.
• Asthma Symptoms (Flu). 2 studies removed (studied a different group of people); 1 study added.
• Bacterial Infection (Upper Respiratory Tract Infection): Result Moderate Improvement → Improvement; Size moderate → not stated. 1 study added.Why: No linked study. Upper Respiratory Tract Infection group. Re-cited the stored 140-person source, RCT 23242238 in patients with frequent (bacterial) respiratory infections: vitamin D3 4000 IU/d for a year cut the infectious score (symptoms plus antibiotic use) to 202 vs 249 points (relative 0.77…
• Beta-cell function (Prediabetes). 3 studies added.
• Blood glucose (Type 2 Diabetes). 2 studies removed (studied a different group of people); 2 studies added.
• Blood glucose (Endometriosis): Result Small Improvement → No effect; Size small → not stated. 2 studies removed (studied a different group of people); 1 study added.Why: Direction error: the page shows Improves ('Small Improvement') for blood glucose in endometriosis, but both links fail population (obese children; PCOS) and the only endometriosis trial, RCT 33508990 (60 women, the stored source), found vitamin D improved pelvic pain, TC/HDL ratio, hs-CRP and TAC…
• Blood glucose (Nonalcoholic Fatty Liver Disease (NAFLD)): Result Small Improvement → Mixed effect; Size small → not stated. 2 studies removed (studied a different group of people); 3 studies added.Why: NAFLD group. Both links fail population (obese children; PCOS). Meta-analyses of RCTs in NAFLD disagree on fasting glucose: 34803681 (16 RCTs) and 32966467 (10 RCTs) found a significant fall, while 37861495 (8 RCTs, 657 patients), 38774194 (recent placebo-controlled trials) and 28751149 found none.
• Blood Pressure: Result Small Improvement → Mixed effect; Size small → not stated.Why: General group, any population. The strongest link, meta-analysis 19587609 (11 RCTs), found a nonsignificant fall in systolic BP, a small significant fall in diastolic BP (-3.1 mmHg) and no reduction in normotensive participants; the authors call it 'weak evidence' of a small effect in…
• Body Fat (Immune Health): Result Small Decrease → No effect; Size small → not stated. 3 studies added.Why: Direction error: the page shows Improves ('Small Decrease') for body fat, but no study was linked and three meta-analyses of RCTs agree vitamin D does not change fat mass: 26180255 (26 RCTs, 42,430 adults: fat mass -0.43 kg, CI -1.69 to 0.84), 29563638 (percentage fat mass -0.31%, not significant)…
• Body Fat (Coronary Artery Disease (CAD)). 1 study added.
• Bone Mineral Density (Osteoporosis). 1 study removed (studied a different group of people); 1 study removed (not a study of this supplement).
• Bone turnover markers (Bone Health): Result Small Improvement → Improvement; Size small → not stated.Why: Bone Health is a general group. RCT ancillary 37390941 (45 adults with cystic fibrosis, single 250,000 IU vitamin D dose vs placebo during a pulmonary exacerbation): CTX-1 and P1NP fell on vitamin D and rose non-significantly on placebo. Improves (down arrow) holds, but the abstract gives no…
• Combined Anxiety & Depression (Depression): People studied 7,534 → not stated; Form studied not stated → vitamin D3 at least 2,000 IU/day (most positive trials <= 4,000 IU/day) for 8-24 weeks, mainly in people who already have depressive symptoms; 2,000 IU/day for 5 years did not prevent depression in older adults (VITAL-DEP); no clear effect on anxiety. 3 studies added.Why: Literature checked. In people with depression, meta-analyses agree on a small reduction in depressive symptoms (35816192 g -0.32, GRADE very low; 39552387 SMD -0.32 per 1,000 IU, GRADE moderate; 37852593 SMD -0.15 in primary depression), and the linked 2020 MA (32365423) finds less negative emotion overall, but heterogeneity is very high, long trials (> 52 weeks) show no effect and the anxiety part is null (39552387). VITAL-DEP (prevention in non-depressed older adults) was null. Small Improvement and B kept: meta-analyses agreeing on a small effect with inconsistent certainty. People 7534 cleared (study list changed). The product form and dose pattern the supporting trials used
• Depression Symptoms (Vitamin D Deficiency): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (did not measure this outcome); 4 studies removed (studied a different group of people); 3 studies added.Why: Vitamin D Deficiency group. All 5 links fail: four study older adults, adults in general, or type 2 diabetics not selected for deficiency, and the PMS trial reports no depression outcome. In deficient people the evidence conflicts: meta-analysis 35979473 (29 RCTs) finds those with low vitamin D…
• Fall Risk (Fall Prevention): Result Moderate Improvement → No effect; Grade A → B; Size moderate → not stated; Form studied not stated → no fall benefit overall in mostly community-dwelling adults; a possible benefit is limited to daily 800-1000 IU in older people with low vitamin D (25(OH)D <= 50 nmol/L) or in care homes; doses above 1000 IU/day or large intermittent doses may raise fall risk. 2 studies added.Why: Strongest linked study (2009 meta-analysis, 8 RCTs) shows 19% fewer falls at 700-1000 IU but none at lower doses; an 800 IU RCT agrees and the STURDY analysis finds no association. Direction kept (A ceiling met); "Moderate" has no basis (19% only at high dose), so size cleared. Large 2018… The editor/auditor 7 Nov ~23:45 (vitamin D page hero). Literature checked (pubmed.py 'vitamin D supplementation falls meta-analysis'; USPSTF 2024 recommends against vitamin D for fall prevention in community-dwelling older adults). The 2026 BMJ meta-analysis (42161415: 69 trials, 153,902 people, mostly community dwelling) finds little to no effect of vitamin D on falls (moderate to high certainty); the strongest evidence decides: No effect. Older positive evidence is linked for the subgroup: the 2009 meta-analysis (19797342) found 700-1000 IU/day lowered falls 19% and the 2024 network meta-analysis (38698349) found 800-1000 IU/day lowered falls (RR 0.85) and more in people with 25(OH)D <= 50 nmol/L, while doses above 1000 IU/day raised falls versus 800-1000 IU; one nursing-home trial (17302660) found 800 IU lowered falls; STURDY (35592513) found no benefit and possibly more consequential falls at higher levels. Grade A -> B. The product form and dose pattern the supporting trials used
• Height (Tuberculosis (TB)): Result Small Increase → No effect; Size small → not stated. 2 studies added.Why: Direction error: the page shows Improves ('Small Increase') for height on the TB page, resting on the 120-child 6-month Mongolian TB feasibility trial (22760564: +0.9 cm stature vs placebo). The phase 3 follow-on trial in the same setting, 36441522 (8851 children, weekly D3 for 3 years), found no…
• Inflammation (Menopause). 1 study removed (not a study of this supplement).
• Influenza Risk (Common Cold): Result Small Improvement → No effect; Size small → not stated.Why: Direction error: the page shows Improves ('Small Improvement') for influenza risk, but both linked placebo-controlled studies found no effect: 569 adults pooled from 10 vitamin D trials (influenza-like illness 38 vs 42, non-significant) and 247 Japanese students on 2000 IU/d (influenza A 13.5% vs…
• Interleukin 5: Result Small Increase → Increase; Size small → not stated.Why: Muscle-size-strength is a general group. RCT 22405472 (30 young adults, placebo vs 200 or 4000 IU/d for 28 days in winter): IL-5 fell on placebo, rose on 200 IU (P < 0.05) and was unchanged on 4000 IU, so vitamin D kept IL-5 above placebo. Increase holds, but the abstract gives no IL-5 figures, so…
• Interleukin 5 (General Athletic Performance): Result Small Increase → Increase; Size small → not stated.Why: General Athletic Performance is a general group. RCT 22405472 (30 young adults, placebo vs 200 or 4000 IU/d for 28 days in winter): IL-5 fell on placebo, rose on 200 IU (P < 0.05) and was unchanged on 4000 IU, so vitamin D kept IL-5 above placebo. Increase holds, but the abstract gives no IL-5…
• Irritable Bowel Syndrome Symptoms (Irritable Bowel Syndrome (IBS)): Result No effect → Improvement; Size none → not stated.Why: Direction error: the page shows 'No effect' for IBS symptoms, but the only link, meta-analysis 39854263 (9 RCTs, 780 people with IBS), found vitamin D improved IBS-SSS symptom severity vs controls (OR 2.34, 95% CI 1.56-3.50). Now 'Improvement' with a down arrow (lower symptom scores); no size word…
• Lower Respiratory Tract Infection Risk (Lower Respiratory Tract Infection). 2 studies added.
• Pain (Aromatase-Inhibitor Related Joint Pain). 1 study removed (studied a different group of people).
• Parkinson's Disease Symptoms (Parkinson's Disease): Result none shown → Mixed effect.Why: Ungraded row shows Improves for PD symptoms. The meta-analysis (40551732, 8 RCTs) found no effect on UPDRS-III motor scores, walk time or TUG; only 6-minute walk distance improved (that outcome has its own row, 3987). Mixed effect, not a clean benefit; stays ungraded (ceiling B).
• Pre-Eclampsia Risk (Preeclampsia): Result Moderate Improvement → Mixed effect; Grade A → C; Size moderate → not stated; People studied 5,035 → not stated; Form studied not stated → oral vitamin D3 (cholecalciferol) daily from early or mid pregnancy to delivery; trial doses median 2,000 IU/day (range 400-60,000 IU, some as weekly or monthly boluses); 1,000 IU/day (MAVIDOS) did not lower pre-eclampsia; stay within the 4,000 IU/day adult upper limit, which applies in pregnancy. 4 studies added.Why: Literature checked; same finding as c005/3990. The linked 2024 MA (39716171, 33 RCTs) reports RR 0.55, but the 2024 Cochrane update (39077939), after setting aside 20 of its 30 earlier trials on trustworthiness, finds the effect very uncertain (RR 0.53, CI 0.21-1.33; 1 study, 165 women); a 2025 MA (38950419) and the Academy MA (31669079) find no effect, and the MAVIDOS RCT (39880969) found pre-eclampsia 3.8% vs 3.3%. Benefit appears only in pools without a trustworthiness screen: Mixed effect, size cleared, grade A -> C (meta-analyses disagree; trustworthy evidence small and very low certainty). People 5035 cleared. The product form and dose pattern the supporting trials used
• Pre-Eclampsia Risk (Pregnancy and Delivery Health): Result Moderate Improvement → Mixed effect; Grade A → C; Size moderate → not stated; People studied 5,035 → not stated; Form studied not stated → oral vitamin D3 (cholecalciferol) daily from early or mid pregnancy to delivery; trial doses median 2,000 IU/day (range 400-60,000 IU, some as weekly or monthly boluses); 1,000 IU/day (MAVIDOS) did not lower pre-eclampsia; stay within the 4,000 IU/day adult upper limit, which applies in pregnancy. 4 studies added.Why: Literature checked; same finding as c005/3990. The linked 2024 MA (39716171, 33 RCTs) reports RR 0.55, but the 2024 Cochrane update (39077939), after setting aside 20 of its 30 earlier trials on trustworthiness, finds the effect very uncertain (RR 0.53, CI 0.21-1.33; 1 study, 165 women); a 2025 MA (38950419) and the Academy MA (31669079) find no effect, and the MAVIDOS RCT (39880969) found pre-eclampsia 3.8% vs 3.3%. Benefit appears only in pools without a trustworthiness screen: Mixed effect, size cleared, grade A -> C (meta-analyses disagree; trustworthy evidence small and very low certainty). People 5035 cleared. Population: Pregnancy and Delivery Health is general pregnancy; same evidence applies. The product form and dose pattern the supporting trials used
• Seminal Motility (Infertility): Result No effect → Small Improvement; Size none → small. 3 studies added.Why: Direction error: the page shows 'No effect' for sperm motility in infertility, with no study linked (people 0). Meta-analyses of trials in infertile men report a small significant improvement in motility: 38178948 (5 RCTs, 648 men: total motility +4.96 points, progressive +4.14) and 42004696 (11…
• No human study left after the re-check, so no grade: Acute Respiratory Tract Infection Symptoms (Eczema (Atopic Dermatitis)), Body Fat (Upper Respiratory Tract Infection), Body Fat (High Cholesterol), Upper Respiratory Tract Infection Symptoms (Pneumonia). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Vitamin D: the page as it is now

• Bone Mineral Density (Bone Health): Result Moderate Improvement → Mixed effect; Size moderate → not stated. 1 study removed (did not measure this outcome).Why: Shows Moderate Improvement, but the four meta-analyses conflict (21674202 and 39657786: lumbar BMD up; 31076817, 36 RCTs: no evidence of a BMD effect after removing biased trials; 35625785: femoral BMD n.s.) and the largest RCTs (19113922, 18252784, 17287908) found no BMD effect while others…
• Bone Mineral Density (Osteoporosis). 14 studies removed (studied a different group of people); 1 study removed (did not measure this outcome).
• Bone Mineral Density (Menopause): Result Moderate Improvement → Mixed effect; Size moderate → not stated; Form studied not stated → lumbar-spine BMD gains come mostly from menatetrenone (MK-4) 45 mg/day trials in women with osteoporosis; in non-osteoporotic postmenopausal women, phylloquinone 1 mg/day or MK-4 45 mg/day for 1-3 years did not change BMD, while MK-7 180 ug/day for 3 years slowed lumbar and femoral-neck loss. 8 studies removed (studied a different group of people); 1 study removed (did not measure this outcome); 3 studies added.Why: Shows Moderate Improvement. In postmenopausal women the evidence conflicts: the 36-RCT meta-analysis (31076817) finds no evidence of a BMD effect, the two largest RCTs (19113922, 381 women; 17287908, 325) found no BMD effect, while 23525894, 14506950, 16594930, 10227010 and 23702931 found less… The product form and dose pattern the supporting trials used
• Bone Mineral Density (Osteopenia): Result none shown → Mixed effect. 16 studies removed (studied a different group of people); 1 study removed (did not measure this outcome).Why: Ungraded row shows Improves (BMD up). The only study in osteopenia (11886767, 172 women with osteopenia/osteoporosis) found K2+D3 raised BMD 4.92% but K2 alone only 0.135%; the other 17 links are in other populations or do not report BMD. Now Mixed effect; grade stays empty (ceiling C).
• Insulin Resistance (Metabolic Health): Result none shown → Mixed effect.Why: Ungraded row shows Improves (insulin resistance down). Its two meta-analyses conflict: 29523009 (5 trials) found no effect on HOMA-IR, fasting glucose or insulin; 37724446 (7 trials) found a small HOMA-IR reduction. Now Mixed effect; grade stays empty (ceiling B).
• Insulin Resistance (Type 2 Diabetes). 2 studies removed (studied a different group of people); 3 studies added.
• Insulin Resistance: Result none shown → Mixed effect.Why: Ungraded row shows Improves (insulin resistance down). Its two meta-analyses conflict: 29523009 (5 trials) found no effect on HOMA-IR, fasting glucose or insulin; 37724446 (7 trials) found a small HOMA-IR reduction. Now Mixed effect; grade stays empty (ceiling B).

Vitamin K: the page as it is now

• Triglycerides: Effect note rewritten from its studies; Size small → not stated. 1 study removed (not a study of this supplement).Why: Row shows Small Improvement with a prose note, but the only extract study (15005645) found a non-significant triglyceride trend (p=0.07); the snack-bar trial is a bean-and-oats food, not the extract. Now No effect; size cleared; grade C (one RCT) kept.

White Kidney Bean Extract: the page as it is now

• Hyperpigmentation (Skin Health): Result Small Improvement → Improvement; Size small → not stated; Form studied not stated → topical: 75% mulberry (Morus alba) extract oil applied to melasma patches for 8 weeks; not evidence for white mulberry taken by mouth.Why: Our auditor agreed: the only evidence is a topical oil. Literature checked: no trial of white mulberry taken by mouth for pigmentation exists (searches above); the two reviews (29552273, 31741361) cover the same topical trial. The row is the white mulberry page's only row and the page summary already names the topical oil, so the row is kept on the topical form with an evidence_form label instead of being pulled. "Small" has no basis (the abstract reports within-group changes, the placebo arm improved less on MASI and worsened on the Mexameter, no between-group statistic): size cleared, label "Improvement". One small single-blind RCT: C stays. People 50 matches the abstract. The product form and dose pattern the supporting trials used

White Mulberry: the page as it is now

• Working Memory: Result Small Improvement → Mixed effect; Size small → not stated.Why: The 28-day RCT 31829793 found no group effect on accuracy, only faster reaction times; the pilot 33498314 measured acute neurophysiology. Mixed, not a clean improvement.

Whole Coffee Fruit Extract: the page as it is now

• No human study left after the re-check, so no grade: Nipple Cracks (Breast Pain). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Yarrow: the page as it is now

• Phobia Symptoms (Claustrophobia). 1 study removed (studied a different group of people).
• Phobia Symptoms (Fear of Flying): Result Small Improvement → No effect; Size small → not stated. 1 study removed (studied a different group of people).Why: Row shows Small Improvement for fear of flying, but the only fear-of-flying RCT (22116378) found no evidence yohimbine enhanced exposure therapy; the claustrophobia trial is a different phobia population. Now No effect; size cleared; grade C (one RCT) kept.

Yohimbine: the page as it is now

• Acute Respiratory Tract Infection Risk (Acute Respiratory Infection (ARI)): Result Moderate Improvement → No effect; Grade A → C; Size moderate → not stated. 1 study removed (not a study of this supplement); 1 study added.Why: Graded A from one rapid meta-analysis (34728441): oral or intranasal zinc prevented 5 RTIs per 100 person-months (NNT 20), authors calling it 'some evidence'. Direction agrees; the abstract gives no basis for 'Moderate', so size cleared (Improvement). Stored direction 'increase' set to 'decrease'… Literature check before pulling. Prevention evidence conflicts: the rapid meta-analysis 34728441 (28 RCTs, 5446 adults) found oral or intranasal zinc prevented 5 RTIs per… / literature checked: the 2024 Cochrane review (38719213, 34 studies) finds little or no reduction in the risk of developing a cold with zinc (RR 0.93, low certainty), so prevention is No effect, grade C (not ungraded). The rapid review 34728441 pools oral and…
• Blood glucose (Type 2 Diabetes): Form studied not stated → oral zinc taken alone (mostly inorganic salts such as zinc sulfate or gluconate) daily for weeks to months; the fall in fasting glucose grows with dose (about per extra 10 mg/day) and is larger with inorganic zinc. 5 studies added.Why: The product form and dose pattern the supporting trials used
• C-Reactive Protein (CRP) (Metabolic Syndrome): Result none shown → Improvement; Grade not graded → C; Form studied not stated → oral zinc supplements in adults; the 50 mg/day subgroup showed the clearest fall in CRP; studied in general adults, not metabolic syndrome. 1 study removed (studied a different group of people); 1 study added.Why: Re-derived (R4: its only link, a haemodialysis trial 19541504, was removed for population in 091). Literature checked: Mousavi 2018 meta-analysis (30012497; 8 RCTs in adults) found zinc lowered CRP (WMD -1.68 mg/L, 95% CI -2.4 to -0.9), and later meta-analyses agree (another finding). Studied in general adults, not specifically metabolic syndrome: graded one level lower for indirectness (B -> C). The product form and dose pattern the supporting trials used
• C-Reactive Protein (CRP): Result none shown → Improvement; Grade not graded → B; People studied 80 → not stated; Form studied not stated → oral zinc supplements; the 8-RCT meta-analysis found larger CRP falls at 50 mg/day zinc and in people with kidney disease. 4 studies added.Why: Ungraded row shows Improves (CRP down). Its only study, a placebo RCT in 55 hemodialysis patients (19541504), saw a CRP fall in the zinc group that was not significant. No effect; one RCT, ceiling C, row stays ungraded. The dossier's flag line belongs to huperzine another finding (mismatch), so… Literature checked. Four meta-analyses of RCTs agree that zinc lowers CRP (30012497: 8 RCTs, -1.68 mg/L; 33333394: 21 RCTs, -0.92 mg/L; 34560424: 25 trials, -0.03 mg/L; 37399684: 75 RCTs, GRADE-assessed); the single 55-person dialysis trial that #79 relied on was underpowered (its CRP fall was not significant). Label No effect -> Improvement, direction decrease. Size left blank: pooled estimates range from -0.03 to -1.68 mg/L with I2 about 90% and the larger falls in low-quality and kidney-disease trials. General condition, so any adult population counts. People 80 (matched nothing) cleared. Row stays ungraded (helpers never raise); C9 ceiling A. The product form and dose pattern the supporting trials used Lead check: Mousavi 2018 meta-analysis (30012497) of 8 RCTs found zinc lowered CRP (WMD -1.68 mg/L, 95% CI -2.4 to -0.9), and the later meta-analyses the helper linked agree; heterogeneity between trials is high, so B rather than A.
• Common Cold Symptoms (Common Cold): Result Small Improvement → Moderate Improvement; Size small → moderate; Form studied not stated → lozenge (zinc acetate or gluconate), about 75-100 mg elemental zinc a day, started within 24 hours of the first symptoms, for less than 2 weeks. 5 studies added.Why: Seth/ ('zinc is well studied for colds'); literature check (pubmed.py: 'zinc lozenges common cold meta-analysis', 'zinc common cold Cochrane', 'zinc acetate lozenges common cold randomized'). Graded B with no linked study. Zinc LOZENGES started early shorten colds: the 2024… The form and dose the trials used, so pages and the shop can match the product: zinc lozenges, not tablets or nasal zinc.
• Iron Absorption (Optimal Nutrient Levels): Result none shown → Decrease.Why: Page shows Improves with iron absorption going UP. No study found an increase: zinc lowered iron absorption in water at higher zinc:iron ratios (17350802: -56%; 17873388: -28 to -40%; 9740203 between feeds) and did not change it in fortified milk or with feeds (22760642, 9740203). Now…
• Pneumonia Symptoms (Pneumonia): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves. Six of seven passing RCTs in children with pneumonia found no faster recovery (only 21660402, n=128, found one); the flagged 11-trial meta-analysis (read) agrees: No effect. 20631326 measures later illness incidence: removed.
• Preterm Birth Risk (Infant Health): Result none shown → No effect.Why: Ungraded row shows 'Changes; see studies' with stored direction increase (more preterm births). Its Cochrane review found little or no difference in preterm birth: No effect.
• Psoriasis Symptoms (Psoriasis): Result none shown → No effect. 1 study removed (not a study of this supplement); 1 study added.Why: Ungraded row shows Improves on the oral Zinc page, resting on a topical zinc pyrithione cream trial: removed. The flagged oral zinc RCT in psoriasis (read) found no PASI difference: added, No effect.
• Tinnitus Symptoms (Tinnitus): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves for tinnitus on one small trial whose loudness benefit was not significant. The flagged Cochrane review (27879981, read; 3 RCTs, 209 adults) found no difference vs placebo on any tinnitus measure. The review outranks the single trial: No effect. Grade stays unset…
• Wart Severity (Human Papillomavirus (HPV)): Result none shown → Large Improvement; Size not stated → large. 1 study removed (not a study of this supplement).Why: Ungraded row shows 'Changes; see studies' with stored direction increase (warts worse). The oral zinc RCT found 86.9% complete clearance vs no response on placebo, so wart severity went down: direction decrease, Large Improvement. The topical zinc trial is the wrong route: removed.
• No human study left after the re-check, so no grade: Aggression (Depression). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Zinc: the page as it is now

• Vertebral Fracture Risk (Osteoporosis): Grade A → C. 3 studies removed (did not measure this outcome).Why: Every passing vertebral-fracture result comes from one trial, ACTIVE (27533157), and its post hoc subgroup papers (86% reduction, p<0.001; 0.72% vs 4.77% in the highest-risk subgroup; non-significant only in the small >=80 y subgroup) plus three reviews of it. One controlled trial: ceiling C under…

Abaloparatide: the page as it is now

• Renal Recovery in AKI (Acute Kidney Injury): Effect note rewritten from its studies; Grade B → C; Size moderate → not stated. 42 studies removed (not a study of this supplement); 2 studies removed (did not measure this outcome); 2 studies added.Why: None of the 4 linked studies reports renal recovery in AKI (curcumin AD trial, ARB review, ATHOS-3 BP report, shock review): all removed. Re-cited with two post hoc ATHOS-3 analyses (IV, the peptide page's form) showing more RRT liberation with angiotensin II. One trial, post hoc: B to C; the…

Angiotensin II: the page as it is now

• Liver Enzymes (Nonalcoholic Fatty Liver Disease (NAFLD)): Direction goes up → goes down. 3 studies added.Why: No study linked. Two meta-analyses (5 RCTs in NAFLD; 8 trials with a NAFLD subgroup) and a 100-patient NAFLD RCT all show artichoke leaf extract lowers ALT/AST. Direction ok; SMD ~1 supports 'moderate'. Ceiling A, stored C kept (undergraded). Stored direction set to decrease (enzymes fall), label…

Artichoke Extract: the page as it is now

• Anxiety Symptoms (Generalized Anxiety Disorder (GAD)). 1 study removed (not a study of this supplement); 1 study removed (studied a different group of people).
• No human study left after the re-check, so no grade: Anxiety Symptoms (Low Testosterone). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Ashwagandha: the page as it is now

• Exercise-Induced Oxidation (Muscle Recovery): Result No effect → none shown; Size none → not stated.Why: General group (Muscle Recovery). The only study (double-blind RCT, 32 elite young soccer players, 90 days) found the post-exercise rise in superoxide anion significant only with placebo (exercise x supplementation P<0.05), and TAS fell post-exercise only with placebo; TBARS and AOPP did not change…
• Oxidative Stress Biomarkers (Soccer Performance): Result Small Decrease → Mixed effect; Size small → not stated.Why: General-type group (Soccer Performance). The only placebo-controlled RCT (21937848) found no change in erythrocyte phospholipid hydroperoxides. The two studies that report falls in MDA/oxidized LDL/isoprostanes have no placebo arm (30379308 is a 4-arm randomized study with an astaxanthin-alone arm…
• No human study left after the re-check, so no grade: Blood glucose (Cardiovascular Disease), Blood glucose (Metabolic Syndrome), High-density lipoprotein (HDL) (Carpal Tunnel Syndrome), Inflammation (Gastroesophageal Reflux Disease (GERD)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Astaxanthin: the page as it is now

• Alzheimer's Disease Symptoms (Alzheimer’s Disease): Direction goes up → no change.Why: The one study is an early-terminated active-comparator trial (bacopa vs donepezil) with no significant difference; it shows no change in Alzheimer's symptoms attributable to bacopa, so the shown 'Changes; see studies' (goes up) is unsupported. Ungraded row: verdict cleared, link kept.
• No human study left after the re-check, so no grade: Stress Signs and Symptoms (Mental Resilience), Stress Signs and Symptoms (Stress), Stress Signs and Symptoms (Cognitive Improvement). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Bacopa Monnieri: the page as it is now

• Kidney Function (Diabetic Nephropathy): Result none shown → No effect. 1 study added.Why: Row shows Improves with no study. The benfotiamine RCT in T2D nephropathy (20413516) found no change in kidney damage markers (UAE, KIM-1); no GFR data in the abstract. Judgment call: if albuminuria is not accepted as kidney function, ungrade instead.
• Proteinuria (Diabetic Nephropathy): Result none shown → No effect.Why: Row shows Improves (up arrow) but its only study, an RCT in T2D nephropathy (n=82, 12 weeks, 900 mg/day), found no significant fall in 24-h urinary albumin excretion.
• No human study left after the re-check, so no grade: Blood Pressure (Diabetic Nephropathy), HbA1c (Diabetic Nephropathy), High-density lipoprotein (HDL) (Diabetic Nephropathy), Low-density lipoprotein (LDL) (Diabetic Nephropathy), Triglycerides (Diabetic Nephropathy). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Benfotiamine: the page as it is now

• Body Mass Index (BMI) (Body Composition): Result Small Decrease → No effect; Size small → not stated.Why: Page shows Improves (Small Decrease, B) but its only study, a meta-analysis of 12 RCTs (849 adults), found no significant change in BMI (P = 0.247).
• Waist circumference (Body Composition): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with no study. The berberine/barberry meta-analysis (32147051) found no significant change in waist circumference: add it and show No effect. Grade stays empty (never raised).
• Waist-Hip Ratio (Body Composition): Result none shown → Improvement. 1 study added.Why: Row shows Improves with an up arrow (stored increase) and no study. 32147051 reports a significant WHR reduction (WMD -0.03): verdict holds, stored direction should be decrease. Grade stays empty (never raised).
• Weight (Body Composition): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with no study. The berberine/barberry meta-analysis (32147051) found no significant change in body weight (P = 0.830): add it and show No effect.

Berberine: the page as it is now

• Blood glucose (High Cholesterol): Result Moderate Improvement → No effect; Size moderate → not stated. 1 study removed (studied a different group of people); 1 study removed (did not measure this outcome).Why: The row shows Moderate Improvement, but the only on-population evidence (meta-analysis of 12 RCTs in hypercholesterolemic people, 26001090) found no significant effect on fasting glucose or insulin. Acute test-meal MA and the T2DM MA removed. Grade A stands for a No-effect verdict from…
• No human study left after the re-check, so no grade: Waist circumference (Weight Loss & Maintenance). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Beta-glucans: the page as it is now

• Blood Pressure (Weight Loss & Maintenance): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows 'Changes; see studies' (goes up). The betaine cardiovascular-marker meta-analysis (33764214) found no effect on blood pressure: added, verdict No effect. Grade left unset (ceiling A).
• Body Fat (Weight Loss & Maintenance): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows 'Changes; see studies' (goes up). The body-composition meta-analysis (34743773) finds no effect on body fat % or fat mass: added, verdict No effect. Grade left unset (ceiling A).
• High-density lipoprotein (HDL) (Weight Loss & Maintenance): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves for HDL. The betaine cardiovascular-marker meta-analysis (33764214) found no effect on HDL: added, verdict No effect. Grade left unset (ceiling A).
• Muscular Endurance (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves. The 2024 meta-analysis of chronic betaine (39514262) found no significant effect on muscular endurance. Added it; verdict now No effect. Grade left unset (never raised; ceiling A).
• Power Output (General Athletic Performance): Result none shown → Mixed effect. 1 study removed (did not measure this outcome).Why: The row shows Improves, but 3 of the 4 controlled trials that measure power (19250531, 21744011, 22080324) found no effect vs placebo; only 20642826 (12 men) found higher bench-throw power. Mixed effect. The isokinetic force study is removed (force, not power). Ungraded row stays ungraded…
• Power Output (Running Performance): Result none shown → Mixed effect. 1 study removed (did not measure this outcome).Why: The row shows Improves, but 3 of the 4 controlled trials that measure power (19250531, 21744011, 22080324) found no effect vs placebo; only 20642826 (12 men) found higher bench-throw power. Mixed effect. The isokinetic force study is removed (force, not power). Ungraded row stays ungraded…
• Power Output (Cycling Performance): Result none shown → Mixed effect. 1 study removed (did not measure this outcome).Why: The row shows Improves, but 3 of the 4 controlled trials that measure power (19250531, 21744011, 22080324) found no effect vs placebo; only 20642826 (12 men) found higher bench-throw power. Mixed effect. The isokinetic force study is removed (force, not power). Ungraded row stays ungraded…
• Power Output (Muscle Size & Strength): Result none shown → Mixed effect. 1 study removed (did not measure this outcome).Why: Row shows Improves, but 3 of 4 controlled trials measuring power found no effect vs placebo; only 20642826 (12 men) found higher bench-throw power. The 2024 MA (39514262, flag) likewise finds no effect on sprint or bench-throw power but better vertical jump. Mixed effect; force-only study…
• Weight (Muscle Size & Strength): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: The shown 'Changes; see studies' (goes up) had only a NASH trial with no weight outcome (removed). The body-composition meta-analysis (34743773) finds no effect on body mass: added, verdict No effect. Grade left unset (ceiling A).
• Weight (Weight Loss & Maintenance): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: The shown 'Changes; see studies' (goes up) had only a NASH trial with no weight outcome (removed). The body-composition meta-analysis (34743773) finds no effect on body mass: added, verdict No effect. Grade left unset (ceiling A).
• No human study left after the re-check, so no grade: Blood glucose (Warm- or Hot-Weather Exercise Performance), Blood glucose (Running Performance), Blood Pressure (Body Composition), Blood Pressure (Obesity), Body Fat (Body Composition), Body Fat (Obesity), Body Fat (General Athletic Performance), Body Fat (Running Performance), Body Fat (Cycling Performance), Body Fat (Muscle Size & Strength), High-density lipoprotein (HDL) (Coronary Artery Disease (CAD)), High-density lipoprotein (HDL) (Obesity), High-density lipoprotein (HDL) (Metabolic Syndrome), High-density lipoprotein (HDL) (High Cholesterol), Muscle Mass (General Athletic Performance), Muscle Mass (Running Performance), Muscle Mass (Cycling Performance), Muscle Mass (Muscle Size & Strength), Muscular Endurance (General Athletic Performance), Weight (Body Composition), Weight (Obesity), Weight (General Athletic Performance), Weight (Running Performance), Weight (Cycling Performance), Weight (Nonalcoholic Fatty Liver Disease (NAFLD)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Betaine: the page as it is now

• Body Mass Index (BMI) (Type 2 Diabetes): Result none shown → Mixed effect. 1 study added.Why: Ungraded row with no study shows 'Changes; see studies' (goes up) for BMI. The T2DM meta-analysis (36034891) found no overall change in BMI, with a decrease only at doses above 1 g/day: added, verdict Mixed effect. Grade left unset (ceiling B).
• Insulin (Type 2 Diabetes): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows 'Changes; see studies' (goes up) for insulin. The black seed meta-analysis in prediabetes/T2DM (36034891) found no overall change in fasting insulin: added, verdict No effect. Grade left unset (ceiling A).
• Insulin Resistance (Type 2 Diabetes): Result none shown → Mixed effect. 1 study added.Why: Ungraded row with no study shows 'Changes; see studies' (goes up). The T2DM meta-analysis (36034891) found no overall change in HOMA-IR, with a decrease only in trials longer than 8 weeks: added, verdict Mixed effect. Grade left unset (ceiling B).
• No human study left after the re-check, so no grade: Interleukin 6 (Chronic Kidney Disease (CKD)), Interleukin 6 (Metabolic Syndrome), Interleukin 6 (Type 2 Diabetes), Interleukin 6 (Nonalcoholic Fatty Liver Disease (NAFLD)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Black seed: the page as it is now

• Dysmenorrhea Symptoms (Primary Dysmenorrhea (Menstrual Cramps)): Result Moderate Improvement → Improvement; Size moderate → not stated.Why: One placebo-controlled RCT (113 students) found lower menstrual pain severity and duration with 10 mg/day boron. Direction and grade C hold, but the abstract gives no magnitude: 'Moderate Improvement' becomes 'Improvement', size cleared.

Boron: the page as it is now

• Weight (Ski Performance): Result Small Decrease → No effect; Size small → not stated.Why: The row shows 'Small Decrease' (Improves). Its only study is a controlled trial where BCAA did not significantly change weight or body composition (the BCAA group's 1.2% loss was n.s.; the control lost more). No effect; size cleared; grade C kept (one controlled trial).

Branched-Chain Amino Acids: the page as it is now

• Anxiety Symptoms (Anxiety Disorders (Other)): Effect note rewritten from its studies; Size small → not stated.Why: 21322821: open-label multicenter study (728 patients with psychoautonomic syndrome and asthenia, anxiety-depressive spectrum disorders among them), reports anxiolytic efficacy with no control arm and no anxiety effect size. Improves holds; 'small' has no basis and the note's 'placebo-controlled…
• Asthenia Symptoms (Neurasthenia): Effect note rewritten from its studies; Grade B → C; Size moderate → not stated.Why: Ladasten = bromantane. 20559263 and 21322821 are two PubMed records of the same open-label multicenter study (728 asthenic patients, 28 days, no control arm): responder rates only, so Improves holds but no size basis. The note's 'n=76 open-label' and 'n=156 double-blind placebo-controlled' are not…
• Cognitive/Psychomotor Performance (Cognitive Function): Effect note rewritten from its studies; Size small → not stated.Why: 10998997 (10 healthy men, single dose vs placebo): principal operator-performance components unchanged, only EEG vigilance signs and tremor reduction improved; it tested untired men, not fatigue as the note says. A clean 'Improves / small' overstates it: Mixed effect, clear size. One…
• Dependence/Withdrawal Signs (Short-Term): Effect note rewritten from its studies. 2 studies removed (did not measure this outcome); 2 studies added.Why: The two linked records (same open-label multicenter study) report sustained benefit after stopping but never measure withdrawal or dependence signs: removed. Re-cited 19491814 (randomized placebo-controlled neurasthenia trial with a placebo run-out: no withdrawal syndrome) and 11109517 (rats: no…
• No human study left after the re-check, so no grade: Dopamine Synthesis (TH/AADC Expression), Physical Work Capacity (Primarily Preclinical) (General Athletic Performance). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Bromantane: the page as it is now

• Antioxidant Status: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 2 studies added.Why: No studies linked; the note says in vitro/animal only, which the added mouse and cell studies confirm. Ceiling D equals stored D, keep; clear 'small' (no basis). No passing human study (animal, lab or review evidence only): no grade
• Blood Glucose: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 2 studies added.Why: No studies linked; the note correctly says rodent-only. Two diabetic-rodent extract studies confirm lower blood glucose. Ceiling D equals stored D, keep. 'Small' has no basis in animal abstracts: clear size. No human study found. No passing human study (animal, lab or review evidence only): no grade
• Liver Protection: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 2 studies added.Why: No studies linked; the note correctly says rodent-only. Two rat studies (flower extract vs CCl4, bark fraction vs thioacetamide) confirm liver protection. Ceiling D equals stored D, keep; clear 'small' (no basis). No passing human study (animal, lab or review evidence only): no grade

Butea Monosperma: the page as it is now

• Cortisol (Rugby Performance): Result Small Increase → Increase; Size small → not stated.Why: The row shows Improves with a downward arrow (stored decrease) for cortisol. Its study shows caffeine raised cortisol vs control. Now 'Increase' (direction increase); no basis for a size word. Grade C kept (one small randomized crossover trial).
• No human study left after the re-check, so no grade: Cortisol (Low Testosterone), Glycemic Control (Healthy Muscle Aging), Glycemic Control (Type 2 Diabetes), Glycemic Control (General Athletic Performance). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Caffeine: the page as it is now

• Weight (Weight Loss & Maintenance): Result none shown → No effect.Why: The row shows 'Changes; see studies' (goes up) for weight; its Cochrane review finds little to no difference in body weight with calcium. Now No effect. Ungraded row: grade left unset (ceiling A).

Calcium: the page as it is now

• Body Fat (Type 2 Diabetes): Result none shown → No effect.Why: Ungraded row shows Improves for body fat (T2D page); its only study, a double-blind RCT in prediabetes/T2D (39770949), found no difference from placebo. Now No effect; grade unset (ceiling C).
• Body Fat (Prediabetes): Result none shown → No effect.Why: Ungraded row shows Improves for body fat (prediabetes page); its only study, a double-blind RCT in prediabetes/T2D (39770949), found no difference from placebo. Now No effect; grade unset (ceiling C).
• Bone Mineral Density (Type 2 Diabetes): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves for bone mineral density (T2D page); the flagged double-blind RCT in prediabetes/T2D (39770949, added) found no difference from placebo. Now No effect; grade unset (ceiling C).
• Bone Mineral Density (Prediabetes): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves for bone mineral density (prediabetes page); the flagged double-blind RCT in prediabetes/T2D (39770949, added) found no difference from placebo. Now No effect; grade unset (ceiling C).
• Muscle Strength (Type 2 Diabetes): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves for muscle strength (T2D page); the flagged double-blind RCT in prediabetes/T2D (39770949, added) found no difference from placebo. Now No effect; grade unset (ceiling C).
• Muscle Strength (Prediabetes): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves for muscle strength (prediabetes page); the flagged double-blind RCT in prediabetes/T2D (39770949, added) found no difference from placebo. Now No effect; grade unset (ceiling C).
• No human study left after the re-check, so no grade: High-density lipoprotein (HDL) (Type 2 Diabetes), High-density lipoprotein (HDL) (Prediabetes), Insulin (Type 2 Diabetes), Insulin (Prediabetes), Insulin Resistance (Type 2 Diabetes), Insulin Resistance (Prediabetes), Low-density lipoprotein (LDL) (Type 2 Diabetes), Low-density lipoprotein (LDL) (Prediabetes). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Carnosine: the page as it is now

• Appetite (Weight Loss & Maintenance): Result Small Decrease → Decrease; Grade C → D; Size small → not stated.Why: One small study (16 people) compared 500 vs 2,000 mg/day citicoline for 6 weeks with no placebo arm: appetite ratings fell in the high-dose group, weight did not change. A single small uncontrolled study caps the grade at D (regrade C to D); it gives no effect size, so 'small' is cleared and the…
• Attention (Focus & Attention): Result Modest improvement in attention tasks → Mixed effect; Size small → not stated. 2 studies added.Why: No linked study; C row would lose its grade, so re-cited. Cochrane review (14 RCTs, elderly) found no attention benefit; one 28-day RCT in healthy adolescent boys found better attention. Mixed, not 'modest improvement'. C kept.
• Cocaine Addiction Symptoms (Cocaine Abuse): Result Small improvement in addiction markers → No effect; Size small → not stated.Why: The row shows 'Small improvement in addiction markers' (Improves), but its only study, a double-blind placebo-controlled trial, found citicoline had no effect on cocaine craving or use. Now No effect, size cleared, grade C kept (one RCT).
• No human study left after the re-check, so no grade: Cocaine Addiction Symptoms (Bipolar Disorder). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

CDP-Choline: the page as it is now

• No human study left after the re-check, so no grade: Anxiety, Cholesterol, Cognitive Function, Depression, Intestinal Smooth Muscle Relaxation, Neuroprotection, Stress Resilience. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Celastrus Paniculatus: the page as it is now

• No human study left after the re-check, so no grade: Atherosclerosis Progression. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Chinese Hawthorn: the page as it is now

• No human study left after the re-check, so no grade: Anti-Angiogenic Effects, Anti-Cancer Effects (Colon Cancer), Anti-Hepatocellular Carcinoma Effects, Blood Glucose Levels, Blood Lipid Levels, Insect Repellent / Larvicidal Activity, PTP1B Inhibition (Insulin Sensitization). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Chinese juniper: the page as it is now

• Vaccine Augmentation (Immune Health): Result none shown → No effect.Why: Row shows Improves but its RCT (124 adults over 50) found no effect on antibody response to flu vaccine overall; only a 50-55-year subgroup rose. Show No effect; grade stays empty.
• No human study left after the re-check, so no grade: High-density lipoprotein (HDL) (High Blood Pressure), High-density lipoprotein (HDL) (High Cholesterol), High-density lipoprotein (HDL) (Nonalcoholic Fatty Liver Disease (NAFLD)), High-density lipoprotein (HDL) (Dyslipidemia), High-density lipoprotein (HDL) (Obesity), Triglycerides (High Blood Pressure), Triglycerides (High Cholesterol), Triglycerides (Nonalcoholic Fatty Liver Disease (NAFLD)), Triglycerides (Dyslipidemia), Triglycerides (Obesity). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Chlorella: the page as it is now

• Depression Symptoms (Dysthymia): Result none shown → No effect. 1 study removed (studied a different group of people); 1 study removed (did not measure this outcome).Why: Strongest passing evidence, a 113-patient RCT in atypical depression that enrolled dysthymia, found no difference on primary measures (benefit only in a carb-craving subgroup). 5-patient case series positive. Removed: bipolar letter (no abstract), MDD pilot. Show No effect.
• Low-density lipoprotein (LDL) (Body Composition): Result none shown → No effect.Why: Row shows Improves (LDL down) but its umbrella review of 8 meta-analyses found no significant LDL effect of chromium in adults (Body Composition is a general condition, so the adult population fits). Show No effect; grade stays empty.
• Low-density lipoprotein (LDL) (Weight Loss & Maintenance): Result none shown → No effect.Why: Row shows Improves (LDL down) but its umbrella review of 8 meta-analyses found no significant LDL effect of chromium in adults (Weight Loss & Maintenance is a general condition, so the adult population fits). Show No effect; grade stays empty.
• No human study left after the re-check, so no grade: Kidney Function (Type 2 Diabetes), Kidney Function (Obesity), Kidney Function (Overweight), Kidney Function (Prediabetes), Low-density lipoprotein (LDL) (Type 2 Diabetes), Low-density lipoprotein (LDL) (High Cholesterol), Low-density lipoprotein (LDL) (Polycystic Ovary Syndrome (PCOS)), Low-density lipoprotein (LDL) (Obesity), Low-density lipoprotein (LDL) (Overweight), Low-density lipoprotein (LDL) (Metabolic Syndrome), Low-density lipoprotein (LDL) (Dyslipidemia), Low-density lipoprotein (LDL) (Human Immunodeficiency Virus (HIV)), Low-density lipoprotein (LDL) (Prediabetes). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Chromium: the page as it is now

• Asthma Symptoms (Asthma): Grade C → D.Why: The only study is an open-label, uncontrolled before-after pilot (41 obese asthmatics, 2 weeks): ACQ fell 0.46 points and FeNO rose. Direction and Small Improvement hold, but a single small uncontrolled study caps the grade at D: regrade C to D.

Citrulline: the page as it is now

• Antifungal Activity: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 2 studies added.Why: No studies linked; the note correctly says limited in vitro evidence. Cnidium fruit extracts inhibit a human skin fungus (T. rubrum) and plant fungi in culture. Ceiling D equals stored D, keep; clear 'small' (no basis). No passing human study (animal, lab or review evidence only): no grade
• Erectile Function: Effect note rewritten from its studies; Grade C → not graded; Size moderate → not stated. 3 studies added.Why: No studies and graded C, though its own note says no human trials exist. Real lab and rat studies of Cnidium's coumarins (osthole) show corpus cavernosum relaxation and better erectile response. Preclinical only: ceiling D, regrade C to D; clear 'moderate' (no basis). No passing human study (animal, lab or review evidence only): no grade
• Inflammation: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 2 studies added.Why: No studies linked; the note correctly says in vitro/animal only. A Cnidium volatile-oil cream lowered inflammatory cytokines in mouse eczema, and osthole blocked NF-kB signalling. Ceiling D equals stored D, keep; clear 'small' (no basis). No passing human study (animal, lab or review evidence only): no grade
• Neuroprotection: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 2 studies added.Why: No studies linked; the note correctly says animal only. A Cnidium extract reversed scopolamine amnesia in rats, and osthole reduced infarct size after rat stroke. Ceiling D equals stored D, keep; clear 'small' (no basis). No passing human study (animal, lab or review evidence only): no grade

Cnidium monnieri: the page as it is now

• Adrenaline: Result Small Decrease → Improvement; Grade C → D; Size small → not stated. 2 studies removed (did not measure this outcome); 1 study added.Why: The page shows Worsens (adrenaline down), but no study reports a harm. Group: general-cardiovascular-health (any population). The JACC letter has no abstract and its title does not show adrenaline; the Thromb Haemost RCT measured epinephrine but reports no group difference, only that the…
• Adrenaline (Stress): Result Small Decrease → Improvement; Grade C → D; Size small → not stated. 2 studies removed (did not measure this outcome); 1 study added.Why: The page shows Worsens (adrenaline down), but no study reports a harm. Group: Stress (the trial classified free-living subjects by anxiety trait). The JACC letter has no abstract and its title does not show adrenaline; the Thromb Haemost RCT measured epinephrine but reports no group…
• Arterial Stiffness (Overweight): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (did not measure this outcome); 1 study added.Why: Linked study is a single dose in healthy volunteers (C3c; PWV unchanged). Re-cited the 4-week RCT in 30 overweight adults (24274771): arterial stiffness (AI) fell in women only. Mixed effect, not Small Improvement; C kept.
• Blood Flow (Obesity). 2 studies removed (studied a different group of people); 2 studies added.
• Blood Flow (Skin Health): Result Moderate Increase → Increase; Size moderate → not stated.Why: Skin Health is a general group. High-flavanol cocoa for 12 weeks raised cutaneous and subcutaneous blood flow in women vs low-flavanol cocoa (16702322); dark chocolate raised flow-mediated dilatation in smokers but not in healthy controls (21807659, crossover vs milk chocolate). Neither abstract…
• Blood Flow (Type 2 Diabetes). 2 studies removed (studied a different group of people); 3 studies added.
• Blood Flow (Peripheral Arterial Disease): Result Moderate Increase → Mixed effect; Size moderate → not stated. 2 studies removed (studied a different group of people); 2 studies added.Why: Row is under PAD; both links study smokers/healthy adults or healthy women: removed. Re-cited two PAD RCTs: 6 months of cocoa improved calf muscle perfusion only marginally (P=0.098, under the trial's 1-sided P<0.10 rule) with more capillaries (32078436), while a single dark-chocolate dose left…
• Blood Pressure (Glaucoma): Result Small Improvement → No effect; Size small → not stated. 9 studies removed (studied a different group of people).Why: Row is under Glaucoma and shows Improves (BP down, small), but the only glaucoma study (24628966, randomized dark vs white chocolate in 30 glaucoma patients and 30 controls) found systolic/diastolic BP unchanged. The other nine study healthy adults, hypertensives, prehypertensives, pregnant…
• Blood Pressure (Cirrhosis): Result Small Improvement → Small Increase. 9 studies removed (studied a different group of people).Why: Row is under Cirrhosis and shows BP lowered (Improves ↓, small), but the only cirrhosis study (22811444, double-blind RCT, 22 patients, dark vs white chocolate meal) found dark chocolate mildly RAISED arterial pressure (+8.8% vs -0.3%, P = 0.002), which the authors call amelioration of…
• Cognition: Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with no study. COSMOS-Mind (36102337, 2,262 older adults, 3 years) found cocoa extract had no effect on global cognition; general-cardiovascular-health accepts any adult population. Show No effect.
• Cognition (Cognitive Improvement): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves with no study. COSMOS-Mind (36102337, 2,262 older adults, 3 years) found cocoa extract had no effect on global cognition; Cognitive Improvement accepts any adult population. Show No effect.
• Heart Failure Risk (Heart Failure): Result No effect → Mixed effect.Why: Meta-analysis of 5 prospective cohorts (106,109 people) on incident heart failure: low-to-moderate chocolate intake was linked to 14% lower HF risk (HR 0.86, 0.82-0.91), high intake to no difference (HR 0.94, 0.80-1.09), a curvilinear dose-response. A clean 'No effect' misstates a significant…
• No human study left after the re-check, so no grade: Arterial Stiffness, High-density lipoprotein (HDL) (Metabolic Syndrome). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Cocoa Extract: the page as it is now

• Blood glucose (Type 1 Diabetes): Result Small Improvement → No effect; Size small → not stated. 1 study removed (studied a different group of people); 1 study removed (not a study of this supplement).Why: Population: only the type 1 diabetes RCT (31942840) counts, and it found no difference in fasting glucose or HbA1c: No effect.
• Blood glucose (End-Stage Renal Disease): Result Small Improvement → No effect; Size small → not stated. 2 studies removed (studied a different group of people).Why: Graded C 'Small Improvement', but the only study in the ESRD population (60 diabetic hemodialysis patients, 12 weeks) found no effect on fasting glucose or HbA1c. Pediatric T1DM trial and all-adult meta-analysis fail C5. C kept.
• Fatigue Symptoms (Cancer-Related Fatigue): Result none shown → No effect. 3 studies removed (studied a different group of people); 1 study added.Why: Row is under Cancer-Related Fatigue; the three links studied healthy men, healthy volunteers and MS patients (fail population). Added the flagged 236-woman breast-cancer RCT: no difference in fatigue (POMS-F, FACIT-F) vs placebo at 24 weeks. Verdict 'Improves' becomes No effect. Ungraded…
• Parkinson's Disease Symptoms (Parkinson's Disease): Result none shown → No effect. 1 study added.Why: Row shows Improves. Meta-analysis of 8 RCTs (899 PD patients) found no UPDRS difference vs placebo, and the 600-patient QE3 trial found no benefit; only a 4-week, 28-patient trial was positive. Show No effect.
• Quality of Life (Mitochondrial Cytopathy): Result none shown → No effect. 1 study added.Why: Ungraded row showing 'Improves' with no study. The flagged crossover RCT in 30 mitochondrial cytopathy patients measured quality of life and found only minor effects on exercise lactate/VO2, nothing on other clinically relevant measures. Added it (coordinator rule for ungraded Improves rows)…

Coenzyme Q10: the page as it is now

• Muscle protein synthesis (MPS): Result none shown → No effect.Why: Ungraded row shows Improves (MPS up), but its only study, a double-blind RCT, found collagen peptides did not raise myofibrillar or muscle connective protein synthesis vs placebo. Now No effect; grade left unset (ceiling C). Flag confirmed.

Collagen Peptides: the page as it is now

• Blood glucose (Type 2 Diabetes): Result No effect → Small Increase; Size none → small. 3 studies added.Why: Graded D 'No effect' with no linked study. Re-cited from studies already read (no search needed): the 13-RCT meta-analysis in patients at risk of CVD found CLA raised fasting glucose (WMD 4.49 mg/dL, effects called small); a type 2 diabetes RCT found fasting glucose up 6.3% (P < 0.05); a…
• Blood Pressure (Metabolic Health): Result none shown → No effect.Why: Page shows Improves (BP down). Metabolic Health accepts any human population. Both trials are null: 21270839 (61 healthy adults, crossover vs oleic acid: systolic +0.11 mm Hg, CI -1.27 to 1.49) and 16549463 (60 healthy young men: no effect on BP vs control diet). No effect. 2 RCTs: ceiling B…
• Blood Pressure (Overweight): Result none shown → No effect. 2 studies removed (studied a different group of people); 2 studies added.Why: Page shows Improves (BP down) under Overweight. Both linked trials are in healthy, normal-weight volunteers (16549463: BMI 22.5), not this population, and both are null: removed. Added two flagged no-effect studies read in this batch: 19923377 (401 overweight and obese adults, 6 mo…
• Blood Pressure (Obesity): Result none shown → No effect. 2 studies removed (studied a different group of people); 2 studies added.Why: Page shows Improves (BP down) under Obesity. Both linked trials are in healthy, normal-weight volunteers (16549463: BMI 22.5), not this population, and both are null: removed. Added two flagged no-effect studies read in this batch: 19923377 (401 overweight and obese adults, 6 mo…
• Blood Pressure (Weight Loss & Maintenance): Result none shown → No effect.Why: Page shows Improves (BP down). Weight Loss & Maintenance (a goal, not a disease or population group) accepts any human population. Both trials are null: 21270839 (61 healthy adults, crossover vs oleic acid: systolic +0.11 mm Hg, CI -1.27 to 1.49) and 16549463 (60 healthy young men: no effect…
• Blood Pressure: Result none shown → No effect.Why: Page shows Improves (BP down). general-cardiovascular-health accepts any human population. Both trials are null: 21270839 (61 healthy adults, crossover vs oleic acid: systolic +0.11 mm Hg, CI -1.27 to 1.49) and 16549463 (60 healthy young men: no effect on BP vs control diet). No effect. 2…
• Blood Pressure (General Athletic Performance): Result none shown → No effect.Why: Page shows Improves (BP down). General Athletic Performance accepts any human population. Both trials are null: 21270839 (61 healthy adults, crossover vs oleic acid: systolic +0.11 mm Hg, CI -1.27 to 1.49) and 16549463 (60 healthy young men: no effect on BP vs control diet). No effect. 2 RCTs…
• Body Fat: Result No effect → Small Decrease; Size none → small.Why: Row shows 'No effect' (grade D). Muscle Size & Strength accepts any human population. Five of six placebo/oil-controlled RCTs found less body fat with CLA: 16531905 (resistance training, -0.8 vs +0.4 kg fat), 15159244 (180 overweight, 1 y, BFM 6.9-8.7% lower), 16924272, 19535429, 20200257; the…
• Body Fat (Muscle Size & Strength): Result No effect → Small Decrease; Size none → small.Why: Row shows 'No effect' (grade D). Muscle Size & Strength accepts any human population. Five of six placebo/oil-controlled RCTs found less body fat with CLA: 16531905 (resistance training, -0.8 vs +0.4 kg fat), 15159244 (180 overweight, 1 y, BFM 6.9-8.7% lower), 16924272, 19535429, 20200257; the…
• C-Reactive Protein (CRP): Result none shown → Increase.Why: Page shows Improves (CRP down). general-cardiovascular-health accepts any human population. The only linked trial, 16277783 (53 adults, 4.2 g/d CLA, 3 months, placebo-controlled), found CRP rose (P=0.003). Increase (a harm), no size basis. One RCT: ceiling C; stays ungraded.
• Glycemic Control (Metabolic Health): Result none shown → Mixed effect. 1 study removed (not a study of this supplement).Why: Ungraded row shows Improves for glycemic control (Metabolic Health, a general group). Passing studies conflict: one RCT found no change in insulin sensitivity (21593349), one small RCT found ISI up (15126715), an uncontrolled study found insulin sensitivity down and glucose AUC up (17510671).…
• Glycemic Control (Overweight): Result none shown → No effect. 1 study removed (studied a different group of people); 1 study removed (not a study of this supplement).Why: Ungraded row shows Improves for glycemic control (Overweight). The only controlled trial in an overweight population (BMI >= 25) found no change in insulin sensitivity (21593349); an uncontrolled 9-person study found it worse (17510671). The young-sedentary trial fails population and the…
• Glycemic Control (Obesity): Result none shown → No effect. 1 study removed (studied a different group of people); 1 study removed (not a study of this supplement).Why: Ungraded row shows Improves for glycemic control (Obesity). The only controlled trial in an overweight population (BMI >= 25) found no change in insulin sensitivity (21593349); an uncontrolled 9-person study found it worse (17510671). The young-sedentary trial fails population and the…
• Glycemic Control (Weight Loss & Maintenance): Result none shown → Mixed effect. 1 study removed (not a study of this supplement).Why: Ungraded row shows Improves for glycemic control (Weight Loss & Maintenance, a general group). Passing studies conflict: one RCT found no change in insulin sensitivity (21593349), one small RCT found ISI up (15126715), an uncontrolled study found insulin sensitivity down and glucose AUC up…
• Glycemic Control: Result none shown → Mixed effect. 1 study removed (not a study of this supplement).Why: Ungraded row shows Improves for glycemic control (general-cardiovascular-health, a general group). Passing studies conflict: one RCT found no change in insulin sensitivity (21593349), one small RCT found ISI up (15126715), an uncontrolled study found insulin sensitivity down and glucose AUC up…
• Glycemic Control (High Cholesterol): Result none shown → No effect. 2 studies removed (studied a different group of people); 1 study removed (not a study of this supplement).Why: Ungraded row shows Improves for glycemic control under High Cholesterol. The only study in that population (borderline hypercholesterolemic men, 21593349) found no change in insulin sensitivity. The other three fail population or intervention: removed. Now No effect; grade unset (ceiling C).
• HbA1c (Metabolic Health): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (HbA1c down) under Metabolic Health. Its only study does not report a CLA effect on HbA1c (glucohemoglobin only in a correlation; it concludes CLA does not affect glucose metabolism): removed. Added the flagged 13-RCT meta-analysis in patients at risk of CVD: no…
• HbA1c (Overweight): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (HbA1c down) under Overweight. Its only study does not report a CLA effect on HbA1c (glucohemoglobin only in a correlation; it concludes CLA does not affect glucose metabolism): removed. Added the flagged 13-RCT meta-analysis in patients at risk of CVD: no effect on…
• HbA1c (Obesity): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (HbA1c down) under Obesity. Its only study does not report a CLA effect on HbA1c (glucohemoglobin only in a correlation; it concludes CLA does not affect glucose metabolism): removed. Added the flagged 13-RCT meta-analysis in patients at risk of CVD: no effect on…
• HbA1c (Weight Loss & Maintenance): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (HbA1c down) under Weight Loss & Maintenance. Its only study does not report a CLA effect on HbA1c (glucohemoglobin only in a correlation; it concludes CLA does not affect glucose metabolism): removed. Added the flagged 13-RCT meta-analysis in patients at risk of…
• HbA1c (High Cholesterol): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (HbA1c down) under High Cholesterol. Its only study does not report a CLA effect on HbA1c (glucohemoglobin only in a correlation; it concludes CLA does not affect glucose metabolism): removed. Added the flagged 13-RCT meta-analysis in patients at risk of CVD: no…
• HbA1c (Type 2 Diabetes): Result none shown → No effect. 1 study removed (did not measure this outcome); 2 studies added.Why: Ungraded row shows Improves (HbA1c down) under Type 2 Diabetes. Its only study does not report a CLA effect on HbA1c (glucohemoglobin only in a correlation; it concludes CLA does not affect glucose metabolism): removed. Added the flagged 13-RCT meta-analysis in patients at risk of CVD: no…
• High-density lipoprotein (HDL) (Metabolic Health): Result none shown → No effect. 2 studies removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (HDL up) under Metabolic Health (general group). Of the passing trials one found HDL up (T2D, 15447895), two found no change (21295383, 17119522) and one found HDL lower (18641189); two links report no HDL result (removed). Added the flagged 14-RCT meta-analysis: no…
• High-density lipoprotein (HDL) (Overweight): Result none shown → No effect. 3 studies removed (studied a different group of people); 2 studies removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (HDL up) under Overweight. The only linked trial in an obese population (21295383, obese T2D women) found CLA did not alter metabolic parameters (the HDL rise was with safflower oil). Three trials in non-obese or unspecified populations fail C5 and two report no HDL…
• High-density lipoprotein (HDL) (Obesity): Result none shown → No effect. 3 studies removed (studied a different group of people); 2 studies removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (HDL up) under Obesity. The only linked trial in an obese population (21295383, obese T2D women) found CLA did not alter metabolic parameters (the HDL rise was with safflower oil). Three trials in non-obese or unspecified populations fail C5 and two report no HDL…
• High-density lipoprotein (HDL) (Weight Loss & Maintenance): Result none shown → No effect. 2 studies removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (HDL up) under Weight Loss & Maintenance (general group). Of the passing trials one found HDL up (T2D, 15447895), two found no change (21295383, 17119522) and one found HDL lower (18641189); two links report no HDL result (removed). Added the flagged 14-RCT…
• High-density lipoprotein (HDL): Result none shown → No effect. 2 studies removed (did not measure this outcome); 1 study added.Why: Ungraded row shows Improves (HDL up) under general-cardiovascular-health (general group). Of the passing trials one found HDL up (T2D, 15447895), two found no change (21295383, 17119522) and one found HDL lower (18641189); two links report no HDL result (removed). Added the flagged 14-RCT…
• High-density lipoprotein (HDL) (High Cholesterol): Result none shown → No effect. 4 studies removed (studied a different group of people); 2 studies removed (did not measure this outcome); 2 studies added.Why: Page shows Improves (HDL up) under High Cholesterol. No linked study is in people with high cholesterol: 15447895 (HDL +8%) is diet-controlled type 2 diabetes, 21295383 obese diabetic women (CLA arm unchanged; the HDL rise was safflower oil), 17119522 healthy young women (no change), 18641189…
• High-density lipoprotein (HDL) (General Athletic Performance): Result none shown → No effect. 2 studies removed (did not measure this outcome); 1 study added.Why: Page shows Improves (HDL up). General group, so all human trials count, and they conflict: 15447895 (32 people with type 2 diabetes) HDL +8%; 21295383 CLA arm unchanged; 17119522 no HDL change; 18641189 HDL lower with the CLA mixture vs olive oil (a harm). 17298695 and 22293214 report no HDL…
• High-density lipoprotein (HDL) (Metabolic Syndrome): Result none shown → No effect. 4 studies removed (studied a different group of people); 2 studies removed (did not measure this outcome); 1 study added.Why: Page shows Improves (HDL up) under Metabolic Syndrome. No linked study is in metabolic syndrome: 15447895 (HDL +8%) and 21295383 are type 2 diabetes, 17119522 and 18641189 healthy women (no change; HDL lower vs olive oil); 17298695 and 22293214 report no HDL. All removed. Added the flagged…
• Inflammation (Metabolic Health): Result none shown → No effect.Why: Page shows Improves (inflammation down). Metabolic Health accepts any human population. The only linked trial, 21753062 (61 healthy adults, 3-wk crossover, CLA at 7% of energy vs oleic acid), found CLA did not significantly affect IL-6, CRP, TNF receptors, MCP-1 or E-selectin. No effect. One…
• Inflammation: Result none shown → No effect.Why: Page shows Improves (inflammation down). general-cardiovascular-health accepts any human population. The only linked trial, 21753062 (61 healthy adults, 3-wk crossover, CLA at 7% of energy vs oleic acid), found CLA did not significantly affect IL-6, CRP, TNF receptors, MCP-1 or E-selectin. No…
• Inflammation (Immune Health): Result none shown → No effect.Why: Page shows Improves (inflammation down). The only linked study, a randomized crossover trial in 61 healthy adults (7% of energy as CLA for 3 wk), found CLA did not significantly change IL-6, CRP, TNF receptors, MCP-1 or E-selectin. Immune Health is a general group. No effect; one RCT: ceiling…
• Low-density lipoprotein (LDL) (Metabolic Health): Result none shown → No effect. 1 study removed (did not measure this outcome).Why: Page shows Improves (LDL down). Metabolic Health accepts any human population. Every passing trial is null for LDL vs control: 19923377 (401 overweight/obese adults, 6 mo: no effect on lipids), 26402730 (obese women + exercise: no effect on lipoproteins), 17381964 (LDL fell in both CLA and…
• Low-density lipoprotein (LDL) (Overweight): Result none shown → No effect. 2 studies removed (studied a different group of people); 1 study removed (did not measure this outcome).Why: Page shows Improves (LDL down) under Overweight. Three trials in overweight/obese people (BMI >= 25) are null vs control: 19923377 (401 adults, 6 mo: no effect on lipids), 26402730 (obese women: no effect on lipoproteins), 20679151 (moderately overweight: CLA milk failed to alter LDL).…
• Low-density lipoprotein (LDL) (Obesity): Result none shown → No effect. 3 studies removed (studied a different group of people); 1 study removed (did not measure this outcome).Why: Page shows Improves (LDL down) under Obesity. Two trials include obese people and are null vs control: 19923377 (401 overweight and obese adults, 6 mo: no effect on lipids) and 26402730 (28 obese women: no effect on lipoproteins). Removed: 17381964 (normal weight), 16600923 (healthy men…
• Low-density lipoprotein (LDL) (Weight Loss & Maintenance): Result none shown → No effect. 1 study removed (did not measure this outcome).Why: Page shows Improves (LDL down). Weight Loss & Maintenance (a goal, not a disease or population group) accepts any human population. Every passing trial is null for LDL vs control: 19923377 (401 overweight/obese adults, 6 mo: no effect on lipids), 26402730 (obese women + exercise: no effect on…
• Low-density lipoprotein (LDL): Result none shown → No effect. 1 study removed (did not measure this outcome).Why: Page shows Improves (LDL down). general-cardiovascular-health accepts any human population. Every passing trial is null for LDL vs control: 19923377 (401 overweight/obese adults, 6 mo: no effect on lipids), 26402730 (obese women + exercise: no effect on lipoproteins), 17381964 (LDL fell in…
• Low-density lipoprotein (LDL) (High Cholesterol): Result none shown → No effect. 4 studies removed (studied a different group of people); 1 study removed (did not measure this outcome).Why: Page shows Improves (LDL down) under High Cholesterol. Only 20679151 studies people with raised lipids (moderately overweight, borderline hyperlipidemic): CLA-enriched milk failed to alter LDL vs control. The others are overweight-but-healthy, obese, normal-weight or healthy-men populations…
• Low-density lipoprotein (LDL) (Body Composition): Result none shown → No effect. 1 study removed (did not measure this outcome).Why: Page shows Improves (LDL down). Body Composition accepts any human population. Every passing trial is null for LDL vs control: 19923377 (401 overweight/obese adults, 6 mo: no effect on lipids), 26402730 (obese women + exercise: no effect on lipoproteins), 17381964 (LDL fell in both CLA and…
• Low-density lipoprotein (LDL) (Type 2 Diabetes): Result none shown → No effect. 5 studies removed (studied a different group of people); 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (LDL down) under Type 2 Diabetes. No linked trial is in people with diabetes (overweight-but-healthy, obese women, normal-weight exercisers, healthy men, borderline hyperlipidemic; all null on LDL anyway; 18287358 reports no LDL): all removed. Added the flagged…
• Low-density lipoprotein (LDL) (General Athletic Performance): Result none shown → No effect. 1 study removed (did not measure this outcome).Why: Page shows Improves (LDL down). General Athletic Performance accepts any human population. Every passing trial is null for LDL vs control: 19923377 (401 overweight/obese adults, 6 mo: no effect on lipids), 26402730 (obese women + exercise: no effect on lipoproteins), 17381964 (LDL fell in both…
• Low-density lipoprotein (LDL) (Metabolic Syndrome): Result none shown → No effect. 5 studies removed (studied a different group of people); 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (LDL down) under Metabolic Syndrome. No linked trial is in metabolic syndrome (overweight-but-healthy, obese women, normal-weight exercisers, healthy men, borderline hyperlipidemic; all null on LDL anyway; 18287358 reports no LDL): all removed. Added the flagged…
• Oxidative Stress Biomarkers (Metabolic Health): Result none shown → Detriment. 1 study removed (not a study of this supplement).Why: Page shows Improves (oxidative stress down) under Metabolic Health. 12956622 (60 healthy adults, CLA 3.5-4 g/day for 4 wk; CLA effect measured before/after, no CLA-free arm) found both CLA preparations raised urinary 8-iso-PGF2alpha (lipid peroxidation): a harm. 17093147 tests trans-18:1…
• Oxidative Stress Biomarkers: Result none shown → Detriment. 1 study removed (not a study of this supplement).Why: Page shows Improves (oxidative stress down) under general-cardiovascular-health. 12956622 (60 healthy adults, CLA 3.5-4 g/day for 4 wk; CLA effect measured before/after, no CLA-free arm) found both CLA preparations raised urinary 8-iso-PGF2alpha (lipid peroxidation): a harm. 17093147 tests…
• Total cholesterol (Obesity): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (total cholesterol down) under Obesity. Added the flagged 14-RCT meta-analysis in patients at risk of CVD: no effect on lipid profile vs control. Now No effect; grade unset (ceiling A).
• Triglycerides (Metabolic Health): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (triglycerides down) under Metabolic Health. Added the flagged 14-RCT meta-analysis in patients at risk of CVD: no effect on lipid profile vs control. Now No effect; grade unset (ceiling A).
• Triglycerides (Overweight): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (triglycerides down) under Overweight. Added the flagged 14-RCT meta-analysis in patients at risk of CVD: no effect on lipid profile vs control. Now No effect; grade unset (ceiling A).
• Triglycerides (Obesity): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (triglycerides down) under Obesity. Added the flagged 14-RCT meta-analysis in patients at risk of CVD: no effect on lipid profile vs control. Now No effect; grade unset (ceiling A).
• Triglycerides: Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (triglycerides down) under general-cardiovascular-health. Added the flagged 14-RCT meta-analysis in patients at risk of CVD: no effect on lipid profile vs control. Now No effect; grade unset (ceiling A).
• Triglycerides (High Cholesterol): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (triglycerides down) under High Cholesterol. Added the flagged 14-RCT meta-analysis in patients at risk of CVD: no effect on lipid profile vs control. Now No effect; grade unset (ceiling A).
• Triglycerides (General Athletic Performance): Result none shown → No effect. 2 studies added.Why: Ungraded row with no study shows Improves (triglycerides down) under General Athletic Performance. Added the flagged 14-RCT meta-analysis in patients at risk of CVD: no effect on lipid profile vs control. The flagged CLA-plus-exercise meta-analysis (36048508: no lipid-profile improvement) is…
• Triglycerides (Metabolic Syndrome): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (triglycerides down) under Metabolic Syndrome. Added the flagged 14-RCT meta-analysis in patients at risk of CVD: no effect on lipid profile vs control. Now No effect; grade unset (ceiling A).
• Weight (Muscle Size & Strength): Result none shown → Decrease. 5 studies removed (did not measure this outcome).Why: Row is stored as weight going up ('Changes; see studies'). The only linked trial reporting body weight, 21697535 (85 overweight men, 4 wk), found CLA decreased body weight vs safflower oil. 15277146 and 15354322 report only body composition, 17623486 only fat mass, 20140250 lipids, 17823448…
• No human study left after the re-check, so no grade: Blood glucose (Metabolic Health), Blood glucose (Overweight), Blood glucose (Weight Loss & Maintenance), Blood glucose, Blood glucose (High Cholesterol), Blood glucose (Body Composition), C-Reactive Protein (CRP) (Overweight), C-Reactive Protein (CRP) (Obesity), C-Reactive Protein (CRP) (High Cholesterol), C-Reactive Protein (CRP) (Type 2 Diabetes), C-Reactive Protein (CRP) (Menopause), Glycemic Control (Type 2 Diabetes), Glycemic Control (Metabolic Syndrome), Inflammation (Overweight), Inflammation (High Cholesterol), Inflammation (Type 2 Diabetes), Low-density lipoprotein (LDL) (Menopause), Low-density lipoprotein (LDL) (Coronary Artery Disease (CAD)), TNF-Alpha (Overweight), TNF-Alpha, TNF-Alpha (High Cholesterol), TNF-Alpha (Immune Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Conjugated Linoleic Acid: the page as it is now

• Collagen Synthesis (Wound Healing): Result Moderate Increase → none shown; Grade B → not graded; Size moderate → not stated; People studied 100 → not stated.Why: Graded B with no studies. PubMed has no human study of copper (oral or topical) measuring collagen synthesis; only lab/animal work, and the row's note ('Moderate Increase') does not describe preclinical evidence, so those cannot carry it. Ungrade, clear size/effect note; people 100 has no source…
• Wound Closure Rate (Wound Healing): Result Moderate Increase → none shown; Grade B → not graded; Size moderate → not stated; People studied 160 → not stated.Why: No linked studies, so B had no basis. PubMed has no study of oral copper supplements on wound closure. The only human data are uncontrolled studies of topical copper-oxide wound dressings (2 single-arm studies, 1 case series of 10, two by the dressing maker), all reporting faster closure. Judgment…

Copper: the page as it is now

• Aerobic Exercise Metrics (Mitochondrial Cytopathy). 1 study removed (studied a different group of people).
• Anaerobic Capacity (Muscle Recovery): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (not a study of this supplement).Why: General group (Muscle Recovery). 15142001 tested creatine + sodium bicarbonate together (effect not attributable to creatine): removed. Of the 10 passing placebo-controlled trials, 3 report higher sprint/Wingate power (14625517, 17685723, 16446682), 1 helps men only (20543729) and 6 find no…
• Anaerobic Capacity (Cycling Performance): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (not a study of this supplement).Why: General group (Cycling Performance). 15142001 tested creatine + sodium bicarbonate together (effect not attributable to creatine): removed. Of the 10 passing placebo-controlled trials, 3 report higher sprint/Wingate power (14625517, 17685723, 16446682), 1 helps men only (20543729) and 6 find no…
• Anaerobic Capacity (Ice Hockey Performance): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (not a study of this supplement).Why: General group (Ice Hockey Performance). 15142001 tested creatine + sodium bicarbonate together (effect not attributable to creatine): removed. Of the 10 passing placebo-controlled trials, 3 report higher sprint/Wingate power (14625517, 17685723, 16446682), 1 helps men only (20543729) and 6 find no…
• Anaerobic Capacity (Muscle Size & Strength): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (not a study of this supplement).Why: General group (Muscle Size & Strength). 15142001 tested creatine + sodium bicarbonate together (effect not attributable to creatine): removed. Of the 10 passing placebo-controlled trials, 3 report higher sprint/Wingate power (14625517, 17685723, 16446682), 1 helps men only (20543729) and 6 find no…
• Bilirubin (Kidney Health). 1 study removed (did not measure this outcome); 1 study added.
• Bilirubin (Football Performance). 1 study removed (did not measure this outcome); 1 study added.
• Bilirubin (General Liver Health). 1 study removed (did not measure this outcome); 1 study added.
• Blood glucose (Metabolic Health): Result Small Improvement → No effect; Size small → not stated.Why: General group (Metabolic Health). The only study, a systematic review/meta-analysis (healthy and diabetic people), found no significant effect of creatine on fasting blood glucose (SMD 0.05, p = 0.28) and concluded the basis is insufficient. Page shows 'Improves / Small Improvement' ( direction…
• Blood glucose (Dyslipidemia): Result Small Improvement → No effect; Size small → not stated. 1 study removed (studied a different group of people); 1 study added.Why: Row is under Dyslipidemia; the linked meta-analysis pooled healthy and diabetic people (no dyslipidemia population): removed (it also found no glucose effect). Re-cited the RCT in 34 hypercholesterolaemic adults: no significant glucose difference within or between groups (only a P = 0.051 trend in…
• Blood glucose (Martial Arts Performance): Result Small Improvement → No effect; Size small → not stated.Why: General group (Martial Arts Performance). The only study, a systematic review/meta-analysis (healthy and diabetic people), found no significant effect of creatine on fasting blood glucose (SMD 0.05, p = 0.28) and concluded the basis is insufficient. Page shows 'Improves / Small Improvement' (…
• Creatinine (Fibromyalgia). 1 study removed (studied a different group of people); 2 studies removed (did not measure this outcome).
• Cystic Fibrosis Symptoms (Cystic Fibrosis): Result No effect → Mixed effect.Why: Open-label uncontrolled pilot in 18 CF children: no change in lung function or sweat electrolytes, but muscle strength rose 18.4% and general well-being improved on a questionnaire. A clean 'No effect' understates the reported well-being benefit: Mixed effect. Single small uncontrolled study…
• Dizziness (Traumatic Brain Injury): Result Moderate Improvement → none shown; Size moderate → not stated.Why: Randomized open-label pilot in 39 children/adolescents with TBI: dizziness significantly improved (p=0.005), so 'Improves' is right. The abstract gives only a p-value for a categorical outcome, no effect size, so 'Moderate' cannot be supported: clear size and the 'Moderate Improvement' note. One…
• Exercise Tolerance (McArdle Disease). 1 study removed (studied a different group of people).
• Exercise Tolerance (Heart Failure). 3 studies removed (studied a different group of people); 2 studies added.
• Kidney Function (Chronic Kidney Disease (CKD)). 1 study removed (did not measure this outcome); 4 studies removed (studied a different group of people); 1 study added.
• Mitochondrial Cytopathies Symptoms (Mitochondrial Myopathy): Result Small Improvement → No effect; Size small → not stated. 1 study removed (did not measure this outcome); 3 studies added.Why: The only link is a 1999 letter with no abstract whose title does not show a symptom outcome: removed (no abstract). Re-cited the three creatine RCTs in mitochondrial myopathy: two found no significant effect on exercise performance, daily activities or clinical scores (11113239, 15804248); the…
• Muscle Mass (Colorectal Cancer): Result Small Improvement → No effect; Size small → not stated. 4 studies removed (studied a different group of people).Why: Row is under Colorectal Cancer. Two meta-analyses in healthy adults, a knee-OA trial and a prostate-cancer trial fail population. The only colorectal-cancer RCT (16701923, 31 patients on chemotherapy) found creatine 'failed to improve muscle mass' (body cell mass rose only in a subgroup). Page…
• Uric Acid (Soccer Performance): Result Small Decrease → No effect; Size small → not stated.Why: The only study (8-week RCT, 14 football players) reports uric acid only 'tended to decrease' (a non-significant trend), while CK rose significantly. Page shows 'Improves / Small Decrease': set No effect, clear size. One RCT: ceiling C = stored C.
• No human study left after the re-check, so no grade: Attention (Mild Cognitive Impairment (MCI)), Bilirubin (Surgical Recovery), Creatinine (Duchenne Muscular Dystrophy), Creatinine (Kearns-Sayre Syndrome (KSS)), Oxygen Uptake (Mitochondrial Cytopathy), Power Output (Mitochondrial Cytopathy). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Creatine: the page as it is now

• Blood glucose (Coronary Artery Disease (CAD)): Result Small Improvement → No effect; Size small → not stated. 18 studies removed (studied a different group of people); 1 study added.Why: Row is under Coronary Artery Disease. All 18 links study T2D, prediabetes, overweight, COPD, hypercholesterolaemic, postmenopausal or healthy people, or the general population (fail C5 strict). Re-cited the one placebo-controlled curcumin trial in CAD patients that reports glucose (25901155, n=33…
• Pancreatitis Symptoms (Pancreatitis): Result none shown → No effect.Why: Randomised placebo-controlled pilot in 20 tropical pancreatitis patients (curcumin 500 mg with 5 mg piperine as absorption aid): oxidative markers improved but pain, the symptom measured, did not. 'Improves' is an error: No effect. Ungraded, ceiling C.
• Uric Acid (Hyperuricemia): Result none shown → No effect. 1 study removed (studied a different group of people).Why: Row is under Hyperuricemia; the NAFLD trial is a different population. The only hyperuricemia RCT (39 people) found serum urate fell equally with curcumin and placebo (p = 0.532). 'Improves' is an error: No effect. Ungraded, ceiling C.

Curcumin: the page as it is now

• Blood Glucose Regulation: Effect note rewritten from its studies; Size moderate → not stated. 2 studies removed (did not measure this outcome); 1 study added.Why: Page shows Improves (moderate, grade C) for blood glucose, but every linked study is mice, rats or cells (no grade under C9). 32692982 (cells) and 29686513 (no glucose result) fail outcome. Re-cited the flagged human RCT 35385209 (abstract read; one PubMed search found no purified-C3G human…
• Lipid Levels: Effect note rewritten from its studies; Size small → not stated. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows lipids going down (small, grade D) from a rat study and a mouse study only (no grade under C9); 22535762 reports aortic, not blood, cholesterol: removed. Re-cited the flagged human RCT 35385209 (abstract read): 28 days of isolated black-rice (cyanidin-type) anthocyanins in 52…
• No human study left after the re-check, so no grade: Energy Expenditure. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Cyanidin: the page as it is now

• Angina (Coronary Artery Disease (CAD)): Result Small Improvement → No effect; Size small → not stated. 1 study added.Why: Page shows 'Small Improvement' at grade C for angina in CAD with no linked study (grade would be lost). Re-cited the flagged RCT 1354276 (abstract read, no search; 20 men with CAD): ribose improved time to ST depression but time to moderate angina did not differ from placebo. No effect; one…
• Muscle Strength (Muscle Recovery): Result none shown → No effect. 1 study added.Why: Page shows Improves (strength up) under Muscle Recovery with no linked study. Added the flagged placebo-controlled RCT 32778175 (abstract read; 21 untrained men): isokinetic muscle strength did not differ between D-ribose and placebo at 24 h or 48 h. General group, any population. No effect…
• Muscle Strength: Result none shown → No effect. 1 study added.Why: Page shows Improves (strength up) under muscle-size-strength with no linked study. Added the flagged placebo-controlled RCT 32778175 (abstract read; 21 untrained men): isokinetic muscle strength did not differ between D-ribose and placebo at 24 h or 48 h. General group, any population. No…
• Muscle Strength (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Page shows Improves (strength up) under Muscle Size & Strength with no linked study. Added the flagged placebo-controlled RCT 32778175 (abstract read; 21 untrained men): isokinetic muscle strength did not differ between D-ribose and placebo at 24 h or 48 h. General group, any population. No…
• Oxidative Stress Biomarkers (Muscle Size & Strength): Result none shown → Decrease.Why: Page shows oxidative stress markers going up ('Changes; see studies', stored increase). Both linked trials report them going DOWN: 19627222 (double-blind crossover, 7 adults, 7 g ribose around one hypoxic ride, acute outcome) urinary MDA lower with ribose (P < .05); 32778175 (RCT, 21 men) MDA…
• Peak power output (PPO) (Anaerobic Exercise Performance): Result none shown → No effect.Why: Page shows Improves (peak power up). 12660407 (RCT, 19 trained men, 10 g/d for 5 d) found no effect on Wingate peak power; 16521849 (double-blind crossover, 12 cyclists, single 3 g ribose + 150 microg folate drink before 5 x 30 s anaerobic tests, acute outcome) found no effect on any…
• Power Output (Muscle Recovery): Result none shown → Mixed effect.Why: Page shows a clean Improves (power up) under Muscle Recovery (general group). 11641371 (RCT, 19 men): power similar to placebo; 12580655 (RCT crossover, men): higher mean/peak power in sprint 2 only, 'not ... consistent or substantial'; 29296106 (double-blind crossover vs dextrose, 26 adults)…
• Power Output (Anaerobic Exercise Performance): Result none shown → Mixed effect.Why: Page shows a clean Improves (power up) under Anaerobic Exercise Performance (general group). 11641371 (RCT, 19 men): power similar to placebo; 12580655 (RCT crossover, men): higher mean/peak power in sprint 2 only, 'not ... consistent or substantial'; 29296106 (double-blind crossover vs…
• Power Output (Aerobic Exercise Performance): Result none shown → Mixed effect.Why: Page shows a clean Improves (power up) under Aerobic Exercise Performance (general group). 11641371 (RCT, 19 men): power similar to placebo; 12580655 (RCT crossover, men): higher mean/peak power in sprint 2 only, 'not ... consistent or substantial'; 29296106 (double-blind crossover vs…
• No human study left after the re-check, so no grade: Brain Natriuretic Peptide (Heart Failure), Creatine Kinase (Muscle Recovery), Creatine Kinase (Aerobic Exercise Performance), Lactate Dehydrogenase (Muscle Recovery), Lactate Dehydrogenase, Lactate Dehydrogenase (Muscle Size & Strength), Maximal isometric voluntary contraction (Muscle Recovery), Maximal isometric voluntary contraction (Anaerobic Exercise Performance), Muscle Soreness (Muscle Size & Strength), Myoglobin (Muscle Recovery), Myoglobin, Myoglobin (Muscle Size & Strength), Rating of Perceived Exertion (Muscle Recovery), Rating of Perceived Exertion (Aerobic Exercise Performance). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

D-Ribose: the page as it is now

• 15-Minute Recovery Rate: Effect note rewritten from its studies; Grade A → B. 17 studies removed (not a study of this supplement); 3 studies removed (did not measure this outcome); 1 study added.Why: Only the autoinjector phase 3 trial (34169625) reports the 15-minute recovery rate: 88% with dasiglucagon vs 0% placebo, so 'Improves'/large holds. The MA reports mean time to recovery, not the 15-min rate; cilofexor and two no-abstract letters are off-topic: removed. One RCT: ceiling C, regrade A… Added 35239971 (phase 3 RCT, 170 adults with type 1 diabetes: 99% recovered within 15 min vs 2% placebo; abstract read). Two RCTs agree: B (was A).
• Blood Glucose Control: Effect note rewritten from its studies. 1 study removed (not a study of this supplement); 6 studies removed (did not measure this outcome).Why: Placebo-controlled trials and a 5-RCT MA agree that dasiglucagon raises plasma glucose from hypoglycaemia (recovery 24.7 min sooner than placebo; dose-dependent PG rise in 30350477; faster than oral glucose in 35475907), with reviews concurring: 'Improves'/moderate holds. Removed: ADA meeting… Dasiglucagon raises blood glucose out of hypoglycaemia; the app reads lower glucose as better, so 'Improvement' would show a down arrow and 'decreases, which is beneficial'. A plain 'Increase' shows 'Changes; see studies' until the polarity rule knows the hypoglycaemia context.
• Pediatric Efficacy: Grade A → B. 17 studies removed (not a study of this supplement); 2 studies removed (studied a different group of people); 2 studies removed (did not measure this outcome); 3 studies added.Why: No linked study is paediatric: the autoinjector trial is adult-only, the 5-RCT MA reports no paediatric result, plus cilofexor and two no-abstract letters: all removed. Re-cited the paediatric phase 3 T1DM trial the note describes (33934456: 10 vs 30 min, all recovered within 20 min vs 18% placebo)
• Ready-to-Use Formulation Benefit: Effect note rewritten from its studies; Grade B → C. 17 studies removed (not a study of this supplement); 5 studies removed (did not measure this outcome); 2 studies added.Why: No linked study measures the ready-to-use benefit: the trials and MAs time recovery from injection (excluding reconstitution) or compare ready-to-use products with each other; cilofexor and two letters are off-topic: removed. Re-cited the randomized crossover handling study (34809479: autoinjector…
• Safety/Tolerability: Effect note rewritten from its studies; Size small → not stated. 4 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Two MAs of the T1D RCTs and the integrated sponsor analysis agree that rescue-dose dasiglucagon is tolerated like reconstituted glucagon with no serious AEs (nausea 56.5%, vomiting 24.6%); the autoinjector RCT agrees. A neonatal CHI case shows a rare severe harm (necrolytic migratory erythema)…
• Time to Glucose Recovery (Adult). 17 studies removed (not a study of this supplement); 1 study removed (studied a different group of people); 5 studies removed (did not measure this outcome).
• No human study left after the re-check, so no grade: Anti-Aging. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Dasiglucagon (Zegalogue): the page as it is now

• No human study left after the re-check, so no grade: Cardioprotection. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Date Palm Pollen: the page as it is now

• Blood glucose (Metabolic Health): Result none shown → Mixed effect. 1 study added.Why: Ungraded row shows a clean Improves (glucose down) on one 24-man RCT (12843164) whose glucose fall is steady-state glucose in an insulin-suppression test. The flagged meta-analysis 23824417 (25 RCTs, 1353 elderly men) found no effect on glycaemic metabolism (the unlinked 12-month RCT 21521341…
• Blood glucose: Result none shown → Mixed effect. 1 study added.Why: Ungraded row shows a clean Improves (glucose down) on one 24-man RCT (12843164) whose glucose fall is steady-state glucose in an insulin-suppression test. The flagged meta-analysis 23824417 (25 RCTs, 1353 elderly men) found no effect on glycaemic metabolism (the unlinked 12-month RCT 21521341…
• Body Fat (Low Testosterone). 1 study added.
• Body Fat (Frailty). 1 study added.
• Body Fat (Healthy Muscle Aging): Result No effect → Small Decrease; Size none → small. 2 studies added.Why: Row graded D shows 'No effect' with no linked study (would lose its grade, so re-cited). Both flagged meta-analyses report less body fat with DHEA: 23824417 (25 RCTs, elderly men, SMD -0.35, P = .02; authors call it small) and 32745490 (fat mass -0.85%). Healthy Muscle Aging accepts any…
• Cognitive Decline (Cognitive Improvement): Result none shown → No effect. 1 study removed (did not measure this outcome); 2 studies added.Why: Ungraded row shows Improves (less cognitive decline). Its only study (16804050) measured physical frailty, not cognition: removed. Flagged studies read: DAWN RCT 18482290 (225 healthy older adults, 1 year) found no difference in cognitive change, and Cochrane review 17054283 found no benefit.…
• Cognitive Decline (Mild Cognitive Impairment (MCI)). 1 study removed (did not measure this outcome); 1 study added.
• Cortisol (General Athletic Performance): Result Small Decrease → Increase; Size small → not stated.Why: Row shows cortisol going down (Small Decrease); its only study (16393880) found DHEA increased cortisol at several hours of the day. General group accepts this population. Show Increase, size cleared (no size given); grade C holds (one RCT).
• Cortisol: Result none shown → Increase.Why: Ungraded row shows cortisol going down; its only study (16393880) found DHEA increased cortisol. Population passes for muscle-size-strength (a general goal). Show Increase; ceiling C, grade left unset.
• Cortisol (Menopause): Result none shown → Increase.Why: Ungraded row shows cortisol going down; its only study (16393880) found DHEA increased cortisol. Population passes for Menopause (postmenopausal women studied). Show Increase; ceiling C, grade left unset.
• Cortisol (Cognitive Improvement): Result none shown → Increase.Why: Ungraded row shows cortisol going down; its only study (16393880) found DHEA increased cortisol. Population passes for Cognitive Improvement (a general goal). Show Increase; ceiling C, grade left unset.
• Fertility (Infertility): Result none shown → No effect. 1 study added.Why: Ungraded row shows fertility improving on one 33-woman IVF trial (live birth 23.1% vs 4.0%, P=0.05). The flagged Cochrane review (38837771, 9 RCTs, N=1433) finds DHEA likely makes little to no difference in live birth or clinical pregnancy. Judged on the meta-analysis: show No effect.
• Glycemic Control (Body Composition): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (glycaemic control). Flagged meta-analysis 23824417 (25 RCTs, 1353 elderly men) found no effect on glycaemic metabolism; Body Composition accepts any population. Added; No effect. Stays ungraded.
• Glycemic Control (Metabolic Health): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (glycaemic control). Flagged meta-analysis 23824417 (25 RCTs, 1353 elderly men) found no effect on glycaemic metabolism; Metabolic Health accepts any population. Added; No effect. Stays ungraded.
• High-density lipoprotein (HDL) (Metabolic Health): Result none shown → Mixed effect. 2 studies added.Why: Ungraded row with no study shows Improves (HDL up). No study shows HDL rising: meta-analysis 23824417 (25 RCTs, elderly men) found no effect on lipids, and RCT 21521341 (119 older adults, 12 months) found HDL fell (P = 0.01). Both added (Metabolic Health accepts any population); Mixed effect…
• High-density lipoprotein (HDL): Result none shown → Mixed effect. 2 studies added.Why: Ungraded row with no study shows Improves (HDL up). No study shows HDL rising: meta-analysis 23824417 (25 RCTs, elderly men) found no effect on lipids, and RCT 21521341 (119 older adults, 12 months) found HDL fell (P = 0.01). Both added (general-cardiovascular-health accepts any population)…
• Libido (General Athletic Performance): Result none shown → No effect.Why: Ungraded row shows libido improving; its only study (15989411, 50 postmenopausal women) found no significant change in sexual function with DHEA. Population passes for General Athletic Performance (general). Show No effect; ceiling C, grade left unset.
• Libido: Result none shown → No effect.Why: Ungraded row shows libido improving; its only study (15989411, 50 postmenopausal women) found no significant change in sexual function with DHEA. Population passes for muscle-size-strength (general goal). Show No effect; ceiling C, grade left unset.
• Libido (Menopause): Result none shown → No effect.Why: Ungraded row shows libido improving; its only study (15989411, 50 postmenopausal women) found no significant change in sexual function with DHEA. Population passes for Menopause (postmenopausal women studied). Show No effect; ceiling C, grade left unset.
• Libido (Mood Improvement): Result none shown → No effect.Why: Ungraded row shows libido improving; its only study (15989411, 50 postmenopausal women) found no significant change in sexual function with DHEA. Population passes for Mood Improvement (general goal). Show No effect; ceiling C, grade left unset.
• Libido (Muscle Size & Strength): Result none shown → No effect.Why: Ungraded row shows libido improving; its only study (15989411, 50 postmenopausal women) found no significant change in sexual function with DHEA. Population passes for Muscle Size & Strength (general goal). Show No effect; ceiling C, grade left unset.
• Low-density lipoprotein (LDL) (Body Composition): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (LDL down). Flagged meta-analysis 23824417 (25 RCTs, 1353 elderly men, oral DHEA) found no effect on lipid metabolism; Body Composition accepts any population. Added; No effect. Stays ungraded.
• Low-density lipoprotein (LDL) (Metabolic Health): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (LDL down). Flagged meta-analysis 23824417 (25 RCTs, 1353 elderly men, oral DHEA) found no effect on lipid metabolism; Metabolic Health accepts any population. Added; No effect. Stays ungraded.
• Low-density lipoprotein (LDL): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (LDL down). Flagged meta-analysis 23824417 (25 RCTs, 1353 elderly men, oral DHEA) found no effect on lipid metabolism; general-cardiovascular-health accepts any population. Added; No effect. Stays ungraded.
• Muscle Mass (General Athletic Performance): Result none shown → Small Improvement; Size not stated → small. 1 study added.Why: Meta-analysis 32745490 finds a small lean-mass gain with DHEA (+0.45 kg); it outranks the null single trials.
• Muscle Mass (Body Composition): Result none shown → Small Improvement; Size not stated → small. 1 study added.Why: Meta-analysis 32745490 finds a small lean-mass gain with DHEA (+0.45 kg); it outranks the null single trials.
• Muscle Mass (Metabolic Health): Result none shown → Small Improvement; Size not stated → small. 1 study added.Why: Meta-analysis 32745490 finds a small lean-mass gain with DHEA (+0.45 kg); it outranks the null single trials.
• Muscle Mass: Result none shown → Small Improvement; Size not stated → small. 1 study added.Why: Meta-analysis 32745490 finds a small lean-mass gain with DHEA (+0.45 kg); it outranks the null single trials.
• Muscle Mass (Menopause): Result none shown → No effect. 1 study removed (studied a different group of people).Why: Ungraded row shows Improves (muscle mass). The only study in a population that includes postmenopausal women (21521341, 12 months, adults 60-88) found no difference in regional tissue composition; 17263636 (HIV) fails C5. Flagged meta-analysis 32745490 does not state a menopausal population…
• Muscle Mass (Weight Loss & Maintenance): Result none shown → Small Improvement; Size not stated → small. 1 study added.Why: Meta-analysis 32745490 finds a small lean-mass gain with DHEA (+0.45 kg); it outranks the null single trials.
• Muscle Mass (General Liver Health): Result none shown → Small Improvement; Size not stated → small. 1 study added.Why: Meta-analysis 32745490 finds a small lean-mass gain with DHEA (+0.45 kg); it outranks the null single trials.
• Muscle Mass (Human Immunodeficiency Virus (HIV)): Result none shown → No effect. 1 study removed (studied a different group of people).Why: Ungraded row shows Improves (muscle mass) on the HIV page; the HIV trial 17263636 found no lean-muscle benefit. 21521341 (older adults without HIV) fails C5. Flagged meta-analysis 32745490 does not state an HIV population, so not added. No effect. Stays ungraded.
• Muscle Mass (Immune Health): Result none shown → Small Improvement; Size not stated → small. 1 study added.Why: Meta-analysis 32745490 finds a small lean-mass gain with DHEA (+0.45 kg); it outranks the null single trials.
• Muscle Mass (Healthy Muscle Aging): Result none shown → Small Improvement; Size not stated → small. 1 study added.Why: Meta-analysis 32745490 finds a small lean-mass gain with DHEA (+0.45 kg); it outranks the null single trials.
• Muscle Mass (Muscle Size & Strength): Result none shown → Small Improvement; Size not stated → small. 1 study added.Why: Meta-analysis 32745490 finds a small lean-mass gain with DHEA (+0.45 kg); it outranks the null single trials.
• Power Output (General Athletic Performance): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows power output improving. Its only link (12639206) measured strength and muscle area, not power (and found no benefit): removed. The flagged frailty RCT (16804050) measured leg extensor power and found no DHEA-placebo difference; passes for General Athletic Performance (general)
• Power Output: Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows power output improving. Its only link (12639206) measured strength and muscle area, not power (and found no benefit): removed. The flagged frailty RCT (16804050) measured leg extensor power and found no DHEA-placebo difference; passes for muscle-size-strength (general goal).…
• Power Output (Healthy Muscle Aging): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows power output improving. Its only link (12639206) measured strength and muscle area, not power (and found no benefit): removed. The flagged frailty RCT (16804050) measured leg extensor power and found no DHEA-placebo difference; passes for Healthy Muscle Aging (general; older…
• Power Output (Muscle Size & Strength): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Ungraded row shows power output improving. Its only link (12639206) measured strength and muscle area, not power (and found no benefit): removed. The flagged frailty RCT (16804050) measured leg extensor power and found no DHEA-placebo difference; passes for Muscle Size & Strength (general goal).
• Subjective Well-Being (General Athletic Performance): Result none shown → No effect.Why: Ungraded row shows well-being improving; its only study (DAWN 18482290, 225 adults, 1 year) found no DHEA-placebo difference on well-being or quality-of-life scales. Population passes for General Athletic Performance (general). Show No effect; ceiling C, grade left unset.
• Subjective Well-Being: Result none shown → No effect.Why: Ungraded row shows well-being improving; its only study (DAWN 18482290, 225 adults, 1 year) found no DHEA-placebo difference on well-being or quality-of-life scales. Population passes for muscle-size-strength (general goal). Show No effect; ceiling C, grade left unset.
• Subjective Well-Being (Menopause): Result none shown → No effect.Why: Ungraded row shows well-being improving; its only study (DAWN 18482290, 225 adults, 1 year) found no DHEA-placebo difference on well-being or quality-of-life scales. Population passes for Menopause (115 women aged 55-85, a population that includes postmenopausal women). Show No effect; ceiling…
• Subjective Well-Being (Cognitive Improvement): Result none shown → No effect.Why: Ungraded row shows well-being improving; its only study (DAWN 18482290, 225 adults, 1 year) found no DHEA-placebo difference on well-being or quality-of-life scales. Population passes for Cognitive Improvement (general goal). Show No effect; ceiling C, grade left unset.
• Subjective Well-Being (Mood Improvement): Result none shown → No effect.Why: Ungraded row shows well-being improving; its only study (DAWN 18482290, 225 adults, 1 year) found no DHEA-placebo difference on well-being or quality-of-life scales. Population passes for Mood Improvement (general goal). Show No effect; ceiling C, grade left unset.
• Subjective Well-Being (Muscle Size & Strength): Result none shown → No effect.Why: Ungraded row shows well-being improving; its only study (DAWN 18482290, 225 adults, 1 year) found no DHEA-placebo difference on well-being or quality-of-life scales. Population passes for Muscle Size & Strength (general goal). Show No effect; ceiling C, grade left unset.
• Total cholesterol (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Page shows Improves (total cholesterol down) under General Athletic Performance with no linked study. Added the flagged meta-analysis 23824417 (abstract read; 25 placebo-controlled RCTs, 1353 elderly men): no effect of oral DHEA vs placebo on lipid metabolism. General group, any population. No…
• Total cholesterol (Metabolic Health): Result none shown → No effect. 1 study added.Why: Page shows Improves (total cholesterol down) under Metabolic Health with no linked study. Added the flagged meta-analysis 23824417 (abstract read; 25 placebo-controlled RCTs, 1353 elderly men): no effect of oral DHEA vs placebo on lipid metabolism. General group, any population. No effect; row…
• Total cholesterol: Result none shown → No effect. 1 study added.Why: Page shows Improves (total cholesterol down) under muscle-size-strength with no linked study. Added the flagged meta-analysis 23824417 (abstract read; 25 placebo-controlled RCTs, 1353 elderly men): no effect of oral DHEA vs placebo on lipid metabolism. General group, any population. No effect…
• Total cholesterol (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows 'Changes' (total cholesterol up). Flagged meta-analysis 23824417 (25 RCTs, 1353 elderly men, oral DHEA) found no effect on lipid metabolism; Muscle Size & Strength accepts any population. Added; No effect. Stays ungraded.
• Triglycerides (Metabolic Health): Result none shown → Mixed effect. 2 studies added.Why: Ungraded row with no study shows a clean Improves (TG down). Flagged evidence conflicts: meta-analysis 23824417 (25 RCTs, elderly men) found no effect on lipids, while the 12-month RCT 21521341 (119 older adults) found triglycerides fell. Both added (Metabolic Health accepts any population)…
• Triglycerides: Result none shown → Mixed effect. 2 studies added.Why: Ungraded row with no study shows a clean Improves (TG down). Flagged evidence conflicts: meta-analysis 23824417 (25 RCTs, elderly men) found no effect on lipids, while the 12-month RCT 21521341 (119 older adults) found triglycerides fell. Both added (general-cardiovascular-health accepts any…
• Weight (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (weight down). Flagged meta-analysis 32745490 found DHEA did not change body weight (WMD -0.16 kg, p = 0.72); General Athletic Performance is not a disease population. Added; No effect. Stays ungraded.
• Weight: Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (weight down). Flagged meta-analysis 32745490 found DHEA did not change body weight (WMD -0.16 kg, p = 0.72); muscle-size-strength is not a disease population. Added; No effect. Stays ungraded.
• Weight (Weight Loss & Maintenance): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves (weight down). Flagged meta-analysis 32745490 found DHEA did not change body weight (WMD -0.16 kg, p = 0.72); Weight Loss & Maintenance is not a disease population. Added; No effect. Stays ungraded.
• Weight (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows 'Changes' (weight up). Flagged meta-analysis 32745490 found DHEA did not change body weight (WMD -0.16 kg, p = 0.72); Muscle Size & Strength is not a disease population. Added; No effect. Stays ungraded.
• No human study left after the re-check, so no grade: Cognitive Decline (Frailty), Cortisol (Dyslipidemia), Libido (Low Testosterone), Libido (Male Sexual Dysfunction), Muscle Mass (Low Testosterone), Muscle Mass (Frailty), Muscle Mass (Dyslipidemia), Power Output (Menopause), Power Output (Low Testosterone), Subjective Well-Being (Human Immunodeficiency Virus (HIV)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

DHEA: the page as it is now

• Child behavioral development (Premature Birth): Result none shown → No effect.Why: Ungraded row shows child behaviour improving; its only study (39396702, 132 children) found no difference in behavioural functioning at 5 years nor in any secondary outcome. Population passes for Premature Birth (very preterm children studied). Show No effect; ceiling C, grade left unset.
• Child behavioral development: Result none shown → No effect.Why: Ungraded row shows child behaviour improving; its only study (39396702, 132 children) found no difference in behavioural functioning at 5 years nor in any secondary outcome. Population passes for healthy-childhood-development (general). Show No effect; ceiling C, grade left unset.
• Infant Birth Weight (Pregnancy and Delivery Health): Result none shown → Increase.Why: Ungraded row shows infant birth weight going down; its only study (meta-analysis of 9 RCTs, 5710 women) found birth weight significantly higher (+101.71 g) and fewer low birth weights. Show Increase; ceiling A, grade left unset.
• Postpartum Depression Symptoms (Pregnancy and Delivery Health): Result none shown → No effect.Why: Ungraded row shows postpartum depression going down; its only study (DOMInO, 2399 women) found no significant difference (RR 0.85, 95% CI 0.70-1.02). Show No effect; ceiling C, grade left unset.
• Pre-Eclampsia Risk (Metabolic Health): Result none shown → No effect.Why: Ungraded row shows pre-eclampsia risk going up ('Changes; see studies', stored increase); its only study (DOMInO, 2399 women) found no significant difference (RR 0.87, 95% CI 0.60-1.25). Population passes for Metabolic Health (general). Show No effect; ceiling C, grade left unset.
• Pre-Eclampsia Risk: Result none shown → No effect.Why: Ungraded row shows pre-eclampsia risk going up ('Changes; see studies', stored increase); its only study (DOMInO, 2399 women) found no significant difference (RR 0.87, 95% CI 0.60-1.25). Population passes for general-cardiovascular-health (general). Show No effect; ceiling C, grade left unset.

Docosahexaenoic Acid: the page as it is now

• Menopausal Symptoms (Monotherapy): Effect note rewritten from its studies; Size small → not stated. 4 studies removed (not a study of this supplement); 1 study removed (did not measure this outcome).Why: The page shows Improves (symptoms down, small) while its own note says dong quai alone does not work. Both monotherapy RCTs find no effect: 24 weeks in 71 postmenopausal women, no difference in flushes or Kupperman index (9418683), and 3 months in 22 men on ADT, no difference in hot-flash…

Dong Quai: the page as it is now

• Blood Glucose Control: Effect note rewritten from its studies. 3 studies removed (did not measure this outcome); 2 studies removed (not a study of this supplement).Why: MA of 12 RCTs (26742577) shows HbA1c -0.68% vs control; reviews and real-world cohorts agree, and the placebo-controlled incretin analysis (40212008, per-agent incl. dulaglutide) shows HbA1c falls of 0.63-1.79%. Removed: no-abstract drug profile, CV-safety MA (MACE only), microbiota review, and…
• Body Weight Reduction (Type 2 Diabetes): Effect note rewritten from its studies; Size moderate → small. 4 studies removed (did not measure this outcome).Why: Weight fell with dulaglutide in AWARD-5 (-3.03 vs -1.53 kg sitagliptin), AWARD-11 (dose-related, -3.0 to -4.6 kg), AWARD-CHN2 post hoc (vs glargine) and AWARD-3 (similar to metformin), plus two reviews and observational pooling (-0.8 kg): 3+ controlled trials agree, A holds. REWIND, AWARD-1, the…
• Cognitive Function: Effect note rewritten from its studies; Size small → not stated. 4 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Only REWIND's cognitive analysis (32562683, 8828 people with MoCA/DSST) remains: its exploratory cognitive-impairment outcome was not significant (HR 0.93, p=0.11) and became significant only after post hoc baseline adjustment (HR 0.86). The mazdutide mouse study uses dulaglutide only as the…
• Endothelial Function: Effect note rewritten from its studies; Size small → not stated. 5 studies removed (did not measure this outcome).Why: One human trial (36199064: 60 T2D patients randomised to metformin with or without dulaglutide for 12 wk) found NO and endothelial progenitor cell number/function rose and baPWV fell only with dulaglutide; HUVEC and mouse studies agree. The REWIND atherosclerosis letter has no abstract and its…
• Fasting Plasma Glucose (Type 2 Diabetes): Effect note rewritten from its studies; Grade A → C; Size large → not stated. 12 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Only the AWARD-CHN2 post hoc (34870792) reports fasting glucose: dulaglutide lowered HbA1c through reductions in both FG and PPG, with no FG figure. The AWARD/REWIND trials, reviews and real-world studies report HbA1c, weight or MACE only (32109448 lists fasting glucose but gives no result)…
• Glycemic Control (HbA1c <7%) (Type 2 Diabetes): Effect note rewritten from its studies. 2 studies removed (did not measure this outcome).Why: AWARD RCTs show more patients reaching HbA1c <7% with dulaglutide; the old note made the page show 'Changes; see studies'.
• HbA1c Reduction (Type 2 Diabetes). 2 studies removed (did not measure this outcome).
• Kidney Function: Effect note rewritten from its studies. 4 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Two controlled trials agree: AWARD-7 (CKD 3-4, eGFR 34.0 vs 31.3 with glargine at 52 wk) and REWIND vs placebo (renal composite HR 0.85; post hoc 37343574: >=40% eGFR decline HR 0.72, slope -1.37 vs -1.56/yr), plus a Lancet comment titled 'slows kidney disease'. 33036617 (cohort) found eGFR fell…
• Liver Protection: Effect note rewritten from its studies; Size small → not stated. 4 studies removed (did not measure this outcome).Why: The only controlled human data (32291277, post hoc of the tirzepatide phase 2 with dulaglutide and placebo arms) found ALT and AST fell from baseline in every arm including placebo, and lists no dulaglutide-vs-placebo difference on ALT, AST, K-18 or Pro-C3. A Taiwanese cohort saw ALT fall 3.08…
• Major Adverse Cardiovascular Events (MACE) (Cardiovascular Disease): Grade A → C; Size moderate → small. 9 studies removed (did not measure this outcome).Why: Only REWIND (31189511; T2D with prior CVD or CV risk, so it includes the CVD population) and a narrative review of it report MACE: HR 0.88 (0.79-0.99), 12.0% vs 13.4%. The AWARD glycaemic trials, observational comparisons, microbiota review and the HF post hoc (MACE only as a subgroup interaction…
• Neuroprotection: Effect note rewritten from its studies; Size small → not stated. 5 studies removed (did not measure this outcome); 2 studies removed (not a study of this supplement).Why: REWIND's exploratory cognitive analysis missed on its own outcome (HR 0.93, p=0.11) and was significant only after post hoc adjustment (HR 0.86); a vascular-dementia rat study shows less neuronal damage. The brain-uptake PK study has no neuroprotection outcome; the Korean dementia cohort and the…
• Non-fatal Stroke (Cardiovascular Disease): Grade A → C; Size moderate → small. 4 studies removed (did not measure this outcome); 1 study added.Why: None of the 4 links reports stroke: the review names non-fatal stroke only as a MACE component, the others are glycaemic/weight comparisons and a microbiota review: removed. Re-cited the REWIND stroke analysis 31924562 (placebo-controlled, T2D with CV risk factors incl. prior CVD): stroke 3.2% vs 4.
• Postprandial Glucose (Type 2 Diabetes): Grade A → C; Size moderate → not stated. 12 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Only the AWARD-CHN2 post hoc (34870792) reports postprandial glucose: dulaglutide lowered HbA1c through reductions in both FG and PPG (7-point SMBG), with no PPG figure; the other 13 abstracts report HbA1c, weight or MACE only, and 40854315 tests ecnoglutide with dulaglutide as comparator. The…
• Safety/Tolerability: Effect note rewritten from its studies; Size moderate → not stated. 6 studies removed (did not measure this outcome); 3 studies removed (not a study of this supplement).Why: Against placebo, dulaglutide raised GI side effects (NMA 27981757: also hypoglycaemia; phase 2 30293770: GI 42.6% vs 9.8%) while not raising CV events (26912057) or hypoglycaemia vs pooled controls (26742577); vs glargine less hypoglycaemia but more GI events, vs first-line drugs more…
• No human study left after the re-check, so no grade: Anti-Cancer Activity, Anti-Inflammatory Activity, Cancer Cell Apoptosis, Systolic Blood Pressure (Cardiovascular Disease). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Dulaglutide (Trulicity): the page as it is now

• Infarct Size (STEMI): Effect note rewritten from its studies; Grade B → C. 4 studies removed (did not measure this outcome); 4 studies removed (not a study of this supplement); 1 study added.Why: No link reports infarct size: the EMBRACE sub-study measured HtrA2 only, the rat study used an SS-31 + S1P liposomal hydrogel, the rest are reviews and an AMD trial. Re-cited the EMBRACE STEMI main paper: no reduction in infarct size (CK-MB AUC), so the no-label row is right. Its note's claim of…
• LV End-Systolic Volume (HFrEF) (Heart Failure): Grade B → C. 3 studies removed (not a study of this supplement); 3 studies removed (did not measure this outcome).Why: PROGRESS-HF (71 HFrEF patients, subcutaneous elamipretide 4 or 40 mg/day for 28 days) found no LVESV change vs placebo, matching the no-label row and its note (every figure in the note is in that abstract). Two reviews and an AMD trial do not report LVESV: removed. One RCT: ceiling C, regrade B to…

Elamipretide (Forzinity/SS-31): the page as it is now

• No human study left after the re-check, so no grade: Hydration Maintenance During Prolonged Exercise. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Electrolytes: the page as it is now

• Weight (Metabolic Health). 6 studies removed (not a study of this supplement).
• No human study left after the re-check, so no grade: Appetite (Obesity), High-density lipoprotein (HDL) (Metabolic Health), Low-density lipoprotein (LDL) (Weight Loss & Maintenance), Subjective Well-Being (General Athletic Performance), Triglycerides (Overweight). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Ephedrine: the page as it is now

• Lean Body Mass: Effect note rewritten from its studies; Size small → not stated. 1 study removed (not a study of this supplement); 1 study removed (did not measure this outcome).Why: 29508691 (39 RCTs): pooled protein/EAA SMD 0.21-0.27 with EAA most effective, but no effect in the 7 low-risk-of-bias trials; the 24-week EAA RCT 29750251 found no lean-mass change. 'Improves' overstates this: Mixed effect. 25268791 pools unnamed protein/amino acid supplements (EAA not separable)…
• Muscle Strength: Effect note rewritten from its studies; Size small → not stated. 1 study removed (not a study of this supplement).Why: 29508691: protein/EAA improved strength overall (SMD 0.21-0.27) but not in the 7 low-risk-of-bias trials; 29750251: strength rose only with EAA plus aerobic training, not EAA alone. Mixed, not a clean 'Improves'. 25268791 pools unnamed protein/amino acid supplements: removed, so the note's Xu…

Essential amino acid (EAA): the page as it is now

• No human study left after the re-check, so no grade: Body Fat and Lipid Metabolism. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Fennel Essential Oil: the page as it is now

• ADHD Symptoms (Cognitive Improvement): Result Small Improvement → Mixed effect; Size small → not stated. 2 studies removed (not a study of this supplement).Why: Five omega-3 RCTs disagree: 25790022 improved parent-rated attention; 11487742 (DHA) no effect on any ADHD measure; 20491709 inattention subscale only, not total score; 14669965 significant on 2 of 16 outcomes; 19436468 only a subgroup responded. 'Small Improvement' overstates it: Mixed effect…
• ADHD Symptoms (Attention Deficit Hyperactivity Disorder (ADHD)): Result Small Improvement → Mixed effect; Size small → not stated. 2 studies removed (not a study of this supplement).Why: Five omega-3 RCTs disagree: 25790022 improved parent-rated attention; 11487742 (DHA) no effect on any ADHD measure; 20491709 inattention subscale only, not total score; 14669965 significant on 2 of 16 outcomes; 19436468 only a subgroup responded. 'Small Improvement' overstates it: Mixed effect…
• Aggression (Mood Improvement): Result Small Improvement → none shown; Size small → not stated. 1 study removed (did not measure this outcome).Why: 16269019 (healthy adults, 35 days omega-3 vs olive-oil placebo): POMS anger reduced. The row stores direction 'increase' (page shows Improves with an up arrow, i.e. more aggression), but the only aggression-type measure fell: direction set to decrease. 28121722 (272 healthy adults) measured…
• Anaerobic Capacity (General Athletic Performance): Result No effect → Moderate Improvement; Size none → moderate.Why: Only link: placebo-controlled RCT in 26 soccer players; anaerobic endurance capacity (Yo-Yo test) improved only in the n-3 group (203 m vs 62 m, 'moderate effect size (Cohen's d of 0.52)'); the title reports 'Improved Anaerobic Endurance Capacity'. Strength, sprint and power were unchanged, but…
• Anaerobic Capacity: Result No effect → Moderate Improvement; Size none → moderate.Why: Only link: placebo-controlled RCT in 26 soccer players; anaerobic endurance capacity (Yo-Yo test) improved only in the n-3 group (203 m vs 62 m, 'moderate effect size (Cohen's d of 0.52)'); the title reports 'Improved Anaerobic Endurance Capacity'. Strength, sprint and power were unchanged, but…
• Anaerobic Capacity (Muscle Size & Strength): Result No effect → Moderate Improvement; Size none → moderate.Why: General group (Muscle Size & Strength). The only study (placebo-controlled RCT, 26 soccer players) found anaerobic endurance capacity (Yo-Yo test) improved in the n-3 group only (p < .01), moderate effect size (d 0.52), and its title states 'Improved Anaerobic Endurance Capacity'; only strength…
• Bipolar Disorder Symptoms (Bipolar Disorder): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (did not measure this outcome).Why: Four placebo-controlled bipolar RCTs split 2-2: 16388069 (ethyl-EPA, HRSD P=0.04) and 10232294 (longer remission) favour omega-3; 16814257 (EPA 6 g, no differences on any outcome) and 22926607 (fish oil, not superior, trend worse) do not. 'Small Improvement' overstates it: Mixed effect, size…
• Blood Flow: Result No effect → none shown; Size none → not stated.Why: Only link: 24-week double-blind placebo-controlled RCT (60 SLE patients, 3 g omega-3): brachial flow-mediated dilation rose from 3.0% to 8.9% (p<0.001) and the authors conclude fish oil 'improves endothelial function'. The page shows 'No effect': direction error, set to Improves (increase). The…
• Blood Flow (Obesity). 1 study removed (studied a different group of people); 1 study added.
• C-Reactive Protein (CRP) (Lung Cancer): Result No effect → none shown; Size none → not stated. 3 studies removed (studied a different group of people).Why: Row is under Lung Cancer. Two links are healthy volunteers and one is peripheral arterial disease (fail population). The only lung-cancer study (22114792, double-blind RCT, 33 NSCLC patients on chemotherapy) found CRP differed significantly from placebo and fell progressively with EPA+DHA. Page…
• C-Reactive Protein (CRP) (Peripheral Arterial Disease). 3 studies removed (studied a different group of people).
• Depression Symptoms (Peripartum Depression): Result Moderate Improvement → No effect; Size moderate → not stated. 1 study removed (not a study of this supplement); 6 studies removed (studied a different group of people); 1 study removed (did not measure this outcome).Why: Six perinatal RCTs pass: five find no difference from placebo (postpartum DHA 12748510, perinatal MDD 18247194 and 18206247, pregnancy prevention 18955102 and 23531328, the two largest) and one small trial (18370571, 36 women) finds benefit. Page shows 'Moderate Improvement': direction error…
• Depression Symptoms (Depression): Result Moderate Improvement → Mixed effect; Grade A → B; Size moderate → not stated. 1 study removed (not a study of this supplement); 1 study removed (did not measure this outcome).Why: Twelve RCTs pass (depressed, at-risk or general populations). In depressed patients results split: 12888186 (P<0.001), 18370571 and the 1 g/d arm of 12365878 favour omega-3, while 18247194, 18206247, 17659823 and 19116322 (overall) find no difference; prevention trials in pregnant/postpartum…
• Depression Symptoms (Perinatal Depression): Result Moderate Improvement → No effect; Size moderate → not stated. 1 study removed (not a study of this supplement); 6 studies removed (studied a different group of people); 1 study removed (did not measure this outcome).Why: Six perinatal RCTs pass: five find no difference from placebo (postpartum DHA 12748510, perinatal MDD 18247194 and 18206247, pregnancy prevention 18955102 and 23531328, the two largest) and one small trial (18370571, 36 women) finds benefit. Page shows 'Moderate Improvement': direction error…
• Erythema (Skin Health): Grade C → D.Why: General group (Skin Health). The only study is an uncontrolled before/after study in 15 volunteers (10 g fish oil daily; no placebo arm, only irradiated vs unirradiated skin sites): minimal erythema dose rose from 18.9 to 41.1 mJ/cm2, so Improves holds and 'small' does not overstate. A single…
• Inflammation (Chronic Kidney Disease (CKD)): Result Small Decrease → Mixed effect; Size small → not stated. 3 studies removed (studied a different group of people).Why: Only the hemodialysis RCT 21757893 (34 patients) is in a CKD population: sICAM-1 fell vs placebo but CRP, IL-6, TNF-alpha and other markers did not change, and the authors conclude no effect on systemic inflammation. 'Small Decrease' overstates this: Mixed effect, size cleared. The other three…
• Triglycerides (Rheumatoid Arthritis (RA)): Result Large Improvement → Small Improvement; Size large → small. 23 studies removed (studied a different group of people); 1 study removed (not a study of this supplement); 2 studies added.Why: Row is under RA. None of the 24 links studies RA patients (type 2 diabetes, hyperlipidemia, healthy adults, MASLD, overweight women); 22113870 is algal DHA, not fish oil. Re-cited two RA meta-analyses (38922552, 28965775) that both report a significant TG fall with omega-3 (SMD -0.47 and -0.32)…
• No human study left after the re-check, so no grade: Depression Symptoms (Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Fish Oil: the page as it is now

• Blood glucose (Coronary Artery Disease (CAD)). 3 studies removed (studied a different group of people); 1 study added.

Flaxseed: the page as it is now

• No human study left after the re-check, so no grade: Angiogenesis, Anti-Cancer Activity, Collagen Synthesis (Skin Health), Hair Growth (Hair Health), Lipid Profile, Liver Protection, Pulmonary Function, Safety/Tolerability, Skin Thickness (Skin Health), Wound Healing Rate (Skin Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

GHK-Cu: the page as it is now

• Dysmenorrhea Symptoms (Primary Dysmenorrhea (Menstrual Cramps)): Result Small Improvement → Improvement; Size small → not stated.Why: One controlled, non-placebo trial (150 women): ginger reduced dysmenorrhea severity as much as mefenamic acid and ibuprofen. Benefit holds but has no placebo arm and no effect size. Stored direction 'increase' is the wrong polarity for a symptom outcome: set 'decrease'; 'small' cleared…
• Gastric Emptying Rate (Motion Sickness): Result Small Increase → No effect; Size small → not stated. 3 studies removed (studied a different group of people).Why: The only motion-sickness study (2062873, 28 volunteers, the row's people figure) found ginger had no effect on gastric emptying in normal or motion-sick subjects. The faster emptying in 18403946/21218090/20149584 is in healthy, dyspeptic and ICU patients. 'Small Increase' is wrong: No effect.…
• Nausea Symptoms (Hyperemesis Gravidarum): Result Moderate Improvement → Improvement; Grade B → C; Size moderate → not stated. 8 studies removed (studied a different group of people).Why: Row is under Hyperemesis Gravidarum. Only 1988321 studies HG (27 women, crossover vs placebo): greater symptom relief with ginger (P=0.035). The others enrolled ordinary nausea and vomiting of pregnancy (not shown to include HG), postoperative or chemotherapy patients: fail C5 strict. One trial…
• Nausea Symptoms (Bone Cancer): Direction goes up → goes down. 8 studies removed (studied a different group of people).Why: Only 20842754 studies the row's population (bone sarcoma patients on cisplatin/doxorubicin): ginger add-on cut acute and delayed moderate-severe nausea vs placebo. The other eight are pregnancy or postoperative nausea trials. 'Moderate Improvement' not overstated; stored direction 'increase' is…

Ginger (Zingiber officinale): the page as it is now

• No human study left after the re-check, so no grade: Anti-Oxidant Enzyme Profile (Diabetic Nephropathy), Blood glucose (Diabetic Nephropathy), Blood Pressure (Diabetic Nephropathy), Blood Urea Nitrogen (Diabetic Nephropathy), C-Reactive Protein (CRP) (Diabetic Nephropathy), Cystatin C (Diabetic Nephropathy), Fibrinogen (Diabetic Nephropathy), HbA1c (Diabetic Nephropathy), Hematocrit (Diabetic Nephropathy), Interleukin 6 (Diabetic Nephropathy), Kidney Function (Diabetic Nephropathy), Low-density lipoprotein (LDL) (Diabetic Nephropathy), Proteinuria (Diabetic Nephropathy), TNF-Alpha (Diabetic Nephropathy), Total cholesterol (Diabetic Nephropathy), Triglycerides (Diabetic Nephropathy), Urinary Albumin (Diabetic Nephropathy). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Ginkgo Biloba: the page as it is now

• Osteoarthritis Symptoms (Osteoarthritis (OA)): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (not a study of this supplement).Why: The Cochrane review (20 RCTs) finds a pooled benefit driven by the Rotta preparation but no benefit in trials with adequate concealment or non-Rotta products, and no WOMAC benefit. Placebo RCTs split: 4 glucosamine-sulfate trials positive (7002479, 11214126, 12374520, 17265490), 5 null including…

Glucosamine: the page as it is now

• Diagnostic Accuracy (Hypogonadotropic Hypogonadism): Effect note rewritten from its studies; Grade A → D; Size moderate → not stated. 79 studies removed (not a study of this supplement); 1 study removed (did not measure this outcome).Why: The only study that tests GnRH (gonadorelin) as a diagnostic in this population (15554892, 17 adolescents with suspected HH given 7 days of pulsatile GnRH) found the gonadotropin rise was the same in HH and constitutional delay, so the test could not tell them apart. Nothing linked supports better…
• Hormone Levels: Effect note rewritten from its studies; Grade C → D. 1 study removed (did not measure this outcome).Why: Gonadorelin raised LH and testosterone in dogs (8229946) and testosterone >6-fold in bulls (10071824); the 2-case HH report (25131486) reports raised gonadotropins. The no-abstract editorial is about GnRH+GH on height. Only animal studies and a case report: ceiling D (stored C lowered); the '3…
• Puberty Induction (Hypogonadotropic Hypogonadism): Grade A → C. 79 studies removed (not a study of this supplement); 1 study removed (did not measure this outcome).Why: 15554892: 68 HH males on pulsatile GnRH all achieved testicular growth and virilization (uncontrolled series); 25131486: two gonadorelin-pump cases with improved androgen deficiency. 26365959 is a diagnostic stimulation test and 32445446 is about hCG+FSH. Improves/large and the note hold; no…
• Reproductive Outcomes: Effect note rewritten from its studies; Grade C → D. 4 studies removed (did not measure this outcome).Why: Only human evidence is 3908673, an uncontrolled 8-woman Factrel series (ovulation in 80% of cycles, 4 pregnancies); three cattle studies show gonadorelin induces ovulation, two compare GnRH products only (no untreated control). No-abstract editorials/reviews and the 2-case androgen report removed.…
• Safety/Tolerability: Effect note rewritten from its studies; Size small → not stated. 1 study removed (not a study of this supplement); 1 study removed (did not measure this outcome).Why: 35691791 (randomised, 36 infants, intranasal gonadorelin vs none) found no specific effect on penile size, testis volume or hormones and concludes the treatment 'can be considered safe'. 17290340 is triptorelin, a different agonist; the HH case report gives no safety data. Favourable tolerability…
• Spermatogenesis Induction (Hypogonadotropic Hypogonadism): Effect note rewritten from its studies; Grade A → C. 79 studies removed (not a study of this supplement); 1 study removed (did not measure this outcome).Why: The clinical series in 15554892 (pulsatile GnRH, i.e. gonadorelin, in 68 HH men) reports spermatogenesis in 58 (85%), supporting 'Improves'/large. The hCG/FSH review studies gonadotropins (GnRH only named), and the 2-patient gonadorelin report gives no sperm result: removed. The note's '6 months…
• Testicular Growth (Hypogonadotropic Hypogonadism): Grade A → C. 79 studies removed (not a study of this supplement); 1 study removed (did not measure this outcome).Why: Only 15554892 (uncontrolled series of 68 HH males on pulsatile GnRH) reports testicular growth: growth in all patients, so Improves/large and the '100%' note hold. 32445446 is about hCG+FSH, not GnRH; the 2-case gonadorelin report gives no testicular data. No controlled trial: ceiling C, stored A…
• No human study left after the re-check, so no grade: Anti-Cancer Activity, Hair Growth, Immune Function. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Gonadorelin (Factrel): the page as it is now

• Chronic Venous Insufficiency Signs (Chronic Venous Insufficiency). 1 study removed (did not measure this outcome).
• Chronic Venous Insufficiency Signs (Varicose Veins): Result Moderate Improvement → Improvement; Size moderate → not stated. 1 study removed (did not measure this outcome).Why: Three placebo-controlled trials of oral TTFCA in venous hypertension/CVI (7936334, 11666126, 11666117) report improved skin flux, tcPO2/PCO2, ankle swelling and signs/symptoms vs placebo; an uncontrolled study (2389834) shows reduced capillary permeability. The 'no change' wording refers to…

Gotu Kola: the page as it is now

• No human study left after the re-check, so no grade: Blood Pressure (Dyslipidemia). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Grape Seed Extract: the page as it is now

• No human study left after the re-check, so no grade: Body Composition. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Haskap Berry: the page as it is now

• No human study left after the re-check, so no grade: High-density lipoprotein (HDL) (High Cholesterol), Low-density lipoprotein (LDL) (Metabolic Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Hemp Protein: the page as it is now

• Bone Mineral Density (Osteoporosis): Result Small Improvement → Improvement; Size small → not stated. 1 study removed (studied a different group of people).Why: A meta-analysis of 12 RCTs in osteoporosis (35431937) found Epimedium improved BMD as an add-on (p=0.03) and alone vs conventional drugs (p=0.009). The 24-month trial 17419678 enrolled healthy late-postmenopausal women with T-scores of -2 to -2.5 (osteopenia, not osteoporosis) and gave icariin…

Horny Goat Weed: the page as it is now

• Corticosteroid-Induced Bone Loss: Effect note rewritten from its studies; Size small → not stated. 2 studies removed (did not measure this outcome).Why: Two small controlled trials in corticosteroid-treated patients: 2997764 (36 CAH patients) found significantly less cortical-plate loss with MCHC (P<0.025); in 6373153 (40 on prednisolone) the cortical-thickness difference vs controls only 'came close' to significance (pain fell significantly). The…

Hydroxyapatite: the page as it is now

• Muscle Strength (Body Composition): Effect note rewritten from its studies; Grade B → not graded; Size moderate → not stated. 2 studies removed (did not measure this outcome); 2 studies removed (not a study of this supplement); 1 study added.
• No human study left after the re-check, so no grade: Body Weight (Body Composition). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Ipamorelin: the page as it is now

• No human study left after the re-check, so no grade: Appetite Suppression (Oral - Safety Concerns), Collagen & Hyaluronic Acid Synthesis. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Jojoba: the page as it is now

• Egg Maturation Trigger (Infertility): Effect note rewritten from its studies; Grade A → C; Size large → not stated. 3 studies removed (not a study of this supplement); 5 studies removed (did not measure this outcome).Why: Kisspeptin-54 triggered egg maturation in 53 IVF women (uncontrolled dose-finding trial, 25036713) and a second dose raised oocyte yield vs one dose in a 62-woman RCT (28854728); one review names oocyte maturation as an established human use. The rest are reviews with no maturation result, an…
• FSH Secretion (Subfertility): Grade A → C. 3 studies removed (not a study of this supplement); 5 studies removed (did not measure this outcome).Why: Only the kisspeptin-vs-saline RCT in hypothalamic amenorrhea (19820030) reports FSH: +9.1 IU/L acutely, desensitized after 14 days of repeated dosing; one review says exogenous kisspeptin stimulates gonadotropin secretion. The acute-dosing note matches and is kept; 'moderate' is consistent. One…
• IVF Pregnancy Rate (Infertility): Grade B → C; Size moderate → not stated. 3 studies removed (not a study of this supplement); 6 studies removed (did not measure this outcome).Why: Two kisspeptin-54 trigger studies report pregnancies: 23% clinical pregnancy in 53 IVF patients (25036713, matching the note, which is kept) and 53% clinical pregnancy per transfer in high-OHSS-risk women (26192876, dose-randomized). Neither has a non-kisspeptin comparator, so 'moderate' has no…
• LH Secretion (Subfertility): Effect note rewritten from its studies; Grade A → B. 3 studies removed (not a study of this supplement); 3 studies removed (did not measure this outcome).Why: Kisspeptin-54 vs saline in hypothalamic amenorrhea raised LH by 24 IU/L acutely (19820030; the response desensitized after 14 days of twice-daily dosing), and KP54 produced an LH rise in healthy, PCOS and HA women in the MVT-602 comparison (33196464); two reviews agree. Improves/large holds for…
• Oocyte Maturation (IVF) (Infertility): Effect note rewritten from its studies; Grade A → B. 3 studies removed (not a study of this supplement); 5 studies removed (did not measure this outcome).Why: Kisspeptin-54 triggered oocyte maturation in 95% of 60 high-OHSS-risk women (dose-randomized phase 2, 26192876), at every dose in 53 IVF patients (25036713), and a second dose beat saline for oocyte yield (71% vs 45%, 28854728); a review concurs. Improves/large holds. Only two randomized trials…
• Ovarian Hyperstimulation Syndrome Prevention (Infertility): Effect note rewritten from its studies; Grade A → C; Size large → not stated. 4 studies removed (not a study of this supplement); 7 studies removed (did not measure this outcome).Why: Two Hammersmith trials in high-OHSS-risk women report low OHSS after a kisspeptin-54 trigger (no moderate/severe/critical OHSS in 60 women; moderate OHSS 1/31 vs 0/31 with a second dose), so a benefit direction holds, but neither has an hCG or non-kisspeptin arm for OHSS. The note's '7% mild OHSS'…
• Reproductive Hormone Recovery (Hypothalamic Amenorrhea) (Subfertility). 4 studies removed (not a study of this supplement); 5 studies removed (did not measure this outcome); 3 studies added.

Kisspeptin-54: the page as it is now

• Anti-inflammatory (Topical) (Skin Health): Effect note rewritten from its studies; Grade D → not graded; Size moderate → not stated; People studied 30 → not stated. 65 studies removed (not a study of this supplement); 3 studies removed (did not measure this outcome); 2 studies added.
• Mortality: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 5 studies removed (not a study of this supplement); 1 study added.
• No human study left after the re-check, so no grade: Anti-Cancer Activity, Antimicrobial Activity, Colitis Severity (Animal) (General Gut Health), GI Protection, Immune Function, Intestinal Inflammation (Animal) (General Gut Health), Macrophage Activation Suppression (Immune Health), Pro-inflammatory Cytokine Reduction (Immune Health), Pulmonary Function, Wound Healing. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

KPV: the page as it is now

• ADHD Symptoms (Attention Deficit Hyperactivity Disorder (ADHD)): Result Small Improvement → Mixed effect; Size small → not stated.Why: Four placebo-controlled trials split 2-2: the largest (112 children, ALC) missed its primary endpoint and the ALC add-on to methylphenidate trial (40) found no difference, while a 24-boy carnitine crossover and a 51-boy fragile X ALC trial found less hyperactivity. A clean 'Small Improvement'…
• Alcohol Dependence Symptoms (Alcohol Use Disorder): Result Small Improvement → Improvement; Size small → not stated.Why: Pilot RCT in 64 anhedonic alcohol-dependent patients: ALC lengthened time to first drink and the 1 g dose cut craving vs placebo, though abstinence and relapse rates did not differ. Improves holds; no effect sizes are reported, so 'small' is cleared. One RCT: C = stored C.
• Ammonia (Cirrhosis). 1 study removed (studied a different group of people).
• Ammonia (Surgical Recovery): Result Moderate Decrease → Decrease; Size moderate → not stated. 5 studies removed (studied a different group of people); 1 study added.Why: No link studies surgical patients (four cirrhosis/hepatic-encephalopathy studies and one exercise study in healthy men): all removed. Re-cited a 208-patient RCT around hepatectomy (abstract read; the stored 208 people match it): perioperative L-carnitine restored serum ammonia faster than usual…
• Atherosclerotic Signs (Polycystic Ovary Syndrome (PCOS)): Result Mixed effect → Improvement.Why: The one RCT (60 women with PCOS, 250 mg/d for 12 wk) found significant falls in all four carotid IMT measures vs placebo (P <= 0.001); only hs-CRP, an inflammatory marker rather than an atherosclerotic sign, was unchanged. 'Mixed effect' understates a clean CIMT benefit: Improvement (CIMT down).…
• Attention (Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)): Result Small Improvement → Improvement; Size small → not stated.Why: Open-label study in 90 CFS patients randomised among acetyl-, propionyl- and combined carnitine (no placebo arm): Stroop attention improved in all groups. Improves holds, but with no control and no figures 'small' has no basis: Improvement, size cleared. One human trial (not small): C = stored C.
• Blood Carnitine (Peripheral Arterial Disease): Result Large Increase → Mixed effect; Size large → not stated. 2 studies removed (studied a different group of people); 1 study added.Why: Neither link is a PAD population (collegiate swimmers; acne patients on isotretinoin): removed. Three searches found one on-topic study (abstract read): in 22 claudicants, IV L-carnitine vs placebo raised exercise plasma acetylcarnitine in the 7 patients with an abnormal profile but left the other…
• Blood Carnitine (Acne): Result Large Increase → Increase; Size large → not stated. 1 study removed (studied a different group of people).Why: In cystic-acne patients whose blood carnitine fell on isotretinoin, L-carnitine (vs placebo, 20 per group) normalised carnitine levels; no figures are given, so 'large' is cleared (note becomes 'Increase'). The swimmer trial is not an acne population. One controlled trial: C = stored C.
• Blood glucose (Nonalcoholic Fatty Liver Disease (NAFLD)): Result Small Improvement → Improvement; Size small → not stated. 1 study removed (did not measure this outcome); 4 studies removed (studied a different group of people); 1 study added.Why: No linked study is in NAFLD: the metabolic-syndrome meta-analysis pools unstated populations (FBS not significant overall), and the rest are cardiovascular-risk, athlete, healthy-men and lean/overweight-men studies (one reports no glucose result): all removed. Re-cited the NASH RCT (NASH is NAFLD…
• Blood glucose (Prediabetes): Result Small Improvement → Improvement; Grade B → C; Size small → not stated. 1 study removed (did not measure this outcome); 3 studies removed (studied a different group of people).Why: Only 19620516 fits prediabetes: in an uncontrolled off-on-off study of nondiabetic adults at raised cardiovascular risk, 24 wk of acetyl-L-carnitine improved impaired glucose tolerance in the insulin-resistant group. Removed: the metabolic-syndrome meta-analysis (pooled RCTs of unstated…
• Blood glucose (High Blood Pressure): Result Small Improvement → Improvement; Size small → not stated. 1 study removed (did not measure this outcome); 3 studies removed (studied a different group of people).Why: Only 19620516 fits high blood pressure: in an uncontrolled off-on-off study of hypertensive nondiabetic adults at raised cardiovascular risk, 24 wk of acetyl-L-carnitine improved glucose tolerance in the insulin-resistant group. Removed: the metabolic-syndrome meta-analysis (pooled RCTs of…
• Blood glucose (Diabetic Neuropathy): Result Small Improvement → none shown; Grade C → not graded; Size small → not stated; People studied 232 → not stated. 1 study removed (did not measure this outcome); 4 studies removed (studied a different group of people); 1 study added.
• Blood Lactate (Exercise) (Chronic Obstructive Pulmonary Disease (COPD)): Result No effect → Improvement; Size none → not stated. 1 study removed (did not measure this outcome); 4 studies removed (studied a different group of people); 1 study added.Why: No link studies COPD: a healthy-subject meta-analysis (no lactate effect), footballers, a PAD study with no lactate measure, sprint cyclists and GPLC in resistance-trained men: all removed. Re-cited the one COPD RCT (abstract read): with training, L-carnitine lowered exercise blood lactate vs…
• Blood Pressure (End-Stage Renal Disease): Result Small Improvement → No effect; Size small → not stated. 1 study removed (studied a different group of people); 2 studies added.Why: The only link is a meta-analysis of 10 RCTs in general populations (no ESRD subgroup; DBP -1.2 mmHg, SBP unchanged): removed. Two searches found no ESRD trial reporting blood pressure in mmHg; the ESRD blood-pressure outcome studied is intradialytic hypotension, and two meta-analyses of dialysis…
• Body Fat (General Athletic Performance): Result none shown → No effect.Why: The row shows Improves (body fat goes down), but its only study, a double-blind RCT, found no change in fat mass and no difference from placebo. Now No effect. Ungraded row: grade left unset (ceiling C).
• Body Fat (Metabolic Health): Result none shown → No effect.Why: The row shows Improves (body fat goes down), but its only study, a double-blind RCT, found no change in fat mass and no difference from placebo. Now No effect. Ungraded row: grade left unset (ceiling C).
• Body Fat: Result none shown → No effect.Why: The row shows Improves (body fat goes down), but its only study, a double-blind RCT, found no change in fat mass and no difference from placebo. Now No effect. Ungraded row: grade left unset (ceiling C).
• Body Fat (Obesity): Result none shown → No effect.Why: The row shows Improves (body fat goes down), but its only study, a double-blind RCT, found no change in fat mass and no difference from placebo. Now No effect. Ungraded row: grade left unset (ceiling C).
• Body Fat (Cognitive Improvement): Result Small Decrease → No effect; Size small → not stated.Why: The only study (RCT, 36 overweight women, 4 g/d L-carnitine with walking for 8 wk) found no change in fat mass and no between-group difference. The page shows Improves / 'Small Decrease': wrong, set to No effect. Cognitive Improvement is a goal group, so the population is accepted. One RCT: C =…
• Body Fat (Immune Health): Result none shown → No effect.Why: The row shows Improves (body fat goes down), but its only study, a double-blind RCT, found no change in fat mass and no difference from placebo. Now No effect. Ungraded row: grade left unset (ceiling C).
• Body Fat (Weight Loss & Maintenance): Result Small Decrease → No effect; Size small → not stated.Why: The row shows 'Small Decrease' (Improves) for body fat, but its only study (double-blind RCT) found no change in fat mass and no difference from placebo. Now No effect, size cleared; grade C kept (one RCT).
• Body Fat (Body Composition): Result none shown → No effect.Why: The row shows Improves (body fat goes down), but its only study, a double-blind RCT, found no change in fat mass and no difference from placebo. Now No effect. Ungraded row: grade left unset (ceiling C).
• Body Mass Index (BMI) (End-Stage Renal Disease): Result none shown → No effect. 1 study removed (studied a different group of people); 1 study added.Why: Ungraded row shows Improves for BMI on the ESRD page. 1 linked studies in other populations (diabetes, PCOS, NAFLD, CAD, osteoarthritis) removed. The meta-analysis of 28 RCTs in hemodialysis patients (39687901) found no significant change in BMI (flagged; added). Now No effect; grade…
• Cognition (Fatigue). 1 study removed (studied a different group of people).
• Erections (Erectile Dysfunction): Grade B → C. 1 study removed (not a study of this supplement).Why: Double-blind RCT in 40 diabetic men with sildenafil-refractory ED: propionyl-L-carnitine added to sildenafil beat sildenafil alone (improved erections 68% vs 23%), so the carnitine effect is isolated; 'small' does not overstate. The one-arm PLC + L-arginine + niacin study cannot separate…
• Fertility (Infertility): Result none shown → Mixed effect. 3 studies added.Why: Ungraded row with no study shows Improves for fertility. The meta-analysis of carnitines in male infertility (35128424) found no effect on clinical pregnancy rate: added, verdict No effect. Grade left unset (ceiling A). Two meta-analyses in oligoasthenoteratozoospermia find more pregnancies with L-carnitine (31701550, 25707144) and the 2020 one finds none: Mixed effect (p004 reader).
• Fertility (Idiopathic Oligoasthenoteratozoospermia (IOAT)): Result Moderate Improvement → Mixed effect; Grade A → B; Size moderate → not stated. 3 studies added.Why: Graded A 'Moderate Improvement' with no study. Population idiopathic oligoasthenoteratozoospermia. Two meta-analyses in OAT/oligoasthenozoospermia report more pregnancies with carnitines (31701550, 25707144), but the 2020 meta-analysis of 8 RCTs (35128424, flagged) found no effect on clinical…
• Fertility (Oligospermia): Result Moderate Improvement → Mixed effect; Grade A → B; Size moderate → not stated. 3 studies added.Why: Graded A 'Moderate Improvement' with no study. Population oligospermia (OAT/oligoasthenozoospermia men are oligospermic). Two meta-analyses in OAT/oligoasthenozoospermia report more pregnancies with carnitines (31701550, 25707144), but the 2020 meta-analysis of 8 RCTs (35128424, flagged) found no…
• Hematocrit (Renal Anemia): Result No effect → Improvement; Size none → not stated.Why: The only study (uncontrolled 3-month trial, 14 haemodialysis patients with EPO-resistant anaemia, oral L-carnitine 500 mg/d) found a significant haematocrit rise (p = 0.003; 36% rose >2 points). The page shows 'No effect': wrong, set to Improvement (Hct up), no size basis. Single small…
• High-density lipoprotein (HDL) (Atherosclerosis). 11 studies removed (studied a different group of people); 1 study removed (not a study of this supplement); 1 study added.
• High-density lipoprotein (HDL) (End-Stage Renal Disease): Result none shown → No effect. 12 studies removed (studied a different group of people); 1 study added.Why: Ungraded row shows Improves for HDL on the ESRD page. 12 linked studies in other populations (diabetes, PCOS, NAFLD, CAD, osteoarthritis) removed. The meta-analysis of 28 RCTs in hemodialysis patients (39687901) found no significant change in HDL (flagged; added). Now No effect; grade…
• Low-density lipoprotein (LDL) (End-Stage Renal Disease): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves for LDL on the ESRD page. The meta-analysis of 28 RCTs in hemodialysis patients (39687901) found no significant change in LDL (flagged; added). Now No effect; grade unset (ceiling A).
• Oxygen Uptake (General Athletic Performance): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: The row shows Improves for oxygen uptake, but the only study measuring it (3305002, two double-blind crossover trials) found no change in VO2max. Now No effect. IV study (wrong route) and the work-output study (no VO2 result) removed. Ungraded row: grade left unset (ceiling B).
• Oxygen Uptake (Metabolic Health): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: The row shows Improves for oxygen uptake, but the only study measuring it (3305002, two double-blind crossover trials) found no change in VO2max. Now No effect. IV study (wrong route) and the work-output study (no VO2 result) removed. Ungraded row: grade left unset (ceiling B).
• Oxygen Uptake: Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: The row shows Improves for oxygen uptake, but the only study measuring it (3305002, two double-blind crossover trials) found no change in VO2max. Now No effect. IV study (wrong route) and the work-output study (no VO2 result) removed. Ungraded row: grade left unset (ceiling B).
• Oxygen Uptake (Running Performance): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: The row shows Improves for oxygen uptake, but the only study measuring it (3305002, two double-blind crossover trials) found no change in VO2max. Now No effect; IV study and the no-VO2 study removed. Ungraded row: grade unset (ceiling B). Same as p003 another finding/9819/9852.
• Oxygen Uptake (Mitochondrial Myopathy): Result none shown → Improvement. 2 studies removed (studied a different group of people); 1 study removed (not a study of this supplement); 1 study added.Why: Added 25714882 (RCT in mitochondrial myopathy, oral L-carnitine: oxygen uptake rose; abstract read by the p004 and n001 readers).
• Prostate-Specific Antigen (Male Sexual Dysfunction): Result none shown → No effect.Why: The row shows Improves (PSA goes up), but its only study (RCT) found carnitines did not significantly change PSA. Now No effect. Ungraded row: grade left unset (ceiling C).
• Sperm Count (Infertility): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves for sperm count. The carnitine male-infertility meta-analysis (35128424) found no effect on sperm concentration (motility and morphology did improve): added, verdict No effect. Grade left unset (ceiling A).
• Sperm Count (Idiopathic Oligoasthenoteratozoospermia (IOAT)): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves for sperm count (idiopathic oligoasthenoteratozoospermia). The flagged meta-analysis (35128424) found no effect on sperm concentration. The two OAT meta-analyses read for another finding agree (25707144: 'no statistically significant differences were…
• Sperm Count (Oligospermia): Result none shown → No effect. 1 study added.Why: Ungraded row with no study shows Improves for sperm count (oligospermia). The flagged meta-analysis (35128424) found no effect on sperm concentration. The two OAT meta-analyses read for another finding agree (25707144: 'no statistically significant differences were observed in sperm concentration'…
• Total cholesterol (End-Stage Renal Disease): Result none shown → No effect. 6 studies removed (studied a different group of people); 1 study added.Why: Ungraded row shows Improves for total cholesterol on the ESRD page. 6 linked studies in other populations (diabetes, PCOS, NAFLD, CAD, osteoarthritis) removed. The meta-analysis of 28 RCTs in hemodialysis patients (39687901) found no significant change in total cholesterol (flagged; added).
• Triglycerides (End-Stage Renal Disease): Result none shown → No effect. 3 studies removed (studied a different group of people).Why: Ungraded row shows Improves for triglycerides on the ESRD page. 3 linked studies in other populations (diabetes, PCOS, NAFLD, CAD, osteoarthritis) removed. The meta-analysis of 28 RCTs in hemodialysis patients (39687901) found no significant change in triglycerides (linked already). Now…
• vLDL-C (End-Stage Renal Disease): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves for VLDL on the ESRD page. The meta-analysis of 28 RCTs in hemodialysis patients (39687901) found no significant change in VLDL (flagged; added). Now No effect; grade unset (ceiling A).
• No human study left after the re-check, so no grade: Aerobic Exercise Metrics (Chronic Kidney Disease (CKD)), Blood glucose (Type 1 Diabetes), Body Fat (Type 2 Diabetes), Body Fat (High Cholesterol), Body Fat (Coronary Artery Disease (CAD)), Body Fat (Nonalcoholic Steatohepatitis (NASH)), Body Fat (Prediabetes), Body Fat (Hypothyroidism), Fertility (Male Sexual Dysfunction), Peak flow time (Peripheral Arterial Disease), Sperm Count (Male Sexual Dysfunction). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

L-Carnitine: the page as it is now

• No human study left after the re-check, so no grade: Obesity / Body Weight. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

L-Threonate: the page as it is now

• Abdominal Fat: Effect note rewritten from its studies; Size small → not stated. 2 studies removed (did not measure this outcome).Why: The one RCT (heat-killed L. paracasei K71, n=80) found no between-group difference in any item in the per-protocol set; fat fell only in the stable-lifestyle subgroup. A clean 'Improves' with 'small' overstates this: Mixed effect, size cleared. The other two links are in-vitro bacteriocin/biofilm…

Lacticaseibacillus paracasei: the page as it is now

• Anti-Cancer Activity: Effect note rewritten from its studies; Grade B → C; Size moderate → not stated. 6 studies removed (did not measure this outcome); 6 studies removed (not a study of this supplement).Why: Only three links pass: the NEJM RCT 6436700 (199 men with metastatic prostate cancer; 86% objective response on leuprolide, therapeutically equivalent to DES), the review 2429815 (effective palliative treatment) and an in-vitro ovarian-cancer study (1902482: early slowing, no long-term arrest).…
• Disease Progression (Prostate Cancer): Effect note rewritten from its studies; Grade A → C; Size large → not stated. 6 studies removed (not a study of this supplement); 6 studies removed (did not measure this outcome); 2 studies added.Why: The Drugs review 7533699 states only 'comparable efficacy to bilateral orchiectomy', never disease progression; the other 5 links never report progression: all removed. Re-cited two prostate-cancer depot trials reporting progression: no progression in 80% at 32 weeks (9495710) and <10% progression…
• Dysmenorrhea (Endometriosis): Effect note rewritten from its studies; Grade A → B. 6 studies removed (not a study of this supplement); 6 studies removed (did not measure this outcome); 2 studies added.Why: The Drugs review 7533699 mentions buserelin but not dysmenorrhea ('objective and subjective responses'); the other 5 links never report it: all removed. Re-cited two placebo-controlled RCTs: dysmenorrhea responded significantly (2118858) and improved 1.7 points more than placebo on a 4-point scale…
• Endometriotic Lesions (Endometriosis): Effect note rewritten from its studies; Grade A → B; Size large → not stated. 6 studies removed (not a study of this supplement); 6 studies removed (did not measure this outcome); 3 studies added.Why: The Drugs review 7533699 says only 'objective and subjective responses' (lesions not named); the other 5 links never report lesions: all removed. Re-cited three controlled trials vs danazol with second-look laparoscopy, all showing lesion scores fell on leuprolide (AFS 36 to 29 in 7851578).…
• Hormone Levels: Effect note rewritten from its studies; Grade B → C; Size moderate → not stated. 3 studies removed (did not measure this outcome); 3 studies removed (not a study of this supplement).Why: Every passing study shows hormone levels FALL on leuprolide: testosterone to normal female levels in 12 PCOS women (8405516), pubertal LH suppressed in 64 children (32738042), testosterone below 20 ng/dl (review 26293510), testosterone suppression in rats (29662027) and androgen metabolites in…
• Pelvic Pain (Endometriosis) (Endometriosis): Effect note rewritten from its studies. 6 studies removed (not a study of this supplement); 6 studies removed (did not measure this outcome); 3 studies added.Why: The Drugs review 7533699 says only 'objective and subjective responses' (pain not named); the other 5 links never report pelvic pain: all removed. Re-cited two placebo-controlled RCTs (2118858; 9916956: pelvic pain 1.0 point better than placebo on a 4-point scale) and the 270-patient double-blind…
• PSA Reduction (Prostate Cancer): Effect note rewritten from its studies; Grade A → C. 6 studies removed (not a study of this supplement); 5 studies removed (did not measure this outcome); 2 studies added.Why: None of the 5 links reports PSA (two general reviews, a no-abstract review, a skin case report, a precocious-puberty trial): all removed. Re-cited two uncontrolled leuprolide depot trials in prostate cancer: mean PSA fell 97% (16406989, 111 men) and fell by 50% or more in 97% of patients (9495710…
• Safety/Tolerability: Size small → not stated. 1 study removed (did not measure this outcome).Why: Two human trials pass, as the note says: the 270-patient double-blind RCT vs danazol (8333471: side effects common, few dropouts, no serious complications, but greater bone-density loss) and the 64-child phase 3 trial (32738042: adverse events mild, no discontinuations); plus a 60-week dog…
• Testosterone Suppression (Prostate Cancer): Effect note rewritten from its studies; Grade A → C; Size large → not stated. 6 studies removed (not a study of this supplement); 2 studies removed (did not measure this outcome); 1 study removed (studied a different group of people); 1 study added.Why: Only two narrative reviews pass (StatPearls 31869126 names reduced testosterone; 17970643 says gonadal sex steroid production is suppressed); 16312847 has no abstract, 22882386 is a drug-eruption case report, 32738042 is children with precocious puberty. Direction holds, but no linked abstract… Added 16406989 (open-label trial, 111 men with prostate cancer: 99% reached castrate testosterone on 6-month leuprolide depot; abstract read). One uncontrolled human trial + reviews: C (was A).
• No human study left after the re-check, so no grade: Anti-Aging, Reproductive Outcomes. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Leuprolide (Lupron): the page as it is now

• Cognitive Function: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated; People studied 75 → not stated. 1 study removed (did not measure this outcome); 1 study added.
• No human study left after the re-check, so no grade: Allergic Rhinitis Symptoms, Anti-inflammatory Effects, Antioxidant Status, Blood Glucose Regulation, Cholesterol and Lipid Levels, Respiratory Function and Cough Suppression. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Loquat: the page as it is now

• Overall Survival (Neuroendocrine Tumors): Effect note rewritten from its studies; Grade A → C; Size large → not stated. 3 studies removed (not a study of this supplement); 10 studies removed (did not measure this outcome).Why: Ten links report QoL, dosimetry, shrinkage or are reviews, not a treatment effect on overall survival: removed. The two passing papers are the same NETTER-1 RCT: the interim analysis hinted at benefit, but the prespecified final analysis (HR 0.84, p = 0.30) 'did not significantly improve median…

Lutetium-177 Dotatate (Lutathera): the page as it is now

• No human study left after the re-check, so no grade: Blood glucose (Type 1 Diabetes). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Magnesium: the page as it is now

• Collagen Synthesis (Wound Healing): Result Moderate Increase → none shown; Grade B → not graded; Size moderate → not stated; People studied 120 → not stated.Why: Graded B with no studies. PubMed has no human study of manganese on collagen synthesis; results are nanomaterial/animal work (manganese-oxide hydrogels, MnCl2 in rat fractures) or a different compound (avasopasem manganese, a drug). The row note is not preclinical, so animal work cannot carry it.…
• Fasting Blood Glucose (Glucose Metabolism): Result Small Decrease → Mixed effect; Size small → not stated. 2 studies added.Why: Graded C 'Small Decrease' with no studies. No human trial of manganese on fasting glucose exists. NHANES analyses conflict: urinary Mn rose with fasting glucose in women, while a mid-range urinary Mn went with lower odds of high fasting glucose (U-shaped). Mixed, not a clean decrease. Ceiling C…
• Insulin Sensitivity (Glucose Metabolism): Result Small Increase → Mixed effect; Size small → not stated. 2 studies added.Why: Graded C 'Small Increase' with no studies. No human trial of manganese on insulin sensitivity exists. Two observational studies give mixed signals: low Mn intake went with higher HOMA in girls, but the same abstract reports a positive Mn-HOMA correlation, and NHANES shows a J-shaped blood…
• MnSOD Activity (Antioxidant Status): Result Moderate Increase → none shown; Grade B → C; Size moderate → not stated. 1 study added.Why: Graded B with no studies. One real placebo-controlled trial (47 healthy women, 15 mg/d manganese) found lymphocyte MnSOD activity rose. A single trial allows C: regrade B to C. No size reported: clear 'Moderate'. People 320 unsupported (47): clear.
• MnSOD Levels (Manganese Deficiency): Result Large Increase → none shown; Grade A → not graded; Size large → not stated; People studied 300 → not stated.Why: Graded A 'Large Increase' with no studies. No study in manganese-deficient people reports mnsod levels after repletion; the one supplementation trial measuring it (1550052) is in healthy women (fails C5 for a deficiency group). Ungrade (or C via 1550052 if the population rule is relaxed); clear…
• Oxidative Stress Markers (Antioxidant Status): Result Moderate Decrease → none shown; Grade B → not graded; Size moderate → not stated; People studied 280 → not stated.Why: Graded B with no studies. PubMed has no human trial of manganese alone on oxidative-stress markers (MDA, lipid peroxidation); hits are multi-nutrient products or rat studies. Ungrade, clear size; people 280 has no source, clear.
• Serum Manganese Levels (Manganese Deficiency): Result Large Increase → none shown; Grade A → not graded; Size large → not stated; People studied 400 → not stated.Why: Graded A 'Large Increase' with no studies. No study in manganese-deficient people reports serum manganese levels after repletion; the one supplementation trial measuring it (1550052) is in healthy women (fails C5 for a deficiency group). Ungrade (or C via 1550052 if the population rule is…
• Wound Closure Rate (Wound Healing): Result Moderate Increase → none shown; Grade B → not graded; Size moderate → not stated; People studied 160 → not stated.Why: Graded B with no studies. PubMed has no human study of manganese on wound closure rate; results are nanomaterial/animal work (manganese-oxide hydrogels, MnCl2 in rat fractures) or a different compound (avasopasem manganese, a drug). The row note is not preclinical, so animal work cannot carry it.…

Manganese: the page as it is now

• No human study left after the re-check, so no grade: Longevity. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Maral root: the page as it is now

• Blood Pressure (Body Composition). 3 studies removed (did not measure this outcome).
• Body Mass Index (BMI) (Body Composition): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (decrease) with no study. The melatonin meta-analysis 39113944 (28 RCTs) found no substantial effect on BMI: add it and show No effect.
• Ghrelin (H. Pylori Infection): Result none shown → No effect. 1 study removed (studied a different group of people); 1 study added.Why: Row is under H. pylori infection; the linked study is in NASH patients (wrong population). Added the flagged H. pylori ulcer RCT, read in this batch: ghrelin was not significantly affected by melatonin. 'Improves' becomes No effect. Ungraded, ceiling C.
• Hip Circumference (Body Composition). 1 study added.
• Leptin (H. Pylori Infection): Result none shown → No effect.Why: Randomized trial in H. pylori-positive ulcer patients: leptin rose significantly in every arm, including omeprazole + placebo, so no melatonin-specific effect is reported. 'Improves' becomes No effect. Ungraded, ceiling C.
• Waist circumference (Body Composition): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (decrease) with no study. The melatonin meta-analysis 39113944 (28 RCTs) found no substantial effect on waist circumference: add it and show No effect.
• Weight (Body Composition): Result none shown → No effect. 1 study added.Why: Ungraded row shows Improves (decrease) with no study. The melatonin meta-analysis 39113944 (28 RCTs) found no substantial effect on body weight: add it and show No effect.
• No human study left after the re-check, so no grade: Leptin (Nonalcoholic Steatohepatitis (NASH)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Melatonin: the page as it is now

• No human study left after the re-check, so no grade: Insulin (Type 2 Diabetes). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Moringa: the page as it is now

• Lipid Profile. 2 studies removed (not a study of this supplement); 1 study removed (did not measure this outcome).
• Type 2 Diabetes Risk (Type 2 Diabetes). 3 studies removed (did not measure this outcome); 2 studies removed (not a study of this supplement).
• No human study left after the re-check, so no grade: Age-Related Insulin Resistance (Aging & Longevity), Anti-Aging, Anti-Inflammatory Activity, Blood Glucose Control, Body Weight (Body Composition), Bone Mineral Density, Cancer Cell Apoptosis, Endothelial Function, Fat Accumulation (Body Composition), Glucose Metabolism (Metabolic Health), Insulin Sensitivity (Metabolic Health), Liver Protection, MOTS-c Plasma Levels (Aging & Longevity), Muscle Homeostasis (Body Composition), Neuroprotection, Oxidative Stress, Pain, Pancreatic Islet Cell Senescence (Type 2 Diabetes), Physical Performance (Body Composition), Pulmonary Function, Sepsis Outcomes. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

MOTS-c: the page as it is now

• Helicobacter Pylori Infection Signs (H. Pylori Infection): Result none shown → No effect.Why: Meta-analysis of 8 RCTs (1167 patients): eradication 76.1% with adjuvant NAC vs 72.2% without (RR 1.17, p = 0.07), not superior. 'Improves' is an error: No effect. Ceiling A; ungraded, kept.

N-Acetylcysteine: the page as it is now

• Impulse Control (Pathological Gambling (PG)): Result none shown → No effect.Why: Double-blind placebo-controlled crossover in 28 gamblers who smoke: a nicotine inhaler (a nicotine-replacement form, accepted for the nicotine page) did not change gambling craving or betting. 'Improves' is an error: No effect. Ungraded, ceiling C.

Nicotine: the page as it is now

• Exercise Capacity (Anaerobic Exercise Performance). 1 study removed (not a study of this supplement).

Nitrate: the page as it is now

• No human study left after the re-check, so no grade: Fat Oxidation. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Oleoylethanolamide: the page as it is now

• Anti-tumor Activity: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 1 study removed (not a study of this supplement); 3 studies removed (did not measure this outcome); 1 study added.
• Blood Pressure: Effect note rewritten from its studies; Grade B → not graded; Size moderate → not stated; People studied 300 → not stated. 2 studies removed (did not measure this outcome); 1 study added.
• Endothelial Function: Effect note rewritten from its studies; Grade C → not graded; Size small → not stated; People studied 150 → not stated. 2 studies removed (did not measure this outcome); 1 study added.
• Neuroprotection: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 2 studies removed (did not measure this outcome); 1 study added.
• Skin Health: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 2 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement); 2 studies added.
• No human study left after the re-check, so no grade: Antioxidant Status, Chronic Venous Insufficiency Symptoms. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Orange Peel: the page as it is now

• Alzheimer's Disease Symptoms (Cognitive Improvement): Result Small Improvement → Improvement; Grade B → C; Size small → not stated.Why: One 40-patient randomized trial of heat-processed Panax ginseng in moderately severe AD reports significant MMSE and ADAS improvement: Improves holds. A single controlled trial gives ceiling C, so B is lowered. The abstract gives no effect size, so 'Small Improvement' becomes Improvement and size…
• Alzheimer's Disease Symptoms: Result Small Improvement → Improvement; Grade B → C; Size small → not stated.Why: One 40-patient randomized trial of heat-processed Panax ginseng in moderately severe AD (matches the condition) reports significant MMSE and ADAS improvement: Improves holds. A single controlled trial gives ceiling C, so B is lowered. No effect size in the abstract: 'Small Improvement' becomes…
• Anti-Oxidant Enzyme Profile (Metabolic Health): Result Small Increase → Increase; Size small → not stated.Why: Two placebo-controlled RCTs in healthy adults: Korean red ginseng 6 g/day raised SOD, GPx and catalase vs placebo (22805313); P. ginseng 2 g/day raised GSH-Rd and glutathione but not catalase, SOD or GPx (21699953). No enzyme fell, so an increase holds, though partial in one trial. Ceiling B =…
• Attention (Cognitive Improvement): Result Small Improvement → Improvement; Grade B → C; Size small → not stated.Why: One pilot crossover RCT (50 tired healthy adults): the HRG80 red Panax ginseng preparation improved d2 attention vs placebo (p<0.0001), while standard white ginseng (PGS) was not significantly better than placebo, so the benefit is preparation-specific. One trial: ceiling C, B lowered. No effect…
• Attention (Focus & Attention): Result Small Improvement → Improvement; Size small → not stated.Why: One pilot crossover RCT (50 tired healthy adults): the HRG80 red Panax ginseng preparation improved d2 attention vs placebo (p<0.0001); standard white ginseng was not significantly better than placebo, so the benefit is preparation-specific. Ceiling C = stored C. No effect size in the abstract…
• Blood Flow. 1 study removed (did not measure this outcome).
• Blood glucose (Type 2 Diabetes): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (did not measure this outcome); 2 studies removed (studied a different group of people); 3 studies added.Why: No link is about type 2 diabetes: a healthy-volunteer meal test, a hypertension arterial-stiffness trial (glucose only a covariate) and runners: all removed. Re-cited: the red-ginseng T2D systematic review found no fasting-glucose benefit, while a 12-wk T2D crossover RCT cut OGTT glucose 8-11%…
• Blood glucose (Muscle Recovery): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (did not measure this outcome).Why: In healthy people one KRG root fraction cut postprandial glucose iAUC 27% while the other fraction had no effect (21619921), and 200 mg Panax ginseng left plasma glucose unchanged during running (21321426): a clean Improves overstates this, set Mixed effect, size cleared. 21235416 uses glucose…
• Blood glucose (High Blood Pressure): Result Small Improvement → Improvement; Size small → not stated. 1 study removed (did not measure this outcome); 2 studies removed (studied a different group of people); 1 study added.Why: No link reports glucose in people with hypertension: the hypertension trial (21235416, 64 completers, the people figure's source) uses fasting glucose only as a covariate; the other two are healthy volunteers and runners: all removed. Re-cited the Panax ginseng MA (found in this batch's metabolic…
• Blood glucose (Obesity): Result Small Improvement → Improvement; Size small → not stated. 1 study removed (did not measure this outcome); 2 studies removed (studied a different group of people); 1 study added.Why: No link studies people with obesity (healthy BMI-24 volunteers, hypertensives with glucose only as a covariate, lean runners): all removed. Re-cited the Panax ginseng MA whose populations include obesity: glucose AUC fell vs placebo, so Improves holds. Overweight/obese KRG trials found (23945406…
• Blood glucose (Dyslipidemia): Result Small Improvement → Improvement; Size small → not stated. 1 study removed (did not measure this outcome); 2 studies removed (studied a different group of people); 1 study added.Why: No link studies people with dyslipidemia (healthy volunteers, hypertensives with glucose only as a covariate, runners): all removed. Re-cited the Panax ginseng MA (found in this batch's metabolic searches) whose populations include hyperlipidemia: glucose AUC fell vs placebo, so Improves holds.…
• Blood glucose (Metabolic Syndrome): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (did not measure this outcome); 2 studies removed (studied a different group of people); 2 studies added.Why: No link studies metabolic syndrome: all removed. Re-cited the metabolic-syndrome KRG RCT (48 completers, the people figure's likely source), which found no effect on fasting glucose, and the Panax ginseng metabolic MA (lower glucose AUC across mixed populations). A clean Improves overstates this…
• Blood glucose (Prediabetes). 1 study removed (did not measure this outcome); 2 studies removed (studied a different group of people); 3 studies added.
• Blood Lactate (Exercise) (General Athletic Performance): Result Small Decrease → No effect; Size small → not stated.Why: Direction error: the page shows Improves / 'Small Decrease' in blood lactate, but both controlled trials report none: the G115 RCT found no effect on blood lactic acid (P > .05) and the 7-day extract trial found lactate rose equally with placebo ('no ergogenic effect'). Set No effect, size…
• Blood Lactate (Exercise) (Aerobic Exercise Performance): Result Small Decrease → No effect; Size small → not stated.Why: Direction error: the page shows Improves / 'Small Decrease' in exercise blood lactate, but the G115 RCT (8 wk, graded maximal exercise) found no effect on blood lactic acid (P > .05) and the 7-day extract trial found ginseng and placebo trials similar. Set No effect, size cleared. Two agreeing…
• Cognition (Mood Improvement): Result Small Improvement → Improvement; Size small → not stated. 1 study removed (did not measure this outcome).Why: Most controlled trials report better cognition with Panax ginseng (G115 acute arithmetic/fatigue 15982990, 16401645; KRG 8-wk composite 33217050; AD MMSE/ADAS 18580589, plus the open-label 2-yr follow-up), while 26938637 found no effect and two small trials were mixed: Improves holds on balance.…
• Cognition (Mild Cognitive Impairment (MCI)): Result Small Improvement → Mixed effect; Size small → not stated. 8 studies removed (studied a different group of people); 1 study removed (did not measure this outcome); 2 studies added.Why: No link studies MCI: healthy young adults, Alzheimer's patients and an MS-fatigue trial: all removed. Re-cited the MCI RCT (90 people, the people figure's source), which improved only RCFT memory recall, and a 15-RCT ginseng MA that includes cognitively impaired patients: memory SMD 0.19 but no…
• Creatine Kinase (Jumping Performance): Result Moderate Decrease → Mixed effect; Size moderate → not stated. 1 study removed (did not measure this outcome); 2 studies added.Why: The linked Jilin-ginseng drop-jump trial's abstract reports FFA, glucose, VO2max, jump height and joint stiffness but no creatine kinase: removed. Re-cited two Panax ginseng RCTs: KRG lowered CK 72 h after uphill running (21598413) but had no effect on CK after eccentric squats (32379240).…
• Depression Symptoms (Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)): Result Small Improvement → No effect; Size small → not stated. 1 study removed (studied a different group of people); 1 study added.Why: Direction error once re-cited: the only link studies symptomatic postmenopausal women (exploratory depression subscale benefit), not ME/CFS: removed. The chronic-fatigue KRG RCT (50 patients, the people figure's source) found no between-group difference in any secondary outcome, which include…
• No human study left after the re-check, so no grade: Cognition (Multiple Sclerosis (MS)), Depression Symptoms (Schizophrenia). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Panax Ginseng (Korean Ginseng): the page as it is now

• Acromegaly Symptoms (Acromegaly): Effect note rewritten from its studies; Grade A → C; Size moderate → not stated. 7 studies removed (did not measure this outcome); 2 studies removed (not a study of this supplement).Why: Symptoms improve in the placebo RCT 10770982 (ring size, soft tissue, sweating, fatigue, total score), the 7-patient series 11581004, GPOS 17218728 (signs/symptoms score) and two reviews. Eight abstracts report no symptom result (IGF-1, glucose, tumour, pregnancy, or no pegvisomant): removed. One…
• Anti-Cancer Activity: Effect note rewritten from its studies; Grade C → D; Size small → not stated. 2 studies removed (did not measure this outcome).Why: 16541323: pegvisomant shrank MCF-7 breast-cancer xenografts in mice (no effect on MDA-231/435). 36276070: HCC cells in vitro and in vivo (potentiated sorafenib), plus two sorafenib-resistant patients with tumour stability (case-level human data). 16311417 is about IGF-I control in acromegaly…
• Blood Glucose Control: Effect note rewritten from its studies. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Meta-analysis 30869797 (18 prospective trials, 550 patients): pegvisomant lowered fasting glucose (-0.80 mmol/L), HbA1c (-0.43%), insulin and HOMA-IR; 'small' is consistent. 28150161 never names pegvisomant; 21049223 is a lipodystrophy case with no abstract: removed. Ceiling A, stored D kept…
• Glucose Metabolism (Acromegaly): Grade A → C. 5 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Glucose is reported only by 11734231 (insulin and glucose fell, p<0.05, uncontrolled), GPOS 17218728 (fasting glucose 114.4 to 101.5 mg/dl) and the matched-control trial 18058736 (glucose metabolism improved, insulin doses fell); the other five abstracts report no glucose result: removed. Note's…
• Hormone Levels: Effect note rewritten from its studies; Grade B → C; Size moderate → not stated. 5 studies removed (did not measure this outcome).Why: Passing studies show hormones moving in opposite directions: IGF-I falls (reviews 12511851/17047392/27631335, mice 16541323, patients 23650996, children 29278515) while endogenous GH rises (23650996, 29278515: GH peaks up after priming). A clean 'Improves, increase' overstates this. Removed…
• IGF-1 Normalization (Acromegaly): Grade A → B. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: Normalization is shown by the placebo RCT 10770982 (89% vs 10% on 20 mg), the matched-control trial 18058736, and uncontrolled/observational series (97%, 7/7, 76%). Note numbers (97%, 89%, 'most effective medical therapy') are in 11734231/10770982/12670298. 21049223 is a lipodystrophy case report…
• Liver Protection: Effect note rewritten from its studies; Size small → not stated. 3 studies removed (did not measure this outcome); 2 studies added.Why: No linked study measures liver protection: 30349613 is a monitoring review, 36276070 treats hepatocellular carcinoma (not hepatoprotection), 21049223 is a lipodystrophy case: removed. Search found the opposite of protection: RCT 22298804 (intrahepatic lipid rose with pegvisomant, dose-related) and… Re-cited studies show harm (intrahepatic lipid rose with pegvisomant in an RCT; 28% had abnormal liver tests): the row must say Worsens, which needs the harm label.
• Safety/Tolerability: Effect note rewritten from its studies; Size small → not stated.Why: Meta-analysis of observational studies 30145746: 'No serious adverse events were associated with the use of pegvisomant'; transaminase rise 3.0%, tumour growth 7.3%. Review 37659952: safety well established. 21049223 (no abstract) is kept here because its title reports an adverse event…
• Serum IGF-1 Levels (Acromegaly): Grade A → B. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: IGF-1 fell vs placebo in RCT 10770982 (-62.5% on 20 mg vs -4.0% placebo, P<0.001) and vs octreotide controls in 18058736; open-label/observational series and two reviews agree. Note numbers (62.5%, 4%, 1.75x to 0.89x ULN) are in 10770982 and 17218728; large is consistent. 21049223 (lipodystrophy…
• Treatment-Resistant Acromegaly (Acromegaly). 7 studies removed (did not measure this outcome); 2 studies removed (not a study of this supplement).

Pegvisomant (Somavert): the page as it is now

• No human study left after the re-check, so no grade: Adipogenesis and Fat Accumulation. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Piceatannol: the page as it is now

• No human study left after the re-check, so no grade: Thermogenesis and Body Composition. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Piperine: the page as it is now

• Appetite (Weight Loss & Maintenance): Result Small Decrease → Decrease; Size small → not stated.Why: Two placebo-controlled crossover trials (7647826, 1398229) show more fullness/satiety and less hunger with psyllium; in 9093551 the psyllium cereal suppressed intake less than an equal-energy low-fibre breakfast. Direction holds; no abstract gives a size: 'Small Decrease' becomes 'Decrease'. Grade…

Psyllium: the page as it is now

• No human study left after the re-check, so no grade: Triglycerides (Coronary Artery Disease (CAD)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Pterostilbene: the page as it is now

• Vascular Function: Effect note rewritten from its studies; Size small → not stated.Why: One acute crossover RCT (n=15): calf reactive-hyperemia flow rose but brachial FMD did not change ('no appreciable change'); the note says so too. A clean 'Improves' overstates this: Mixed effect, size cleared. Acute vascular reactivity is an acute outcome, so C3c does not apply. Ceiling C, stored…

Red Spinach Extract: the page as it is now

• Body Weight Reduction (Obesity): Effect note rewritten from its studies. 8 studies removed (not a study of this supplement); 6 studies removed (did not measure this outcome).Why: The placebo-controlled phase 2 trial (-24.2% at 48 wk with 12 mg vs -2.1%) and three meta-analyses (NMA -22.1%, MA -10.66 kg, model-based -26.6%) agree; Improves/large and A hold. The note's phase 2 figures are in 37366315, but 'TRIUMPH-4: 28.7% at 68 weeks' is in no cited abstract, so the note…

Retatrutide (GLP-3 Triple Agonist): the page as it is now

• Antioxidant Status: Effect note rewritten from its studies; Grade D → not graded; Size small → not stated. 1 study removed (did not measure this outcome); 3 studies added.
• Testosterone Levels: Effect note rewritten from its studies; Size small → not stated. 2 studies removed (did not measure this outcome); 1 study added.Why: Neither linked review mentions testosterone: both removed. One search found a single-herb randomized placebo-controlled trial in healthy men (24501522) reporting a highly significant rise in serum testosterone vs placebo: added. The note ('rodent studies'; 'human evidence is lacking') is now…
• No human study left after the re-check, so no grade: Erectile Function, Immune Function, Sexual Function & Libido, Sperm Parameters. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Safed Musli: the page as it is now

• Anxiety Symptoms (Generalized Anxiety Disorder (GAD)). 2 studies removed (studied a different group of people).
• Blood Pressure (Diabetic Nephropathy): Result Small Improvement → Improvement; Size small → not stated. 2 studies removed (studied a different group of people); 1 study removed (did not measure this outcome); 1 study added.Why: Linked studies are stroke (no BP), all-adult meta-analysis and asthma trial (not diabetic population). The T2D trial 31309071 (n=80) cut SBP but not DBP: Improvement holds at C; no size in abstract, so 'Small' cleared.
• Creatinine (Diabetic Nephropathy): Result none shown → No effect. 1 study removed (studied a different group of people).Why: Row shows Improves (up arrow) but the T2D trial 31309071 found serum creatinine not significantly different from placebo. 21480412 is in healthy young men (and also found no effect). Grade stays empty.
• Depression Symptoms (Female Sexual Dysfunction): Result Moderate Improvement → Improvement; Size moderate → not stated. 17 studies removed (studied a different group of people); 1 study removed (not a study of this supplement); 1 study added.Why: Row is under Female Sexual Dysfunction. All 18 links study depression in MDD, older, post-PCI, menopausal, postpartum, youth, fibromyalgia or MCI patients, or men with fluoxetine-induced erectile problems (fail C5); 30798790 is the 'SAFFRON' psychosexual-therapy feasibility trial, not saffron, and…
• Liver Enzymes (Diabetic Nephropathy): Result none shown → No effect. 1 study removed (studied a different group of people); 1 study added.Why: Linked meta-analysis is not in a diabetic population (AST down, ALT/ALP unchanged). In T2D (31309071) liver enzymes were not different from placebo: show No effect, not 'Changes' with an increase.
• Urea (Diabetic Nephropathy): Result none shown → No effect. 1 study added.Why: Row shows Improves (up arrow) with no study; the T2D saffron trial 31309071 found serum urea not significantly different from placebo: add it, show No effect.
• No human study left after the re-check, so no grade: Anxiety Symptoms (Primary Dysmenorrhea (Menstrual Cramps)), Blood glucose (Coronary Artery Disease (CAD)), Blood glucose (Type 1 Diabetes), Homocysteine (Type 2 Diabetes), Serum Albumin (Diabetic Nephropathy), Skin Dryness (Skin Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Saffron: the page as it is now

• Anti-Cancer Activity. 10 studies removed (not a study of this supplement).
• Anti-Inflammatory Activity. 6 studies removed (not a study of this supplement).
• Blood Glucose Control. 2 studies removed (not a study of this supplement).
• Cancer Cell Apoptosis. 3 studies removed (not a study of this supplement).
• Cardiac Protection. 4 studies removed (not a study of this supplement).
• Corneal/Ocular Health. 2 studies removed (not a study of this supplement).
• Hormone Levels: Effect note rewritten from its studies; Size moderate → not stated. 7 studies removed (not a study of this supplement); 1 study removed (did not measure this outcome).Why: Two controlled human studies of sermorelin itself pass: in 5 term-pregnant women vs 5 saline controls, maternal GH rose only non-significantly (P=0.08) and placental GH was unchanged (2143200); in 43 GHD children randomised to two GHRH(1-29)-NH2 doses or GH, the IV GH response was primed at low…
• IGF-1 Levels (Metabolic Health): Effect note rewritten from its studies; Grade A → C; Size moderate → not stated. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement); 2 studies added.Why: The review 18031173 never mentions IGF-1, and 9141536 tests the [Nle27] analogue of sermorelin (MeSH-indexed as Sermorelin; a hand reviewer may accept it): no linked study passes. Re-cited two GHRH(1-29) trials in older men: twice-daily 1 mg raised IGF-I to young-men levels (1379256), but single…
• Pulmonary Function. 5 studies removed (not a study of this supplement).
• No human study left after the re-check, so no grade: Growth Hormone Release (Metabolic Health). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Sermorelin: the page as it is now

• Inflammation (Surgical Recovery): Result Small Decrease → Mixed effect; Size small → not stated.Why: Post-surgical swelling: serrapeptase beat placebo after antrotomy (6366808, n=174) and beat ice/elevation after ankle surgery (2647603), but showed no anti-inflammatory action vs placebo after third-molar surgery (19168326, n=150); 23649050 has only a dexamethasone comparator (serrapeptase less…
• Inflammation (Pain Relief): Result Small Decrease → Mixed effect; Size small → not stated.Why: The row's 150 people are the third-molar placebo RCT (19168326), which found no anti-inflammatory action; the antrotomy placebo RCT (6366808) and the ankle-surgery trial (2647603) found less swelling; the dexamethasone-comparator trial (23649050) cannot show an effect vs nothing. A clean 'Small…
• Inflammation (Trismus): Result Small Decrease → No effect; Size small → not stated. 2 studies removed (studied a different group of people).Why: Direction error: in third-molar surgery (the trismus population) the only placebo-controlled trial (19168326) found serratiopeptidase had no significant anti-inflammatory action, and the 110-patient trial behind the people figure (23649050) only shows it was less effective than dexamethasone…
• Pain (Inflammatory Venous Disease): Result Small Improvement → Improvement; Grade C → D; Size small → not stated. 1 study removed (studied a different group of people); 1 study added.Why: The linked study is breast engorgement, not venous disease: removed. Re-cited the only serrapeptase trial in inflammatory venous disease (40 superficial thrombophlebitis patients, the people figure's source): pain fell 63% in the serrapeptase arm, but it was the active comparator to seaprose S…
• No human study left after the re-check, so no grade: Mucus Production (Allergic Rhinitis (Seasonal Allergies / Hay Fever)). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Serrapeptase: the page as it is now

• No human study left after the re-check, so no grade: Antimicrobial Activity, Antioxidant Status, Blood Glucose, Blood Lipids, Blood Pressure, Testosterone. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Society garlic: the page as it is now

• Anaerobic Capacity (Rowing Performance). 1 study removed (not a study of this supplement).
• Anaerobic Capacity (Anaerobic Exercise Performance). 1 study removed (not a study of this supplement).
• Anaerobic Capacity (Rugby Performance). 1 study removed (not a study of this supplement).

Sodium Bicarbonate: the page as it is now

• Cardiovascular Mortality (Cardiovascular Health). 1 study added.

Spermidine: the page as it is now

• Muscle Soreness (General Athletic Performance): Result none shown → No effect.Why: General group (General Athletic Performance). Placebo-controlled trial in 24 trained men (6 g/day spirulina) after eccentric exercise: DOMS did not differ between groups. 'Improves' is an error: No effect. Ungraded, ceiling C.
• Muscle Soreness (Muscle Recovery): Result none shown → No effect.Why: General group (Muscle Recovery). Placebo-controlled trial in 24 trained men (6 g/day spirulina) after eccentric exercise: DOMS did not differ between groups. 'Improves' is an error: No effect. Ungraded, ceiling C.
• Power Output (Rugby Performance): Result Small Improvement → No effect; Size small → not stated.Why: The only trial (22 elite rugby players, 7 weeks, placebo-controlled) found no effect on leg strength or power, and its 'small advantage' in jump and sprint was non-significant. Improves/small is not supported: No effect, size cleared. One trial: grade C kept.
• Waist circumference (Weight Loss & Maintenance): Result none shown → No effect. 1 study added.Why: Ungraded row under the general goal Weight Loss & Maintenance showing 'Improves' with no study. Added the flagged 17-RCT meta-analysis: spirulina lowered weight, BMI and body fat but had no significant effect on waist circumference (WMD -0.46 cm, p = 0.280). Verdict becomes No effect. Ceiling…
• No human study left after the re-check, so no grade: Fatigue Symptoms (Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)), Waist circumference (Obesity), Waist circumference (Metabolic Syndrome), Waist circumference (Ulcerative Colitis). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Spirulina: the page as it is now

• Cancer Risk (β-Asarone Toxicity): Effect note rewritten from its studies; Grade C → not graded; Size large → not stated. 1 study removed (not a study of this supplement); 6 studies removed (did not measure this outcome); 2 studies added.
• No human study left after the re-check, so no grade: Antimicrobial Activity, Antioxidant Capacity, Blood Pressure, Depressive Symptoms, Neuroprotection, Seizure Susceptibility, Stress-Induced Immune Suppression. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Sweet Flag: the page as it is now

• Anti-Cancer Activity: Effect note rewritten from its studies; Grade C → not graded; Size small → not stated. 9 studies removed (did not measure this outcome); 3 studies added.
• Bone Formation Markers (Bone Health): Effect note rewritten from its studies; Grade A → B. 12 studies removed (did not measure this outcome).Why: Two placebo-controlled RCTs report formation markers: 20580870 (PINP up vs placebo at 1 month, P<0.001; +78.95% vs -17.23% at 12 months) and 18979163 (rapid, sustained PINP/PICP/BAP rises); a retrospective cohort (21863393) saw BALP rise only in non-fracture patients. Two controlled trials…
• Bone Mineral Density: Effect note rewritten from its studies. 11 studies removed (did not measure this outcome).Why: The 14-RCT meta-analysis (32282692) found greater lumbar spine and femoral neck BMD with teriparatide than bisphosphonates, and five narrative reviews report spine BMD gains of about 6-10% and hip about 2.6-3%: 'Improves'/moderate holds. Removed no-abstract news items, reviews that never report…
• Cardiac Protection: Effect note rewritten from its studies; Size small → not stated. 7 studies removed (did not measure this outcome).Why: Only the WHO VigiBase pharmacovigilance study (36543300) reports cardiac outcomes: teriparatide was associated with AF, arrhythmia and angina reports, but with fewer coronary events than alendronate; cardio-protection is only proposed for further study. That does not support a clean 'Improves'…
• Hip Fracture Prevention (Hip Fracture): Grade B → C; Size moderate → not stated. 17 studies removed (did not measure this outcome).Why: Only the Swiss registry cohort (40054513) reports hip fractures: sustained lower hip-fracture incidence after teriparatide then antiresorptives, matching the note and the 'decrease' direction. The rest measure BMD, vertebral or pooled non-vertebral fractures, fracture healing, spinal fusion, OA or…
• Lumbar Spine BMD (Osteoporosis). 5 studies removed (did not measure this outcome).
• Non-Vertebral Fracture Risk (Osteoporosis). 14 studies removed (did not measure this outcome).
• Safety/Tolerability: Effect note rewritten from its studies; Size small → not stated. 6 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: The two meta-analyses vs bisphosphonates disagree: 23 RCTs (39312040) found no increase in adverse events, but 5 RCTs (38064598) found more discontinuations due to adverse events and more dizziness; WHO pharmacovigilance (36543300) links teriparatide to AF, arrhythmia and angina reports (fewer…
• Total Hip BMD (Osteoporosis). 7 studies removed (did not measure this outcome).
• Vertebral Fracture Risk (Osteoporosis). 13 studies removed (did not measure this outcome).
• No human study left after the re-check, so no grade: Angiogenesis. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Teriparatide (Forteo): the page as it is now

• Blood Glucose Control: Effect note rewritten from its studies; Size small → not stated. 1 study removed (did not measure this outcome).Why: The page shows Improves (glucose down, small) but both passing studies report no glycaemic change: the 12-week placebo-controlled RCT in 53 people with type 2 diabetes (28617838: fasting glucose, HbA1c and diabetes control not different) and the 2-week study in 13 healthy men (20943777…
• Body Weight: Effect note rewritten from its studies; Size small → not stated. 3 studies removed (did not measure this outcome); 1 study added.Why: The page shows Improves (weight down, small), but no linked study reports body weight: the inflammatory-marker RCT and two reviews report visceral fat only (VAT is not body weight): removed. Re-cited the 2026 MA of 5 RCTs (41545261), which found no significant BMI reduction with tesamorelin.…
• Cognitive Function in MCI (Cognitive Function): Effect note rewritten from its studies; Size small → not stated. 3 studies removed (did not measure this outcome).Why: 22869065 (152 older adults, 66 with MCI, 20 weeks, placebo-controlled) found a favourable effect on cognition (P=.03), comparable in MCI and healthy participants. The newer trial 39813152 (73 people with HIV and abdominal obesity, tesamorelin vs standard of care) found only a non-significant trend…
• Executive Function (Cognitive Function): Grade B → C. 4 studies removed (did not measure this outcome).Why: 22869065 is the 20-week randomised placebo-controlled trial the note describes: a positive effect on executive function (P=.005) measured with Stroop, Task Switching, Self-Ordered Pointing and Word Fluency, all in the abstract, so note and 'moderate' stand. 39813152 reports a composite…
• Hormone Levels: Effect note rewritten from its studies. 6 studies removed (did not measure this outcome); 1 study removed (not a study of this supplement).Why: General group. IGF-I rose vs placebo in the NEJM phase 3 RCT (18057338, +81% vs -5%), the second phase 3 RCT (20101189) and their pooled analysis (20554713, +108 vs -7 ng/ml); GH and IGF-I rose in 13 healthy men (20943777, uncontrolled). Removed: extension report with no hormone result, 3…
• IGF-1 Levels (Metabolic Health): Effect note rewritten from its studies; Grade A → C. 5 studies removed (did not measure this outcome).Why: 22869065 (152 adults, randomised double-blind placebo-controlled, tesamorelin 1 mg/d for 20 weeks) reports IGF-1 up 117%: direction and 'moderate' are not overstated. The five reviews report visceral fat or GH release, not IGF-1: removed. The note's claim that the rise mediates downstream…
• Immune Function: Effect note rewritten from its studies; Size small → not stated. 4 studies removed (did not measure this outcome).Why: General group. Only 33852720 (12-month placebo-controlled RCT, 61 PWH with NAFLD) measures immune function: tesamorelin lowered 13 circulating immune-activation proteins and hepatic immune pathways, which the authors read as ameliorated immune activation (a benefit, though markers fell rather than…
• Lipid Profile: Effect note rewritten from its studies. 1 study removed (did not measure this outcome); 2 studies removed (not a study of this supplement); 3 studies added.Why: No linked study gives a tesamorelin lipid result: two HIV dyslipidemia reviews only name it (or not at all) and the Drugs review reports body composition: removed. Re-cited three placebo-controlled trials whose abstracts report lower lipids: NEJM phase 3 (18057338: TG -50 vs +9 mg/dl, TC:HDL ratio…
• Liver Fat (NAFLD) (Nonalcoholic Fatty Liver Disease (NAFLD)): Grade A → C. 2 studies removed (did not measure this outcome).Why: 31611038 (61 people with HIV and NAFLD, randomised double-blind, 12 months) is exactly this row: hepatic fat fraction fell 37% relative to baseline vs placebo (p=0.016) and 35% vs 4% reached HFF <5%. Both numbers in the note are from this abstract, so the note and 'large' stand. The two…
• Liver Fibrosis Progression (Nonalcoholic Fatty Liver Disease (NAFLD)): Effect note rewritten from its studies; Grade A → C; Size moderate → not stated. 3 studies removed (did not measure this outcome); 1 study added.Why: The main trial's abstract reports no fibrosis result and says long-term histology effects still need study; the two reviews never mention fibrosis. Re-cited 32701508, the paired-biopsy analysis of the same randomised trial: hepatic gene-expression changes on tesamorelin correlated with an improved…
• Liver Protection: Effect note rewritten from its studies; Size moderate → small. 3 studies removed (did not measure this outcome); 4 studies removed (not a study of this supplement).Why: General group. Two placebo-controlled RCTs show less liver fat: the 6-month JAMA trial (25038357, 'modest reductions in liver fat', net -2.9%; its FGF21 analysis 29031905 agrees) and the 12-month NAFLD trial (32701508: reduced liver fat and prevented fibrosis progression); phase 3 VAT responders…
• Safety/Tolerability: Effect note rewritten from its studies; Size moderate → not stated. 3 studies removed (did not measure this outcome).Why: General group. The 2026 MA of 5 RCTs (41545261) and the phase 3 trials/extensions (18690162, 20101189, 20554713, 38905488, T2D RCT 28617838) agree tesamorelin is well tolerated without serious AEs or glucose perturbation; the MA notes arthralgia, myalgia, paresthesia and injection-site reactions.…
• No human study left after the re-check, so no grade: Growth Hormone Release (Metabolic Health), Visceral Adipose Tissue (Body Composition). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Tesamorelin: the page as it is now

• Body Fat: Size small → not stated.Why: Three placebo-controlled RCTs of Kaempferia parviflora (extract or its purified polymethoxyflavones) all reduce body/visceral fat; only waist/hip circumference unchanged in 40661686. Direction right; note's figures all appear in the abstracts. No abstract gives an effect size: 'small' cleared.…

Thai Ginseng: the page as it is now

• 28-Day Mortality (Sepsis): Result Moderate Reduction → Mixed effect; Size moderate → not stated. 1 study removed (did not measure this outcome); 1 study added.Why: The largest trial (TESTS, 39814420, 1,089 analysed) found no effect on 28-day sepsis mortality (HR 0.99) while the linked 2015 meta-analysis found a benefit: Mixed effect, B kept (p006 reader's recommendation).

Thymosin Alpha-1: the page as it is now

• Free Testosterone (Infertility): Result none shown → No effect. 1 study added.Why: Page shows Improves (up) with no linked study. Added 27337519 (flagged on the sibling testosterone row; 30 men with idiopathic infertility): no change in free testosterone after 3 months. No effect. Single small uncontrolled study: ceiling D; row stays ungraded.
• Luteinizing Hormone (Infertility): Result none shown → No effect. 1 study added.Why: Page shows Improves (up) with no linked study. Added 27337519 (flagged on the sibling testosterone row; 30 men with idiopathic infertility): no change in LH after 3 months. No effect. Single small uncontrolled study: ceiling D; row stays ungraded.
• Muscle Mass (Body Composition): Result none shown → No effect. 1 study added.Why: Page shows Improves (up) with no linked study. Added the flagged placebo-controlled RCT 10861339 (15 resistance-trained men, 8 weeks): no change in body weight, % fat or total body water; 'does not enhance body composition'. Body Composition accepts any population. No effect. One RCT: ceiling…
• Muscle Mass: Result none shown → No effect. 1 study added.Why: Page shows Improves (up) with no linked study. Added the flagged placebo-controlled RCT 10861339 (15 resistance-trained men, 8 weeks): no change in body weight, % fat or total body water; 'does not enhance body composition'. muscle-size-strength accepts any population. No effect. One RCT…
• Muscle Mass (General Athletic Performance): Result none shown → No effect. 1 study added.Why: Page shows Improves (up) with no linked study. Added the flagged placebo-controlled RCT 10861339 (15 resistance-trained men, 8 weeks): no change in body weight, % fat or total body water; 'does not enhance body composition'. General Athletic Performance accepts any population. No effect. One…
• Muscle Mass (Rugby Performance): Result none shown → No effect. 1 study added.Why: Page shows Improves (up) with no linked study. Added the flagged placebo-controlled RCT 10861339 (15 resistance-trained men, 8 weeks): no change in body weight, % fat or total body water; 'does not enhance body composition'. Rugby Performance accepts any population. No effect. One RCT: ceiling…
• Muscle Mass (Muscle Size & Strength): Result none shown → No effect. 1 study added.Why: Page shows Improves (up) with no linked study. Added the flagged placebo-controlled RCT 10861339 (15 resistance-trained men, 8 weeks): no change in body weight, % fat or total body water; 'does not enhance body composition'. Muscle Size & Strength accepts any population. No effect. One RCT…
• Testosterone (Erectile Dysfunction): Result none shown → No effect. 2 studies removed (studied a different group of people); 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (up). Linked studies are not in this population (27337519 infertile men, 15994038 healthy men); 18282674 (two women, 2 days) measures urinary doping markers (T/E ratio, isotope ratio), not testosterone levels: removed. Added the flagged meta-analysis of RCTs in men with ED…
• Testosterone (Infertility): Result none shown → No effect. 1 study removed (studied a different group of people); 1 study removed (did not measure this outcome).Why: Page shows Improves (up). 27337519 (30 men with idiopathic infertility, 3 months, before-after) found no change in total or free testosterone or LH. 15994038 is healthy men (wrong population); 18282674 (two women, 2 days) measures urinary doping markers (T/E ratio, isotope ratio), not…
• Testosterone (Body Composition): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (up). Body Composition is a general group. RCT 15994038 (21 healthy men, 4 weeks) and 27337519 (30 infertile men, 3 months) found no testosterone change; added the flagged RCT meta-analysis 40360723 (total testosterone not different from placebo). 18282674 (two women, 2 days)
• Testosterone: Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (up). muscle-size-strength is a general group. RCT 15994038 (21 healthy men, 4 weeks) and 27337519 (30 infertile men, 3 months) found no testosterone change; added the flagged RCT meta-analysis 40360723 (total testosterone not different from placebo). 18282674 (two women, 2…
• Testosterone (General Athletic Performance): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (up). General Athletic Performance is a general group. RCT 15994038 (21 healthy men, 4 weeks) and 27337519 (30 infertile men, 3 months) found no testosterone change; added the flagged RCT meta-analysis 40360723 (total testosterone not different from placebo). 18282674 (two…
• Testosterone (Male Sexual Dysfunction): Result none shown → No effect. 2 studies removed (studied a different group of people); 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (up). Linked studies are not in this population (27337519 infertile men, 15994038 healthy men); 18282674 (two women, 2 days) measures urinary doping markers (T/E ratio, isotope ratio), not testosterone levels: removed. Added the flagged meta-analysis of RCTs in men with ED…
• Testosterone (Hormone Health): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (up). Hormone Health is a general group. RCT 15994038 (21 healthy men, 4 weeks) and 27337519 (30 infertile men, 3 months) found no testosterone change; added the flagged RCT meta-analysis 40360723 (total testosterone not different from placebo). 18282674 (two women, 2 days)…
• Testosterone (Rugby Performance): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (up). Rugby Performance is a general group. RCT 15994038 (21 healthy men, 4 weeks) and 27337519 (30 infertile men, 3 months) found no testosterone change; added the flagged RCT meta-analysis 40360723 (total testosterone not different from placebo). 18282674 (two women, 2…
• Testosterone (Sexual Health): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (up). Sexual Health is a general group. RCT 15994038 (21 healthy men, 4 weeks) and 27337519 (30 infertile men, 3 months) found no testosterone change; added the flagged RCT meta-analysis 40360723 (total testosterone not different from placebo). 18282674 (two women, 2 days)…
• Testosterone (Muscle Size & Strength): Result none shown → No effect. 1 study removed (did not measure this outcome); 1 study added.Why: Page shows Improves (up). Muscle Size & Strength is a general group. RCT 15994038 (21 healthy men, 4 weeks) and 27337519 (30 infertile men, 3 months) found no testosterone change; added the flagged RCT meta-analysis 40360723 (total testosterone not different from placebo). 18282674 (two women…
• No human study left after the re-check, so no grade: Free Testosterone (Erectile Dysfunction), Free Testosterone (Hypoactive Sexual Desire Disorder), Luteinizing Hormone (Erectile Dysfunction), Luteinizing Hormone (Male Sexual Dysfunction), Muscle Mass (Infertility), Power Output (Body Composition), Power Output, Power Output (General Athletic Performance), Power Output (Rugby Performance), Power Output (Muscle Size & Strength), Testosterone (Hypoactive Sexual Desire Disorder), Testosterone (Oligospermia). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Tribulus Terrestris: the page as it is now

• Urinary Antimicrobial Activity: Effect note rewritten from its studies; Size small → not stated. 4 studies removed (did not measure this outcome).Why: Only 12807345 (4 volunteers taking a bearberry-extract product; their urine with E. coli liberated 2.3-fold more free hydroquinone, the antiseptic) bears on urinary antimicrobial activity. The PK study measures excretion only; the review, CYP450 assay and rabbit safety study give no antimicrobial…
• No human study left after the re-check, so no grade: Anti-inflammatory Effects, Antioxidant Activity, Diuretic Effect, Recurrent UTI Prevention, Tyrosinase Inhibition. Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Uva ursi: the page as it is now

• Pain (Primary Dysmenorrhea (Menstrual Cramps)): Result Small Improvement → Improvement; Size small → not stated.Why: One placebo-controlled RCT (100 students) found a larger pain reduction with valerian (P<0.05); the no-effect wording in the abstract is about systemic manifestations, not pain. Direction and grade C hold, but the abstract gives no effect size, so 'small' is cleared and the note becomes the…

Valerian: the page as it is now

• Skin Barrier Repair (Wound Healing): Result Moderate Increase → none shown; Grade A → not graded; Size moderate → not stated.Why: Graded A with no studies. Three small randomised vehicle/placebo-controlled trials of topical dexpanthenol all report better skin barrier repair or protection (faster repair after SLS irritation, lower water loss, less hydration loss), so A is met and stored A kept. Caveats: healthy-volunteer… No passing human study (animal, lab or review evidence only): no grade
• Wound Closure Rate (Wound Healing): Result Moderate Increase → none shown; Grade A → not graded; Size moderate → not stated.Why: Graded A with no studies. Real controlled trials exist, all of dexpanthenol (provitamin B5): 3 report faster wound healing vs placebo/vehicle/petroleum jelly (tonsillectomy, laser wounds, eye surgery) and 1 shows a non-significant trend (corneal). With one null, they don't all point the same way… No passing human study (animal, lab or review evidence only): no grade

Vitamin B5 (Pantothenic Acid): the page as it is now

• PMS Symptoms (Premenstrual Syndrome (PMS)): Result Small Improvement → Mixed effect; Size small → not stated.Why: Four placebo-controlled B6 trials with abstracts: 3914180 no better than placebo; 3891456 no significant symptom differences but better global rating; 2558186 helped emotional symptoms only ('No significant effect' on other types); 3299182 left most physical/affective symptoms. 17187801 has no…

Vitamin B6: the page as it is now

• Blood Flow. 1 study removed (did not measure this outcome); 1 study removed (not a study of this supplement).
• Blood Flow (High Blood Pressure). 1 study removed (did not measure this outcome); 3 studies removed (studied a different group of people); 2 studies added.
• Blood Flow (Postural Orthostatic Tachycardia syndrome (POTS)). 1 study removed (did not measure this outcome); 3 studies removed (studied a different group of people); 1 study added.
• Blood glucose (Immune Health): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (did not measure this outcome).Why: Page shows Improves / 'Small Improvement' for blood glucose, but neither passing trial shows a fall: 800 mg/day for 4 weeks left fasting glucose unchanged in type 2 diabetes (16126809), and 2 g/day raised 1-h post-OGTT glucose vs placebo in normoglycaemic adults (7942581). 12050273 measured…
• Blood glucose (High Cholesterol): Result Small Improvement → No effect; Size small → not stated. 1 study removed (did not measure this outcome); 2 studies removed (studied a different group of people); 1 study added.Why: Page shows Improves / 'Small Improvement' for blood glucose under High Cholesterol. No link studies people with high cholesterol (type 2 diabetes with low vitamin C, normoglycaemic young adults, healthy volunteers), and they show no fall anyway (fasting glucose unchanged; post-OGTT glucose…
• Blood glucose (Obesity): Result Small Improvement → Mixed effect; Size small → not stated. 1 study removed (did not measure this outcome); 2 studies removed (studied a different group of people); 2 studies added.Why: Row is under Obesity. No link studies obese people (type 2 diabetes with low vitamin C, normoglycaemic 22-year-olds, healthy volunteers) and 12050273 does not measure glucose: all removed. One search found two RCTs in obese adults: fasting glucose fell vs control in 64 obese hypertensive/diabetic…
• Depression Symptoms (Sexual Health): Result Small Improvement → Improvement; Size small → not stated.Why: Sexual Health is a general group. In 81 healthy young adults, 3 g/day sustained-release vitamin C for 14 days lowered Beck Depression scores (placebo did not), so the improvement holds, but the abstract gives no magnitude: 'Improvement', clear 'small'. One RCT: ceiling C = stored C.
• Glycemic Control (General Athletic Performance). 1 study removed (not a study of this supplement); 1 study added.
• Upper Respiratory Tract Infection Risk (Common Cold): Result No effect → Mixed effect. 1 study removed (did not measure this outcome).Why: Row under Common Cold. Page shows a clean 'No effect', but the largest linked RCT (1444 army recruits, 6 g/day) found a 0.80-fold lower cold risk and the 362-person orange-juice trial found 14-21% fewer cold symptoms and more episode-free subjects (authors doubt clinical usefulness); the Antarctic…
• Upper Respiratory Tract Infection Risk (Acute Respiratory Infection (ARI)): Result No effect → Mixed effect. 1 study removed (did not measure this outcome).Why: Row under Acute Respiratory Infection. Page shows a clean 'No effect', but the largest linked RCT (1444 army recruits, 6 g/day) found a 0.80-fold lower cold risk and the 362-person orange-juice trial found 14-21% fewer cold symptoms and more episode-free subjects (authors doubt clinical…

Vitamin C: the page as it is now

• No human study left after the re-check, so no grade: Bone Mineral Density (Osteoporosis). Studies in animals, cells or reviews stay listed on the page but don't earn a grade.

Vitamin D: the page as it is now

• Bone Mineral Density (Osteoporosis): Result Moderate Improvement → No effect; Size moderate → not stated. 14 studies removed (studied a different group of people).Why: Row is under Osteoporosis. The 2019 systematic review of RCTs (31076817) concludes that for post-menopausal or osteoporotic patients there is no evidence vitamin K affects BMD (lumbar gains vanish when high-bias trials are removed); 35625785 finds no significant femoral BMD effect, and in 11886767…

Vitamin K: the page as it is now

• Working Memory: Effect note rewritten from its studies. 1 study removed (not a study of this supplement); 2 studies removed (studied a different group of people).Why: In the row's population (older adults with cognitive decline/impairment), RCT 31829793 (28 days) and pilot 33498314 both show faster working-memory reaction time. 37299382 and 39064791 studied healthy/unspecified adults; 36929344 is WCCE plus phosphatidylserine. The note describes removed trials…

Whole Coffee Fruit Extract: the page as it is now

• Dysgeusia (Carbonic Anhydrase VI Deficiency): Result none shown → Improvement. 1 study removed (studied a different group of people).Why: Only 10616164 is in carbonic anhydrase VI deficiency: open trial, 14 patients, zinc 100 mg/day; dysgeusia diminished in the 10 responders (and 2 of 4 non-responders). So Improves is right, but the stored direction is 'increase' (page arrow says dysgeusia goes up): set to decrease with label…

Zinc: the page as it is now