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mBio 9 , e0204818 (2018)

Many practitioners prefer gradual escalation in smaller increments than the 2.5 mg jumps used in clinical trials, particularly for researchers who experienced significant fatigue or body aches at prior dose increases

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Importantly, unlike PD and MS, where some interventional studies have administered pure caffeine, ALS clinical investigations have largely estimated caffeine exposure indirectly from self-reported coffee, tea, or beverage consumption rather than controlled caffeine dosing

Dikin, D

More experimental studies on that perspective will shed light on the underlying mechanism