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A comprehensive diagnostic workup includes most, if not all, of the following procedures: Electrodiagnostic tests including electromyography (EMG) and nerve conduction velocity (NCV) Blood and urine studies including high resolution serum protein electrophoresis, thyroid and parathyroid hormone levels and 24-hour urine collection for heavy metals Spinal tap X-rays, including magnetic resonance imaging (MRI) Myelogram of cervical spine Muscle and/or nerve biopsy A thorough neurological examination These tests are done at the discretion of the physician, usually based on the results of other diagnostic tests and the physical examination

These studies continue to explore possible biological signaling roles, but they do not establish reliable clinical efficacy in humans [1819]

For decades, its physiological relevance remained speculative, as the peptide had not yet been identified in human tissue