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At around 500mg/day, they are rarely reported, but as intake approaches 1,000mg/day or higher, gastrointestinal complaints become more likely.67 In one study, about 6% of patients at 1,000mg/day experienced GI issues, and a few discontinued the trial as a result.43 Still, research suggests these digestive side effects are often temporary, fading as the body adapts, especially when people start with smaller doses and build up gradually.37 67 Long-term use The best safety data come from ALS studies, where patients took 2,000mg/day (1g twice daily) for up to 18 months.38 42 Roughly 20% experienced gastrointestinal side effects, but most were able to continue by lowering their dose.67 Longer exposure has not been systematically studied, so the safety of multi-year supplementation remains unknown
