Dried cow's first milk; digestion destroys nearly all of it, so it works inside the gut. Fewer cold-like symptom days in heavy training and shorter infectious diarrhoea hold up; muscle, skin and hair claims are conflicted or untested. Most products dose far below the trials; harms are milk allergens and contaminated batches. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Fecal calprotectin | Below 50 µg/g | Gut wall inflammation; room to benefit |
| Urinary lactulose/rhamnose or lactulose/mannitol ratio | No established target; change from baseline | The only direct measure of the mechanism |
| High-sensitivity C-reactive protein | Below 0.5 mg/L | Whole-body inflammation, downstream of the barrier |
| Serum insulin-like growth factor 1 | Lower-to-middle of age range; 100–160 ng/mL at 40–60 | Confirms the product is not raising it |
| Serum immunoglobulin A | 90–400 mg/dL | Selective deficiency changes the expected mucosal response |
| Complete blood count with differential | Lymphocytes 1.5–3.0 × 10⁹/L; neutrophil:lymphocyte below 2.0 | Baseline immune capacity; drift on long-term use |
| 25-hydroxyvitamin D | 40–60 ng/mL | Deficiency confounds the illness outcome |
Cadence: Baseline fasted, then 8 weeks, 6 months, annually; insulin-like growth factor 1 once at 8 weeks.