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Further, the numbers were 35% from anti-estrogenic substances (tamoxifen, clomiphene, fulvestrant, toremifene, and raloxifene) and 20% from AIs (letrozole, anastrozole, exemestane, adrostatrienedione, and armistane) in 2022 (World Anti-Doping Agency, 2024b)
At the same time, it should be emphasized that this effect is strongly dependent on the dose and the patients initial selenium status, as both selenium deficiency and excess can lead to adverse disease outcomes [15]