I am single limb onset and remained so for 3 years. I have a friend who has 10 years only in one limb. She takes riluzole too. I have no idea how we would be without it. I have been in genetic research studies none of the doctors ( leading ALS specialists)indicated an issue with single leg- in fact said early was most beneficial. Can you share your source? Most people are single limb at onset if not bulbar. Slower progressing people can be harder to detect benefit in shorter studies too
I am not a huge caffeine person but certainly have some. The issue is it increases the activity of riluzole somewhat which might not be all bad in moderation???
I feel normal on it. If you can afford it why not try it and see? You can always stop. Does your insurance not cover it?