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Francesco Puppi, recent podium finisher of the Western States 100, wrote a thoughtful piece about the state of drug testing in ultras following the high profile test failure of Joyline Chepngeno in 2025

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The blanket point holds: these compounds are sold for laboratory research only, none is an approved drug, and none has an established human dose

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Post-surgical protocols sometimes extend to 8-12 weeks to support complete tissue remodeling and strength recovery