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Factors like stomach acid levels or gut health can prevent you from getting the full dose

Adotvi O, Vernerey D, Jacoulet P, Meurisse A, Laheurte C, Almotlak H, Jacquin M, Kaulek V, Boullerot L et al (2023) Safety, immunogenicity, and 1-year efficacy of universal cancer peptide-based vaccine in patients with refractory advanced non-small-cell lung cancer: a phase Ib/phase IIa de-escalation study

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These include modulation of nitric oxide (NO) synthesis, upregulation of growth hormone receptor expression, and promotion of angiogenesis