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Indeed, evidence in mice has shown that supplementation of L-malate increased the activity of malate dehydrogenase (MDH) in a doseresponse manner, as higher doses reported more activity (Control mice: 15.7 2.4 vs

If youre still working your way up through the early doses and are in the first 4 to 8 weeks , slower progress can be expected

Alcohol is best avoided during dose titration, as it amplifies GI side effects and affects liver function

Everard A, Belzer C, Geurts L, Ouwerkerk JP, Druart C, Bindels LB, et al

This may continue for several weeks or even months, as neurological recovery is often slower and more variable than haematological response