I usually recommend starting with 3 capsules on an empty stomach, first thing in the morning. When taken this way, the vagus nerve is stimulated and *hopefully* you’ll have a bowel movement in about an hour, reassuring you that things are working as anticipated. When I first started it (I also had hyperadrenergic POTS), I had EXTREME fatigue, and for the first few days, I took about 7 capsules a day! I could feel my energy return, and as it wore off, I could feel the fatigue creep back in. Looking back, I can see how I was very deficient in acetylcholine. Eventually, the liver stores go up, and these swings go away. Please keep us posted! 🙂