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Yes, Citrulline/Oxytocin/Tadalafil should be refrigerated immediately upon delivery to maintain potency and effectiveness

(PubMed) May JM, Qu ZC, Mendiratta S

Standard analysis techniques would surely fail to coregister the very small nuclei that may be related to key ME/CFS symptoms (e.g., nucleus of the solitary tract, area postrema, dorsal motor nucleus of the vagus nerve, periaqueductal gray, reticularis gigantocellularis, and others)