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The earliest reproducible patient-reported change is often improved sleep, sometimes within the first few weeks

A statistical study in 2019 looked at caffeine levels in 7,844 urine samples from elite athletes and showed less than 0.87% violated the old World Anti-Doping Agency (WADA) threshold of 12 ug/ml

Thus, urinary GSH may have important clinical implications as a promising biomarker for identifying TLS in the kidney

These modified proteins can be taken up by antigen-presenting cells (APCs), processed, and presented to T cells, leading to the activation of autoreactive T cells and the production of autoantibodies