Treatment Notebook
Our notebook includes information on diet, lifestyle, lab tests and other treatment options for those with chronic illness including chronic infections. This notebook is a living document and is updated regularly.
The information in these pages is informational only. If you think you might benefit from this information please discuss this with your local healthcare practitioner.
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Treatment Notebook
| Sr. No | Chapter | Section |
|---|---|---|
| 1. | GENERAL SUPPORT AND REQUIRED SUPPLEMENTS | MULTI’s AND COMPLEXES ADRENAL SUPPORT THYROID SUPPORT HORMONES NUTRITION |
CHAPTER 1: GENERAL SUPPORT AND REQUIRED SUPPLEMENTS
MULTI’s AND COMPLEXES
To support energy production, optimal detoxification and general wellness add in one of the following.
Option One
ITI End Fatigue Daily Energy Enfusion: Take ½-1 scoop morning and if needed noon.
- This formulation now has active folic acid making it appropriate for use in most patients.
-This formula does contain whey protein
Option Two
Thorne Basic Nutrients (with or without Iron) 3-5 capsules daily with food.
OR
Vital Nutrients MultiNutrients (With or Without Iron) 3 capsules daily with food.
Option Three
Thorne Stress B 1 pill with breakfast
Plus
Thorne Biomins (I/II) 3 capsules per day.
ADRENAL SUPPORTT
The most gentle form of adrenal support is herbal supplements and B vitamins. This is also the best option for vegans and vegetarians. Glandulars are a little stronger and sometimes more supportive for those treating chronic infections or those with chronic illness. Physiologic dosing of pharmaceuticals is the last level of support. You support need to treat the adrenal glands if you are treating the thyroid.
Labs: Salivary cortisol x 3-4 per day. Serum morning cortisol draw.
Option One:
Thorne Phytisone 1-2 pills breakfast and 1-2 pills lunch as needed.
- Use with a B complex.
Option Two:
Thorne Cortrex 1-2 pills breakfast and 1-2 pill lunch as needed. Do not take too late in the day to avoid interfering with sleep.
Option Three:
Hydrocortisone 5 mg Slowly work up to 1-4 pills breakfast, 1-3 pills lunch and ½-1 pill late evening if needed.
THYROID SUPPORT
Suboptimal thyroid function, including elevated reverse T3, needs to be treated either before treating chronic infections and in chronic illness. If already treating chronic infections and your fatigue worsens consider treating thyroid. Always treat the adrenal glands when you treat the thyroid. Do not take high dose iodine/iodide unless you have tested your serum iodine level first.
Labs: TSH, Free T3, FreeT4, Reverse T3, Thyroid Antibodies. Serum or plasma iodine.
- If you are already taking thyroid medication get your labs drawn in the morning before you take your thyroid medication.
Option One:
Herbal and vitamin support. This is gentle and globally supports thyroid function.
Thorne Thyroscin 1-2 pill breakfast and 1 pill evening.
Option Two:
Glandulars are pharmaceuticals derived from pig thyroid gland. They provide both T3 and T4. If your reverse T3 is above 15 you should use caution with this product and tract your reverse T3. Dosing can be 30-minutues before breakfast and possible 2 hours after lunch. Some take thyroid in the evening as well.
Armour Thyroid 15 mg-180 mg average dosing.
Nature-Throid 16.25- 162.5 mg average dosing.
Option Three:
Non-glandular pharmaceutical options include T4 only and T3 only options. Use caution with T4 only dosing with reverse T3 over 15. Dosing can be 30-minutues before breakfast and possible 2 hours after lunch. Some take thyroid in the evening as well.
Levothyroxine 25 mcg 1-4 pills daily.
Liothyronine 5 mcg – 25 mcg
-T3 only therapy sends a signal to the brain that you have enough thyroid hormone, your TSH decreases, and your T4 output decreases. T4 is the precursor to reverse T3. As T4 decreases reverse T3 decreases. Reverse T3 increases can increase due to genetic predisposition and with infections.
HORMONES
Support hormones can help with anxiety, depression, weakness and can help stabilize MAST cells degranulation.
Labs: Dutch Test, or standard serum labs day 3 and day 21 (at least) of total estrogen, estradiol, free testosterone, total testosterone, progesterone, DHEA and sex hormone binding globulin. Retest hormones after 6-8 weeks of treatment.
Low or suboptimal estrogen
Pure Encapsulations DHEA 5-20 mg 2 times per day or 1 time in the morning.
Or
Topical estriol 0.5-2 mg suppositories vaginally each night for 7-14 days then 2-3 times per week after that. Compounded.
High or relatively high estrogen:
DIM Pro-100 Pure Encapsulations 1-3 pills per day.
Or
Indole-3-Carbionole Thorne 1 capsule 1-2 times daily
Low Progesterone:
Pure Encapsulations Pregnenolone 10-25 mg 2 times per day or 1 time per day at night.
Or
Progesterone (oral Micronized) 100-300 mg 1 pill in the evenings ongoing, day 15-28 or day 5-28.
Low or suboptimal Testosterone:
Pure Encapsulations DHEA 5-20 mg 2 times per day or 1 time in the morning.
Or
Topical Testosterone 1.25- 5 grams topically. Pharmacy
Or
Testosterone troche 75 mg 1 troche orally each morning. Compounded.
Or
Testosterone cyprionate injections 25-100 mg each week. Pharmacy.
High Sex Hormone Binding globulin:
Nettle root extract or stinging nettle root extract (NOT nettle leaf) 300-900 mg 2-3 times per day.
NUTRITION
If your diet is suboptimal or consists mainly of fast food make some simple changes first. Otherwise, I will list a host of diets that I have found to be helpful. I cannot state enough how individual this category is and how it takes trial and error as much as it takes science to know what is the best diet for you. Recently I have been recommending people rotate through 2-3 diets, always eliminating foods they are sensitive to, and I have been seeing great results. The idea is to do the most restrictive diet for 3-4 weeks 3-4 times per year (after initial cleanse period which can be several months long) and to rotate between 1-2 other less restrictive diets during the other times.
-Before starting any diet take 1-3 weeks to plan for the diet. Find meals and snacks you like and be ready for at least 2 weeks of food. This will help you be successful when you are starving and struggling with the diet.
-Always plan for dining at friends house and dining out. This is where most exposures happen.
-Diet and nutrition gets complicated when you combined a specific diet with food sensitivities. It is very important to make sure your nutrition is acceptable if your diet is limited and you may need to speak with your doctor or nutritionist.