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The 2024 AUA/ASRM guidelines strongly recommend varicocele repair as a first-line treatment, noting improvements in sperm concentration of 9-12 million/mL on average

Local rectal delivery in a gastrointestinal condition cannot be assumed to predict systemic exposure, tissue concentrations, effectiveness, or safety from an injection or oral product

Collectively, these considerations explain why -HB has become the principal focus of research, as it is thought to account for the majority of the therapeutic effects associated with KD

If the discoloration is false melena caused by medicine and black poop triggers like iron or bismuth, simply stopping the substance is usually enough

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However, this is an off-label practice, and it is not yet clear whether using sub-clinical doses are either effective or safe