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The USDA Agricultural Research Service used the 148 pmol/L threshold in their national prevalence studies, and the NIH Office of Dietary Supplements acknowledges that lab reference ranges can vary between institutions

Korean Journal of Pediatrics, 58 (2), 41-46

High concentrations of electrolytes can sometimes cause imbalances without careful monitoring, and allergic reactions are possible if you are sensitive to certain ingredients

If the diagnosis is in question, biopsy specimens should be obtained, not primarily to confirm reflux but to identify alternative pathologic conditions, such as eosinophilic esophagitis (EoE)

06 Inspect The solution should be clear with no cloudy particles