I know I'm late but I want to add something for this discussion, so there are no long-term studies but what the heck does that mean. There are no long-term studies for echinacea which works great, Liver Flushing which works great, and other ALTERNATIVE CANCER treatments. That said, some of us are so run over by microbes that we have to do something to get a handle on our immune systems, digestive aids can do that when taken for a short term to get rid of the microbes and help get our bodies back in balance. I take bitters too, but without the enzymes, I would certainly be dead...