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McKinley-Barnard and colleagues states

The rationale has multiple layers

Release of activin and follistatin during cardiovascular procedures is largely due to heparin administration

Other inducers of erythrocyte death and concomitant ATP depletion include metals such as chromium [184], metalloids such as arsenic [185], riboflavin and UV light during RBC storage [186], and the phospholipid signaling molecule lysophosphatidic acid [187]

These symptoms typically occur during initial treatment or following dose increases and often improve as the body adjusts

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