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Maybe we need to sacrifice some of what makes trail running unique and fun and come together to form a worldwide governing body that can administer a testing regime

Sobral et al., 2019)

67 Notably, growth retardation was accompanied by decreased phosphorylation of AKT and IGF-1R/IR tyrosine kinase domains, decreased production of IGF-1 and downregulation of IGF-1R protein expression in the tumors (Figure 4)

95% CI, 8.44 to 1.21

Estrogen levels fluctuate erratically before declining, progesterone drops more steeply and earlier, and the parallel age-related decline in growth hormone pulse amplitude accelerates, compounding symptoms like poor sleep, abdominal fat accumulation, and reduced lean mass

PMID 33837819