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Administering near food intake blunts the GH-release response in research models, so protocols that ignore the empty-stomach window produce smaller research signals than the dosing quantity would predict

Symptoms that wake you from sleep regularly: Nighttime reflux that disrupts sleep despite bed elevation and dietary timing suggests more severe GERD that may require prescription-strength management

Further research is needed to optimize Exos-based therapies and translate these insights into clinical applications

Data availability The data that support the findings of this study are available from the corresponding author for scientific research upon reasonable request

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