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Rising hunger, waist growth, weight gain above about 2 lb per month, persistent heart-rate elevation, or declining strength indicate that the lower dose is not maintaining the prior response

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Zhang X et al

In the monoaminergic neurotransmitter deficiency hypothesis, it is posited that depressive symptoms arise from insufficient levels of monoamine neurotransmitters such as 5-HT, norepinephrine (NE), and/or dopamine (DA) (157)

The duration of fermentation, which ranges between five and 14 days, also determines the concentrations of acid, ethanol, and vitamins, which subsequently dictate whether the drink will taste tart or have stronger vinegar undertones