I started on an extremely small dose and worked up very slowly because I predicted and did in-fact have hyperactivity to it. I got gastroparisis and the associated huge amount of vomiting, couldn’t eat for the first few weeks. But slowly over the course of 3-6 months I was having few and fewer bad days. I take a bunch of other meds as well but this one is one of the most effective. I also do LDN, Amitryptiline, Modafinil, TUDCA, DIM, low dose of TRT and Ipamorelin/ModGRF. I eat the absolute minimum in sugar, one meal per day, and that is usually a large kale salad. The Modafinil / Amitryptiline is probably the most effective treatment I’ve tried, followed by the semaglutide, then the TRT/hGH peptides.