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As the kinetics of these transporters slow with decreasing temperature 59 , it is possible that supercooled storage of RBCs decreases the demand for ATP-mediated ion homeostasis, thereby maintaining ATP levels and obviating 2,3-DPG catabolism

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Anecdotes exist of riders finding it harder to fuel, needing to drastically alter nutrition (often away from optimal carb strategies), and struggling with energy levels during hard efforts while on these medications

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Warning signs include: Cloudiness or turbidity in the solution Visible particles floating in the liquid Color changes or discoloration Any signs of freezing If any of these visual changes are present, the medication should not be used and should be discarded according to local guidelines for pharmaceutical waste