Public protocols

Varicose Vein and Venous Insufficiency Herbal Tx

Varicose Vein and Venous Insufficiency Herbal Tx resource 1

Ashwagandha Best Way to Lower Reverse T3

Ashwagandha Best Way to Lower Reverse T3 resource 1

Hello, I am sending this to you to give you an option for obtaining a refill on the Ashwagandha, if you don't want to drive over to the office get it. You can also order it through here. We switched to NOW brand Ashwagandha based on May 2024 Consumerlab.com review that Pure Encapsulation did not pass but NOW did and is much less expensive. Ashwagandha has been my favorite for a long time, I'm sure it's my #1 most recommended herb, and I read of new reasons to love it every day. I started recommending it for those with elevated Reverse T3. When we've been stressed, eating less to lose weight, or have been ill recently, our body tries to slow us down by converting T4 to Reverse T3 instead of the active thyroid hormone T3. While that might be helpful for a short time, it often gets stuck that way for longer than beneficial. Ashwagandha helps lower Reverse T3 and promotes T4 conversion to T3. It's also recommended for the prevention of Alzheimer's Disease by Dr. Dale Bredesen as part of his ReCode protocol for preventing AD. He recommends 1000 mg but I would caution you to stick to 600 mg or less. Most patients that go over 500-600 mg experience some gastrointestinal side effects so I believe his dose is wrong. Sorry Dale! But he also could be referring to the dosage for a root powder, I'm referring to the dosage of an extract. A daily dose should provide at least 6 mg of withanolides with a dose of 10-30 mg being typical. The above Pure Encapsulation has worked for us for awhile and it contains 12.5 mg of withanolides so again I think some of the recommendations are too high. The NOW brand supplies 11 mg of withanolides in that 450 mg. One brand was studied for improving testosterone and did so at a lower dose and did not at a higher dose. I feel this supports my thinking that the dose is better around 450-500 mg a day or 10-15 mg of withanolamides.  It's been shown in a study in India to reduce time to falling asleep by 5 minutes which consumerlab.com wasn't impressed with but there are FDA approved sleep drugs that don't work that well. (Makes you wonder). In the sleep studies they administered it with water about 20 minutes before dinner.  Ashwagandha also is reported to have anti-inflammatory and analgesic properties. 500 mg of extract split into two doses daily was used and found to reduce pain, stiffness and disability from joint pain after four weeks.  Back in 2014, Consumerlab.com found that PURE Encapsulation was the right amount of withanolides for the best price for that amount. But they didn't pass 2024, NOW Brands did and is much cheaper. For those working on their Methylation Cycle (chronic fatigue, also Alzheimer's prevention, and help for autism), Ashwagandha also helps with balancing Acetylcholine levels, and may help prevent issues after receiving the DPT vaccine. Dr. Yasko also promotes LOW DOSE use of Ashwagandha.  Virtual Hugs, Dr. Knight

Bredesen's End of AD ReCode Protocol Copper Zinc Balancing

COPPER AND ZINC BALANCING Dale Bredesen, MD, PhD, author of The End of Alzheimer's , recommends shooting for a ratio of Copper to Zinc of less than 1.2.  Bredesen states the ratio of Copper to Zinc should be less than 1.2. [He] discusses that the 3rd type of Alzheimer's which is not genetic but is related to toxic exposures, (CIRS [he] mentions by name) commonly has very low Zinc and very high Copper and ideally they would be 1:1 and at a level of 100 mcg/mL each. A ratio of 1.3 or 1.4 or higher is associated with cognitive decline ([he] said 1.3 in one chapter and 1.4 in another). Bredesen said it's a common finding in more affluent countries and the copper excess may be from copper pipes and the zinc due to zinc poor diets and poor absorption. Zinc and copper are both essential but most have too much copper and they compete in intestines for absorption. Zinc is a stable metal with complete outer orbit of electrons. Copper on the hand is short an electron so it's more likely to cause problems trying to acquire an electron. Molecules with unpaired electrons are free radicals. Free radicals bounce around trying to get an electron and damage DNA and other proteins and have to be neutralized by anti-oxidants. Zinc deficiency also reduces insulin sensitivity, interferes with hormonal signaling and increases auto-antibody formation. Also those that test high for copper than should check their free copper by checking ceruloplasmin. It can be estimated by subtracting 3 X ceruloplasmin from copper level. It should be less than 30. If we measure your RBC zinc instead of regular zinc it should be 12-14 mg/mL. Ways to treat Copper overload and Zinc Deficiency :  To treat Copper overload and Zinc deficiency, Bredesen recommended this approach from Prof. George Brewer (U. of Michigan) to do the following: 1. Take Zinc Picolinate , 25 mg to 50 mg but not more than 50 mg daily. 2. Take Alpha Lipoic Acid daily to neutralize the copper free radicals. [He] mentioned 60 mg a day but I've never seen it in lower than 100 or 200 mg, but they might have it here on Fullscript.  3. Vitamin C , 1 gram to 3 grams daily to chelate and remove copper. 4. He recommends Vitamin B6 (Pyridoxine) 100 mg daily. I disagree because I have been finding more people lately toxic with too much B6. I was taught that B vitamins are all water soluble and you pee out what you don't use. Turns out that is wrong for B6.  B6 is the exception to many rules.   a. First of all if it's deficient unlike the other B's it doesn't make your Red Blood Cells bigger, it makes them smaller like iron deficiency.   b. If you RBCs are big and your B12 and Folate levels are good, it's more likely you have TOO MUCH B6 which causes macrocytosis, peripheral neuropathy, poor balance and other MS-like symptoms.   c. I would recommend taking only Pyridoxine-6-Phosphate and only 2-3 mg daily.   d. ANYONE taking B6 even just in MVI should check their dose. If it's over 2-3 mg we need to check your B6 level. 5. Manganese 15 to 30 mg to support enzymatic effects. 6. Also check vitamins and stop any that have copper in them. Unless you've had a bariatric surgery, you will not have a need to supplement copper. If you have had bariatric surgery we have to check. PS Remember the prices listed here are before your discount.

IMO SIBO SIFO and Biofilm Busters

+33 more items in IMO SIBO SIFO and Biofilm Busters

Dear patient,  I'm sending you a prescription for the herbal formulas also effective for the treatment of Small Intestinal Bacterial Overgrowth.  Much better price then the cost of Rifaximin and just as effective.  A multi-center study, including John's Hopkins, found "herbal therapies are at least as effective as Rifaximin" with "similar response rates and safety profiles".  (They) have been using herbal antibiotics for SIBO since 2011. They have consistently found them to be as effective as pharmaceutical antibiotics in relieving symptoms and reducing gas levels on breath testing. Note as of 10/10/2020, I've learned many new things about SIBO. Herbal regimens listed before were really only effective for Hydrogen producing SIBO. For Methane producing we need a different set. I've made a chart to explain better. See attached pdf below. Note as of 11/20/2023, ISEAI just had their first Mold Conference since 2020 and Dr. Jill Carnahan presented on SIBO/SIFO. She mentioned that when treating SIBO we should have high index of suspicion for SIFO (F as in fungal) and consider treating for it too. There isn't a breath test for SIFO unfortunately. But covering for it while treating for SIBO is likely beneficial. Plus the herbals that treat SIBO often cover SIFO and vice versa. Biofilm Busters These will help with eradication of Methane SIBO as well and possibly the other two types. They should be taken while on treatment. N-Acetyl Cysteine 600 mg BID (BID means twice a day) or one of the following Nattokinase Serrapeptidase Lumbrokinase. Another treatment option is 2-3 weeks of elemental diet. We would want to discuss this before doing this option and it's not advised for underweight individuals typically. Also it is recommended between treatment rounds that you use Prokinetic agents regardless of whether you have diarrhea, constipation or mixed. EVERYONE with SIBO is due to abnormal motility in the small intestine which does not determine if you will have diarrhea or constipation. Prokinetic Agents: Iberogast is herbal formula from Germany that was studies versus cisapride and metochlorpropamide and more effective. Those are two prescription drugs. It's backordered/unavailable here but best price is on Amazon. Low Dose Naltrexone or Erythromycin or Tegaserod are other options and these are all by rx. You can make your own low dose naltrexone from rx of regular Naltrexone for a one time cost of about $35 and it'll last you years. Contact the office is you're interested in this deal. Brush Border Healing Supplements and other preventives that are used after effective treatment to help heal and hopefully prevent relapse. These are often not started until you've made it 3 months without relapse. You want to avoid probiotics containing prebiotic such as inulin, arabinogalactan, fructooligosaccharide (FOS), mannoseoligosaccharide (MOS), or galactooligosaccharide (GOS). Hydrochloric acid or Herbal Bitters Probiotics (that don't contain pre-biotics and certain bacteria) Bacillus clausii has even worked as a sole treatment with 47% success Lactobacillus casei and plantarum, Streptococcus faecalis, and Bifidobacterium brevis 82% success (Bioflora) BRUSH BORDER HEALING Licorice (not if hypertensive), Slippery elm, Aloe Vera (not long term, laxative that stains colon), and Marshmallow (plant not the sugary fluff stuff) are mucilaginous but controversial as they are fermentable. Lactose-free colostrum 2 to 6 grams daily L-glutamine 375 mg to 1500 mg daily (not if ADHD, ASD, or sens to methyl donors) Zinc carnosine 75 mg BID (twice daily) Cod Liver Oil 1 tbsp daily HEAL LEAKY GUT Curcumin 400 mg to 3 grams daily (wow they do a high dose first actually then go lower) Resveratrol 250 mg to 2 grams daily (high then low dose) Curcumin and Resveratrol high dose 2 weeks to down regulate NF-kb a mediator causing intestinal permeability and then reduce to maintenance levels. Liposomal Glutathione 50 to 425 mg daily or N-Acetyl Cysteine 200 to 600 mg BID Generally these are used 1 to 3 months but can be used for longer. There is also a new test called IBS SMART that helps determine if SIBO and IBS due to post-infectious cause that created an autoimmune condition. It measures 2 antibodies, one to Cytolethal Distending Toxin (CDT) that is made by the bacteria causing the food poisoning/gastroenteritis that started it all. CDT may destroy the interstitial cells of Cajal (ICC) by stimulating production of autoantibodies against Vinculin, a cytoskeleton protein. Then the CDT-vinculin antibodies complex leads to destruction of the ICC cells which trigger the migrating motor complex (MMC) and are the pacemakers of the small intestine. They now realize 75% or more of IBS is an autoimmune disease after gastroenteritis. Sincerely,  Dr. Rebecca Knight

The Betaine Test

To decide who should reconsider their approach to heartburn/GERD, I have a little questionnaire for you. 1. GERD or heartburn since born (colic)? 2. GERD or heartburn as a kid? 3. Positional GERD or heartburn just from bending over? 4. Told you had a hiatal hernia before? 5. Breakthrough symptoms despite taking PPIs? If you answered yes to 3 or more questions, you should have an esophagram to evaluate if you have hiatal hernia and how bad it is before doing the Betaine test or at least discuss it with me first. Have you been diagnosed with Barrett’s esophagus? Then you should discuss this further with me first. If you answered yes to 2 or less then you should consider doing a Betaine home test. Note you should not perform this test if you are currently taking aspirin, NSAIDS (ibuprofen, meloxicam, Celebrex, aleve, Naprosyn, to name a few), Indocin, prednisone, or Hydrocortisone by mouth. Topical is ok. Inhaled is ok. These drugs damage the stomach lining and make it more susceptible to ulcer and bleeding that supplementary HCL could aggravate or increase the risk to develop. The Betaine Test This is a low-tech method to determine whether you have a low acid problem or not. Start with either one 200 mg Betaine containing capsule of Digestizymes by Designs for Health or one 750 mg Betaine with Pepsin. You can obtain in the office or through Fullscript.com. Sensitive people I recommend start with 200 mg one and that’s what I will use AFTER my hiatal hernia repair. Take one in the early part of a meal. If there are no problems after 2-3 days, increase to 2 capsules. Again, if no problems after 2-3 days, try 3 capsules. You can go slower as well if you want. Slow often wins this kind of race. Continue to increase the dose gradually in this step wise fashion until you feel a mild burning sensation. Then STOP and reduce your dose to previous number of capsules and stay there. Over time you may have to adjust lower or higher. Chris Kresser’s experience has been most of his people ended up around 750 mg to 800 mg level but a different physician claimed his ended up on 5-7 of the larger capsules. So that’s a big range! Both reported that 90% of their GERD patients turned out to be low acid not high acid. You can also hunt around on here for products containing Betaine HCL and Pepsin in other amounts. There are 400 mg and 650 mg ones. But you definitely want it to include both Betaine HCL and some pepsin.

Lithium Orotate or Nutritional Lithium for Chronic Anxiety

I had been taking Lithium Orotate 5 mg daily for almost two years mainly because it improves absorption of B12. I stopped taking it 4-6 weeks ago on accident. I just forgot to bring home more. Then I picked up my sertraline refill 3 weeks ago and they changed me back to a manufacturer that didn't work as well for me before. I had to take a higher dose with that brand. But I forgot to increase it. 22 days later I was in a melt down and shaking like a leaf. I found sertaline from a pharmacy in California where I could specify my brand but it struck me as strange because when I took that brand before it just made me dizzy, but it still worked for my anxiety. So a week later on new one and still super anxious and I was listening to a webinar and they mentioned "nutritional Lithium" or super low dose was excellent for people with anxiety. BINGO! I realized then I wasn't take it and that was the reason. I restarted that and every day my anxiety is less and I'm getting my appetite back. So I would highly recommend taking this daily and seeing if it helps you. Sincerely, Dr. Knight

Covid Recovery Plan

Covid Recovery Plan resource 1

Not only is vitamin D3 and K2 the preferred "preventive" for Covid, it's also been found to help reduce coagulopathy in recovery. This is a much safer option vs. aspirin. However, if you are someone that has to avoid vitamin D, patients with sarcoidosis, then take nattokinase or lumbrokinase instead.

Spring Health 2023

+1010 more items in Spring Health 2023

Overview Between the holiday festivities, shorter days, and cold weather, for many, winter often brings with it a number of health challenges. Restore whole-body fortitude and prepare for spring with the evidence-based ingredients found in this Spring Health 2023 protocol. While there are many ingredients that may be considered part of a wellness protocol, the Integrative Medical Advisory Team (IMAT) has selected these based on general safety, effectiveness, broad applicability, and availability to the adult population. Quercetin Quercetin 200–500 mg per day minimum, for at least 8 weeks ( Mohammadi-Sargang 2017 )( Serban 2016 )( Yamada 2022 )   Allergies:  Quercetin may be helpful for relieving the symptoms of pollen allergies, including itchy eyes, sneezing, runny nose, and sleep issues. ( Yamada 2022 ) Anti-inflammatory:  Quercetin can support optimal C-reactive protein levels and may help support a healthy inflammatory response. ( Mohammadi-Sargang 2017 ) Cardiovascular protection:  Quercetin may help produce small improvements in blood pressure. ( Popiolek-Kalisz 2022 )( Huang 2020 )( Serban 2016 ) Collagen Collagen 2.5–10g of collagen hydrolysate per day, 3 months minimum ( Choi 2019 )( de Miranda 2021 ) When used for at least 90 days, collagen supplementation may help support healthy skin aging by improving skin elasticity and hydration, which may help prevent or slow the development of wrinkles. ( Choi 2019 )( de Miranda 2021 ) Personal care product 1 Personal care products Improving overall wellness and making sustainable, positive changes often means prioritizing health in many areas of life — not just taking the right supplements. That’s why Fullscript is continuously growing its catalog to include new personal care items from high-quality, trusted brands. In addition to the evidence-based ingredients above, several possible recommendations for Personal Care Products relevant to Spring Health have been selected by the Fullscript Merchandising and Brand experts. As always, practitioners are encouraged to use their clinical judgment when making recommendations based on individual patient needs.   Herbal Body Wash - Lavender   Moon Valley Organics 12 Ounces $9.99 each   Sun Shield-Coconut SPF 28   MyChelle 2.3 Ounces $25.99 each For daily use, apply to clean, dry skin and allow to absorb completely before applying makeup. Apply liberally 15 minutes before sun exposure. Natural Retinol Serum   suki skincare 30 Milliliters $56.99 each Use after toner and follow with oils. Massage 1-2 drops of the serum into the face, neck and chest. Natural Retinol Serum can be used during the day. Skin Food Light Nourishing Cream   Weleda 2.5 Ounces $18.99 each Apply as needed, whenever and wherever skin needs immediate moisture on hands, face, or body. Suitable for use on face or body. Probiotics Probiotics ~10 billion CFU per day, for 8 weeks, depending on the patient’s individual needs ( Zhang 2016 ) Digestive health:  Probiotics may reduce the risk and severity of unwanted digestive symptoms, including pain, bloating, and gas, by 21%. ( Ford 2014 )( Didari 2015 ) The positive effects may be seen with doses lower than 10 billion CFU within 8 weeks, but higher doses and duration are also beneficial. ( Zhang 2016 ) Allergies:  Probiotics may be moderately helpful for reducing allergy symptoms and may help improve quality of life, possibly by supporting a healthy helper T cell immune response. ( Luo 2022 ) L-theanine & GABA L-theanine & GABA 200–400 mg of L-theanine ( Hidese 2019 )( Williams 2020 ) & 100–300 mg of GABA per day, minimum 4 weeks ( Hepsomali 2020 ) L-theanine may provide support for stress and nervous tension in people exposed to stressful conditions, ( Williams 2020 ) and may help improve mood and sleep quality. ( Hidese 2019 ) GABA may help provide support for stress and promote sleep, ( Hepsomali 2020 ) with some evidence suggesting it may have positive effects within one hour of taking. ( Abdou 2006) Evidence rating The following protocols were developed using only  a,b,c -quality evidence Learn more about our rating scale References Abdou, A. M., Higashiguchi, S., Horie, K., Kim, M., Hatta, H., & Yokogoshi, H. (2006). Relaxation and immunity enhancement effects of gamma-aminobutyric acid (GABA) administration in humans.  BioFactors ,  26 (3), 201–208. https://doi.org/10.1002/biof.5520260305 Choi, F. D., Sung, C. T., Juhasz, M. L. W., & Mesinkovsk, N. A. (2019). Oral collagen supplementation: A systematic review of dermatological applications.  Journal of Drugs in Dermatology: JDD ,  18 (1), 9–16. https://www.ncbi.nlm.nih.gov/pubmed/30681787 de Miranda, R. B., Weimer, P., & Rossi, R. C. (2021). Effects of hydrolyzed collagen supplementation on skin aging: A systematic review and meta-analysis.  International Journal of Dermatology ,  60 (12), 1449–1461. https://doi.org/10.1111/ijd.15518 Didari, T., Mozaffari, S., Nikfar, S., & Abdollahi, M. (2015). Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis.  World Journal of Gastroenterology ,  21 (10), 3072–3084. https://doi.org/10.3748/wjg.v21.i10.3072 Ford, A. C., Quigley, E. M. M., Lacy, B. E., Lembo, A. J., Saito, Y. A., Schiller, L. R., Soffer, E. E., Spiegel, B. M. R., & Moayyedi, P. (2014). Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: Systematic review and meta-analysis.  The American Journal of Gastroenterology ,  109 (10), 1547–1561. https://doi.org/10.1038/ajg.2014.202 Hepsomali, P., Groeger, J. A., Nishihira, J., & Scholey, A. (2020). Effects of oral gamma-aminobutyric acid (GABA) administration on stress and sleep in humans: A systematic review.  Frontiers in Neuroscience ,  14 , 923. https://doi.org/10.3389/fnins.2020.00923 Hidese, S., Ogawa, S., Ota, M., Ishida, I., Yasukawa, Z., Ozeki, M., & Kunugi, H. (2019). Effects of L-theanine administration on stress-related symptoms and cognitive functions in healthy adults: A randomized controlled trial.  Nutrients ,  11 (10). https://doi.org/10.3390/nu11102362 Huang, H., Liao, D., Dong, Y., & Pu, R. (2020). Effect of quercetin supplementation on plasma lipid profiles, blood pressure, and glucose levels: A systematic review and meta-analysis.  Nutrition Reviews ,  78 (8), 615–626. https://doi.org/10.1093/nutrit/nuz071 Luo, C., Peng, S., Li, M., Ao, X., & Liu, Z. (2022). The efficacy and safety of probiotics for allergic rhinitis: A systematic review and meta-analysis.  Frontiers in Immunology ,  13 , 848279. https://doi.org/10.3389/fimmu.2022.848279 Mohammadi-Sartang, M., Mazloom, Z., Sherafatmanesh, S., Ghorbani, M., & Firoozi, D. (2017). Effects of supplementation with quercetin on plasma C-reactive protein concentrations: A systematic review and meta-analysis of randomized controlled trials.  European Journal of Clinical Nutrition ,  71 (9), 1033–1039. https://doi.org/10.1038/ejcn.2017.55 Popiolek-Kalisz, J., & Fornal, E. (2022). The effects of quercetin supplementation on blood pressure – Meta-analysis.  Current Problems in Cardiology ,  47 (11), 101350. https://doi.org/10.1016/j.cpcardiol.2022.101350 Serban, M.-C., Sahebkar, A., Zanchetti, A., Mikhailidis, D. P., Howard, G., Antal, D., Andrica, F., Ahmed, A., Aronow, W. S., Muntner, P., Lip, G. Y. H., Graham, I., Wong, N., Rysz, J., Banach, M., & Lipid and Blood Pressure Meta‐analysis Collaboration (LBPMC) Group. (2016). Effects of quercetin on blood pressure: A systematic review and meta-analysis of randomized controlled trials.  Journal of the American Heart Association ,  5 (7). https://doi.org/10.1161/JAHA.115.002713 Williams, J. L., Everett, J. M., D’Cunha, N. M., Sergi, D., Georgousopoulou, E. N., Keegan, R. J., McKune, A. J., Mellor, D. D., Anstice, N., & Naumovski, N. (2020). The effects of green tea amino acid L-theanine consumption on the ability to manage stress and anxiety levels: A systematic review.  Plant Foods for Human Nutrition  ,  75 (1), 12–23. https://doi.org/10.1007/s11130-019-00771-5 Yamada, S., Shirai, M., Inaba, Y., & Takara, T. (2022). Effects of repeated oral intake of a quercetin-containing supplement on allergic reaction: A randomized, placebo-controlled, double-blind parallel-group study.  European Review for Medical and Pharmacological Sciences ,  26 (12), 4331–4345. https://doi.org/10.26355/eurrev_202206_29072 Zhang, Y., Li, L., Guo, C., Mu, D., Feng, B., Zuo, X., & Li, Y. (2016). Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: A meta-analysis. BMC Gastroenterology, 16(1), 62. https://doi.org/10.1186/s12876-016-0470-z  

Help for Leptin Resistance

•Animal studies show that pantethine activates lipoprotein lipase16, the enzyme within white adipose tissue that helps break down triglycerides so that fatty acids are available to use as fuel. •This means that pantethine will directly support healthy fat metabolism within white adipose tissue, and as mentioned above this includes the boosting of adiponectin levels. •The net result is to support healthy leptin function with stored fat. And by clearing triglycerides out of the blood, pantethine supports leptin getting into your brain more efficiently, meaning that pantethine helps overcome leptin resistance problems. Pantethine Utilization of Stored Fat for Energy . Horm Metab Res. Noma A, Kita M, Okamiya T.