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Vigorous shaking or agitation can shear and denature the peptide chains, rendering them inactive

PAI-1, a serine protease inhibitor and another factor involved in the pathogenesis of stroke is produced primarily by the endothelium which directly acts as an active inhibitor of tPA and urokinase (uPA), a serine protease which is responsible for cleaving plasminogen to plasmin (Lakhan et al., 2013)

Griese M, Ramakers J, Krasselt A, et al

Older adults and people taking metformin or acid-suppressing drugs who have confirmed low levels or absorption issues (NIH ODS)

R This is the core problem in many chronic illness presentations

However, it is not proven if this actually leads to better results in humans