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13 In their comprehensive review of nonpharmacological therapies for ADHD, Weber and Newmark 14 remarked that the study design did not adequately control for fruits, juices, or other dietary sources of sugar and suggested that future studies should not focus primarily on sugar but rather on a possible link between high-glycemic-index foods and hyperactivity

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However, for individuals actively managing complex, reactive chronic illnesses like Long COVID, ME/CFS, or severe dysautonomia, such high starting doses are rarely recommended due to the high potential for gastrointestinal upset or rapid, uncomfortable detoxification reactions (often referred to as a Herxheimer reaction)