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Dr Rankin's UPDATED Mitochondrial Support Protocol
15 more items in Dr Rankin's UPDATED Mitochondrial Support Protocol04/28/2026 UPDATED VERSION OF MITOCHONDRIAL SUPPORT PROTOCOL Whenever a protocol is modified to include updated information it is released to everyone so that those currently using the protocol can make adjustments to align with current knowledge. I have listed the supplements in the order in which they are recommended by Mitochondrial Specialists so that it is aligned with the official recommendations of their specialty medical societies. There are only THREE Top Tier Core Supplement recommendations. All the rest are considered to be Conditionally Recommended Based on what is known about an individual patient. I have included those which are marked as Tier 2. I have not included any of the supplements such as Arginine that are only recommended in very specific Genetic Mitochondrial disorders ( which are very rare) which is very different from secondary / Induced Mitochondrial Dysfunction which represents the majority of patients. If you look at the attached handouts you can see there are dosing ranges for all these supplements which is the reason all supplements say START WITH versus TAKE. As cost is an issue for most of us I would always suggest starting with my lower end recommendations for at least 3 months before deciding to increase dose as no escalation is needed is symptoms resolve to a significant enough degree. I would also start with one supplement at a time ( if not previously used ) in the order they are listed for 5-7 days before adding in the next product. For those who have told or suspect that their symptoms ( especially fatigue, brain fog, exercise intolerance) may be due to post infection / exposure mitochondrial Start with just the first 3 products which should all consistently be on board for at least 3 months before assessing for evidence of benefit and need or not of adding additional products into the regimen. An exception to this would be also adding in the Methyl Folate Plus product for those patients who have known Folate One Carbon Methylation mutations variants ( MTHFR is one of MANY) that require Methyl Folate to work around the enzyme deficiency and / or have a known medical need for exogenous supplementation with Folinic with or without Methyl Folate. It has the recommended dose of Folinic and also has dose of Methyl Folate sufficient for most FOCM variants. Supplements that are not currently included as a recommended by Mitochondrial Specialists include NAD, NR, NMN which have all become very popular. They are not included because all of them including when given by injection ended up getting converted in the gut back to Nicotinic acid ( which is much less expensive than all of the above) making them expensive unnecessary alternatives to supplementing with Niacin. There are specific genetic mitochondrial disorders where Niacin ( at very high levels that will require titration schedules to help mitigate the flushing / itching response) may be recommended but the lack of current data confirming clinical benefit as compared to just elevated levels on testing is the reason is is not routinely recommended. Ongoing studies may confirm a clinical benefit across the board and if so it will be added as an official recommendation. I have also enclosed sample reports from Religen's Mitoswab report which is based on a cheek swab. It looks at Mitochondrial Function is NOT a genetic test and cannot be used to make that diagnosis. We contact the vendor who mails out the kit after payment is made by patient. The swab is collected and sent back by the patient and we get the results in 3-4 weeks. It is not covered by insurance and can runs a couple hundred dollars. PLEASE READ THROUGH THE OPEN EVIDENCE MITOCHONDRIAL SUPPORT HANDOUT Dr Lisa Rankin Coastalintegrativemedicine.com SMS 772-344-1409 Email cimappts@gmail.com CoQH-CF® Ubiquinol Instructions B-2 100mg Instructions Alpha Lipoic Acid 250mg Instructions Creatine Monohydrate Powder, Unflavored Instructions Acetyl L-Carnitine 800mg Instructions Methyl Folate Plus Instructions Vitamin E Instructions NAC Instructions Benfotiamine w/Thiamine Instructions R-Lipoic Acid 100mg Instructions Resources IMG_3452.jpeg IMG_3454.jpeg IMG_3456.jpeg IMG_3458.jpeg IMG_3461.jpeg IMG_3460.jpeg IMG_3451.jpeg OPEN EVIDENCE Handout Supplements for Mitochondrial health Supplements for mitochondrial health .pdf Template Total starts at $359.90 Remove We won't overwrite any existing dosage in
Dr Rankin's Coenzyme Q10 Protocol
Dr Rankin's Coenzyme Q10 Protocol for Mitochondrial Support. When using to offset CoQ10 depletion from Statin use take times 2 weeks BEFORE starting Statin and continue to use daily with the Statin. Dr Lisa Rankin Coastalintegrativemedicine.com SMS - 877-565-6293 Email- cimappts@myupdox.com
Dr Rankin’s Muscle Building Protocol
IF YOU DON'T CONNECT THE MEDICAL DOTS ALL YOU EVER SEE ARE SPOTS As a result of research done for an N Of One with a rare neurodegenerative disorder that causes severe skeletal muscle loss I belive I may have found at least a partial solution to a problem that plagues two large patient demographics: Perimenopausal / Post Menopausal Women & Those Using Injectable Weight Loss meds whether compounded or the real deal. Both of these demographics suffer loss of skeletal muscle. One is as a result of Injection induced weight loss that is disproportionately a greater amount of muscle than fat and the other as a result of a physiologic process that affects 100% of women who make it to menopause. If you are a women of a certain age AND using Injectable meds for weight loss your skeletal muscle mass loss is exponentially more. Your Basal Metabolic Rate (which is a measure of the minimum number of calories needed to perform functions essential to life while active and at rest ) consumes about 2/3 of the calories you consume each day and it is very much affected by your percentage of skeletal muscle mass. Humans with higher skeletal muscle mass have higher BMR and those with less skeletal muscle mass have lower BMR. This is the reason that the rule is that men have a higher BMR because they are genetically predisposed to have a higher skeletal muscle mass and women have a lower BMR because they are genetically predisposed to have a lower skeletal muscle mass. Yes there are exceptions but exceptions / personal experiences never negate the rule. Once you have gotten to your goal weight by way of the Injectable weight loss meds your BMR will be lower than expected for your final weight as a result of the disproportionate loss of skeletal muscle. Ditto for post menopausal women. Both Demographics will significantly fewer calories than they might expect just to avoid gaining weight. This is beause the skeletal muscle plays an important role in converting T4 which is 80% of what is released daily by the Thyroid to T3 which is the active form of the thyroid hormone. With loss of skeletal muscle Free T3 levels drop with or without an increase in Reverse T3 as a result in a shift in the activity levels of one of Deiodinases which finally provides an explanation as to why a majority of my female patients over the age of 40 as well as a majority of my patients who have lost a significant amount of weight by way of injections have persistently low T3 Free levels that correct only by supplementing with Cytomel / Liothyronine which is the T3 Rx version of Synthroid / Levothyroxine which is only T4. In both of the above scenarios the immediate appropriate intervention is replacement with T3 only. If converting from T4 to T3 is the root of the problem you would not treat it by providing a T4 only medication that would not be appropriately converted to T3. As much as I hate to say it there is no other supplement option that will actually work. Having said that there is a non Rx intervention with POTENTIAL to work which is to PREVENT muscle mass loss and / or to RECOUP muscle mass that has already been lost which brings us to the reason for this Muscle Building Protocol- which I suggest using IN ADDITION TO taking the Rx med Liothyronine NOT INSTEAD OF using the Rx med Liothyronine. I am very familiar with its use professionally and personally as Riley and I have both been on it for years due to persisitenly low Free T3 levels which I now know are likely secondary to lower skeletal muscle mass. As with anything I recommend I have done my due diligence regarding Skeletal muscle mass loss and decreasing Free T3 levels as well as supplement regimens with the POTENTIAL to mitigate / reverse skeletal muscle mass loss that comes with menopause, Injectable weight loss meds as well as persistent inactivity whether intentional or not. There is no evidence that I could find that either of these demographics will see a benefit from supplementation alone or with heavy lifting alone. To have any chance of success you must consistently use both Creatine AND HMB at the recommended doses AND you absolutely positively must do heavy weight lifting 2-3 times a week AND you must involve the legs / glutes as they are large muscle groups. If you don't care about regaining muscle mass no need to do anything other than replacing T3 with Rx Liothyronine. If you choose to use iodine / thyroid support supplements instead of replacing T3 that is fine as long as you have no expectations for benefit. The exception would be if there is a known deficiency in iodine, selenium, zinc, iron which will also decrease the conversion of T4 to T3. If these are deficient in either of the demographics discussed replacement should be done and there may be some improvement BUT it will not be close to the benefit seen with Liothyronine use. Dr Rankin‘s Muscle Building Protocol: Carnitine: Load with 20 grams a day times 5 days. Maintenance dose is 5 grams a day HMB: 3 grams a day. This is different and better than BCAA supplements as is contains a form of leucine that would never naturally be present in metabolically relevant amounts by way of conversion because only 5% of leucine is naturally converted to this form whether ingested in food or in supplement form. For these supplements to provide benefit regular lifting with heavier weights is needed as well as consumption of adequate protein. Heavy lifting means you cannot skip legs as these are large muscle groups that provide a much larger muscle mass increasing bang for the buck. Dr Rankin CoastalintegrativeMedicine.com SMS 877-565-6293
Folinic + Methyl Folate 2.0
This is the first supplements I have come across with more than 1 mg of Folinic acid AND Methyl Folate. For Patients with Cerebral Folate Receptor Antibodies Folinic ( Rx version is Leucovorin) must be used Folinic as it can enter cerebral cells without using the Folate Receptor on the cell surface. For this to happen there must be a large enough extracellular concentration to allow the Folinic to move across the cell membrane sans the receptor. This is why such high doses ( upwards of 100 mg a day) are required to adequately patients with antibodies. Patients WITH Folate One Carbon Methylation Mutations (like but not limited to MTHFR ) which is pretty much 100% of the population human who are WITHOUT Cerebral Folate Receptor Antibodies can use Folinic BUT they will still need to take Methyl Folate as a work around for their multiple FOCM. Folinic and Methyl Folate are NOT interchangeable. Methyl Folate is easily accessible as a supplement and requires not consultation with a medical provider. Folinic can be accessed as a supplement but doses are too low for patients with FRAT. Cerebral Folate Receptor Antibodies are NOT the same as having Folate One Carbon Methylation Mutations including but not limited to MTHFR - which is one of the many FOCM that are shared to some degree by all humans. FRAT requires Folinic. FOCM requires Methyl Folate. While treating FRAT and / or FOCM can improve specific symptoms in patients with Autism it does not CURE Autism because Having one or both is not the cause of Autism. Correlation is not Causation. Autism is a clinical phenotype that has too many to count already known and too many to count yet unknown genetic variants that cause a phenotype with shared features. Trialing Folinic supplements is a low tech way of assessing for negative effects (which are not uncommon at all with Folinic, Methyl Folate & Methyl B12 ) and for assessing for benefit. If a notable benefit is seen while trialing increasing doses by way of the Rx version of Folinic acid aka Leucovorin is reasonable as reaching target dosing of 100 mg day divided in 4 doses of 25 mg is very difficult Using low dose supplements. While trialing any supplement / medication / diet / therapy no other variables can be manipulated if you want to get a true assessment of benefit or not. Lisa Rankin MD CoastalintegrativeMedicine.com SMS 877-565-6293 Fax 772-264-7845 Email cimappts@myupdox.com Products Methyl Folate Plus Instructions Template Total starts at $43.99 Build plan We won't overwrite any existing dosage information.
Dr Rankin's Sleep Protocol
11/13/2023 I Intermittently Update Create and / or Update Protocols Based On Newly Acquired Medical Information. If I believe an updated protocol is relevant to some or many patients I may send it to specific patients or all patients without regard to the date of our most recent visit Just as an FYI. Due to time spent researching for the purpose of updating I know that I am behind in getting recommendations out to patients & I suspect that my self made list of patients waiting for my post visit recommendations to arrive is less than complete. For this reason I have decided to allow the system to notify all patients for each updated protocol versus sending them out to the individual patients which is how they are typically distributed. I am trying to ensure I don't forget any patients who have been patiently waiting for recommendations. I apologize in advance for bombarding your Inbox with emails regarding the updates. Feel Free to disregard / delete these Updated Protocol Messages and /or browse the Supplement Dispensary for unrelated products / protocols & Don’t Forget To Have A Great Day. Dr Rankin -------------------------------------------------------- For patients who only need assistance falling asleep I recommend the Resteva spray via nasal delivery. The product is sold for oral delivery BUT it can be used via Nasal also. I have used it orally and nasally and find the nasal is most effective. If there is trouble falling asleep AND staying asleep try using the spray 30 min before desired bed time AND taking the 5mg Melatonin SR as you are getting into bed. There will be a delayed onset of action but it will help to keep you asleep all night long. If you have already tried and failed melatonin short or long acting hold on using the melatonin product and consider using CBN tincture instead. This is a non-psychoactive but very sedating breakdown product of Delta 8 THC. It can be purchased without a Medical Cannabis Card from the site 3Chi.com. If using with the Resteva Spray take as you are going to bed as you would the melatonin. If you want to use as a stand alone take one hour before bed to help fall asleep and stay asleep. Both of these products can be used in children with some supervision. Please contact me directly to discuss in more detail. If using ONLY the Resteva spray in a child begin with one spray each nostril 60 min before bed. You can increase by one spray each nostril each night and / or can adjust the timing of dosing. If you or your child are using other supplements for sleep be sure to discuss with a medical provider before adding into the mix. Dr Rankin Coastalintegrativemedicine.com 772-344-1409 Text
Dr Rankin's Yeast/ Mold/ Fungal Overgrowth Protocol
Dr Rankin's Yeast/ Mold/ Fungal Overgrowth Protocol resource 1Whenever Dr Rankin updates a protocol it is sent automatically to all patients to ensure that patients currently using products from the original protocol are aware of the updates. Disregard any / all updates that do not apply to you. Likewise feel free to access & utilize any / all products and / or protocols even if not previously discussed. Ditto for accessing any of the products in the expansive Fullscripts Supplement Dispensary outside of Dr Rankin's Protocol Library. Coastalintegrativemedicine.com SMS 877-565-6293 Fax 772-264-7845 Email cimappts@myupdox.com
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