Great question. I can only tell you my experience as a long term taker of it. At first, I started low... For the best effectiveness, I worked up to 5G, twice a day. Have not increased from that point. Nor have I decreased, because it helps and I had suffered far too long before I started Kratom. As I understand my dosage, I would call it medium high. The negativity comes from much higher doses than mine. 25 or more grams a day, are where people start having issues I think. I researched it extensively prior to even starting it. From the research I remember determining right away that I would not go over 18 G in a single day. And so far I have not approached that amount, and still experienced relief.