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from Mad Magazine #481, Sept

All these studies are of low quality according to GRADE 46

[89] Thus, increased COHb levels are able to interfere with the O2 released in the cells in two ways, both of which can reduce VO2max: 1) decreasing the amount of O2 transported in the blood via a reduction in the available receptors on the surface of Hb, and 2) delaying the unloading of O2 into active muscles