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I would, however, prefer to see published certificates of authenticity to bolster consumer confidence in its products

Meta-analysis (Singh et al, 2015) indicates that relative to traditional DMARDs alone , the number of infections seen with Biologic DMARDs increases by: 6 per 1000 patients per year with standard Biologic therapy 17 per 1000 patients for high-dose Biologic DMARDs 55 per 1000 patients for combination Biologic therapy The risk for infection when using biologics (e.g.TNF- inhibitors) needs to be balanced against their potential for therapeutic benefits when making clinical decisions about their use

Apr 30 2021;100(17):e25738

However, excessive sugar consumption leads to fatigue,

The SGRQ consists of 50 items that yield a Total score (effect of disease on overall HRQoL) based on a sum of the total number of items, as well as 3 component scores: Symptoms (frequency and severity of respiratory symptoms), Activity (disturbance or limitations to daily physical activities), and Impacts (psychosocial function disturbances due to airway disease)

Simpson H, Savine R, Snksen P, Bengtsson B-A, Carlsson L, Christiansen JS, Clemmons D, Cohen P, Hintz R, Ho K, Mullis P, Robinson I, Strasburger C, Tanaka T, Thorner M