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Authors contributions YO managed most part of the study, proposed the hypothesis, proposed the study design, performed experiment, performed statistical analysis and wrote the manuscript

Providers typically begin with lower doses to help reduce gastrointestinal side effects and improve overall tolerability

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Unlike AD, PD, or MS, the role of the MGBA in ALS is only beginning to be understood, but recent research suggests the gut microbiome may influence ALS progression and possibly patients metabolic status [210]

Additionally, pre-exercise glutamine could modulate immune function, support antioxidant defenses, and reduce tissue-injury biomarkers, thereby supporting recovery-focused outcomes [21,22,23,73]