Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through C-quality evidence.

Class
Qualifying studies
Minimum requirements
A
Systematic review or meta-analysis of human trials
 
B
RDBPC human trials
2+ studies and/or 1 study with 50 + subjects
C
RDBPC human trials
1 study

The transition between any season can pose challenges to our health; however, optimizing patient wellness during the fall months can help individuals perform at their best and head into the winter months feeling rested and calm. Concerns around topics such as immune health, stress, sleep support, and burnout prevention are common themes that may become particularly relevant this time of year.

Below, Fullscript’s Integrative Medical Advisory Team (IMAT) has provided some ingredient-based suggestions according to supportive evidence for these common health concerns. Consider choosing products that contain multiple or a combination ingredients in order to optimize adherence and cost-effectiveness. Unique to our seasonal wellness protocols, we have also included suggestions for high-quality personal care products selected by our merchandise and brand experts.

Make sure to view this protocol in your Fullscript account to directly apply the product selections to a treatment plan!

Immune health

Vitamin C

A typical dose is 1,000-2,000 mg daily. (Hemila 2013)

    • Generally speaking, taking vitamin C may help reduce the duration of colds by about a half-day, (Ran 2018) or by about 8% in adults and 14-18% in children. (Hemila 2013) It appears to be particularly helpful for individuals who are exercising regularly. (Douglas 2007)

For more information about vitamin C, check out our ingredient review.

N-Acetyl Cysteine (NAC)

A typical dose is 600 mg one to three times daily. (Hashemi 2019)

    • NAC is a precursor to cysteine, one of the amino acids the body needs to synthesize glutathione. Studies indicate that supplementing with NAC can help preserve and replenish glutathione. (Mikhtari 2017)(Shackebaei 2005) Supporting glutathione levels is critical for maintaining healthy immune function. (Ghezzi 2011)(Droge 2000)

Probiotics

A typical minimum dose is 1 billion CFU; however, dosages of 5-10 billion CFU are common as well. (Berggren 2011)

    • Probiotics may modestly reduce the incidence, severity, and duration of colds, and may possibly improve influenza vaccination efficacy. (Zhang 2018)(Kang 2013)(Lei 2017)(Yeh 2018
View immune support products in the Fullscript catalog

Sleep & stress support

Magnesium

A typical dose is 325-1000 mg daily, depending on the form. (Mah 2021)

    • Magnesium is involved with over 300 enzymatic reactions in the body, so it has implications for multiple systems including cardiovascular, musculoskeletal, digestive, metabolic, and neurological function. (de Baaij 2015)
    • Magnesium supplementation has been associated with improvements in both sleep latency (Mah 2021) and symptoms of anxiety. (Boyle 2017)

For more information on magnesium, check out our ingredient review.

GABA

    • Gamma-aminobutyric acid (GABA) is an inhibitory neurotransmitter, a chemical substance found in the nervous system. GABA plays an important role in regulating nervous system activity by balancing nerve excitation and inhibition. (Gajcy 2010)(Ngo 2019)
    • In clinical trials, GABA has been associated with improvements in sleep quality and latency, (Byun 2018), as well as reduced stress markers according to a recent systematic review. (Hepsomali 2020)

L-theanine

A typical dose for L-theanine is 200-400 mg daily. (Williams 2020)

    • L-theanine, an amino acid found in green tea, has been shown to have calming effects. A meta-analysis of nine peer-reviewed articles concluded that L-theanine supplementation reduces stress and anxiety in individuals experiencing stressful situations. (Williams 2020) One study showed that perceived stress was significantly reduced one hour after supplementation and cortisol levels decreased after three hours. (White 2016)

For more information on L-theanine, check out our ingredient review.

Lavender

    • Lavender has long been used as a sleep remedy in various forms including essential oil (aromatherapy) and tea. (Hirokawa 2012)(Chen 2015)
    • A systematic review of 11 randomized controlled trials found that inhaled lavender essential oil had a positive effect on sleep for people with mild sleep disturbances (Lillehei 2014)
View sleep support products in the Fullscript catalog

Energy & adrenal support

B vitamins

    • B vitamins such as vitamin B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), and B12 (cobalamin) are involved in hundreds of chemical reactions in the body, and thus impact a variety of functions and body systems.
    • Factors such as chronic stress, poor sleep, and inadequate diet can lead to B vitamin deficiencies, (Porter 2016), so supplementing with these can be helpful to ensure proper mitochondrial function and energy support. (O’Leary 2010)

Ashwagandha (Withania somnifera)

A typical dose is 125–600 mg daily, depending on the form. (Auddy 2008)(Chandrasekhar 2012)

For more information, check out our Ashwagandha ingredient review.

Other adaptogens

For more information, check out our Rhodiola ingredient review.

View adrenal support products in the Fullscript catalog

Resources

The following resources may support your patient with their fall wellness journey. Check out the in-app patient resource library for additional, downloadable handouts, guides, templates, and infographics.

Personal care products for fall wellness 

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 Fall 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.

Personal care product 1

Dentalcidin Broad-Spectrum Toothpaste with Biocidin by Biocidin Botanicals in the Fullscript catalog

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

View template in-app
References
  1. Auddy, B., Hazra, J., Mitra, A., & Abedon, B. (2008). A standardized Withania Somnifera extract significantly reduces Stress-Related parameters in chronically stressed humans: A Double-Blind, randomized, Placebo-Controlled study. JANA. https://www.researchgate.net/profile/Achintya_Mitra/publication/242151370_A_Standardized_Withania_Somnifera_Extract_Significantly_Reduces_Stress-Related_Parameters_in_Chronically_Stressed_Humans_A_Double-Blind_Randomized_Placebo-Controlled_Study/links/54d6463a0cf2970e4e6a4f3f.pdf – B
  2. Berggren, A., Lazou Ahrén, I., Larsson, N., & Önning, G. (2011). Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections. European journal of nutrition, 50(3), 203–210. https://doi.org/10.1007/s00394-010-0127-6 – B
  3. Boyle, N. B., Lawton, C., & Dye, L. (2017). The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review. Nutrients, 9(5). https://doi.org/10.3390/nu9050429 – A
  4. Chandrasekhar, K., Kapoor, J., & Anishetty, S. (2012). A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults. Indian Journal of Psychological Medicine, 34(3), 255-262. https://doi.org/10.4103/0253-7176.106022 – B
  5. Chen, S. L., & Chen, C. H. (2015). Effects of Lavender Tea on Fatigue, Depression, and Maternal-Infant Attachment in Sleep-Disturbed Postnatal Women. Worldviews on evidence-based nursing, 12(6), 370–379. https://doi.org/10.1111/wvn.12122 – B
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  7. de Baaij, J. H., Hoenderop, J. G., & Bindels, R. J. (2015). Magnesium in man: implications for health and disease. Physiological reviews, 95(1), 1–46. https://doi.org/10.1152/physrev.00012.2014 – A
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  9. Dröge, W., & Breitkreutz, R. (2000). Glutathione and immune function. The Proceedings of the Nutrition Society, 59(4), 595–600. https://doi.org/10.1017/s0029665100000847 
  10. Ghezzi, P. (2010). Role of glutathione in immunity and inflammation in the lung. International Journal of General Medicine, 4, 105-113. https://doi.org/10.2147/IJGM.S15618 – A
  11. Hartz, A. J., Bentler, S., Noyes, R., Hoehns, J., Logemann, C., Sinift, S., Butani, Y., Wang, W., Brake, K., Ernst, M., & Kautzman, H. (2004). Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychological medicine, 34(1), 51–61. https://doi.org/10.1017/s0033291703008791 – B
  12. Hashemi, G., Mirjalili, M., Basiri, Z., Tahamoli-Roudsari, A., Kheiripour, N., Shahdoust, M., Ranjbar, A., Mehrpooya, M., & Ataei, S. (2019). A Pilot Study to Evaluate the Effects of Oral N-Acetyl Cysteine on Inflammatory and Oxidative Stress Biomarkers in Rheumatoid Arthritis. Current rheumatology reviews, 15(3), 246–253. https://doi.org/10.2174/1573403X14666180926100811 – C
  13. Hemilä, H., & Chalker, E. (2013). Vitamin C for preventing and treating the common cold. The Cochrane Database of Systematic Reviews, 2013(1). https://doi.org/10.1002/14651858.CD000980.pub4 – A
  14. Hepsomali, P., Groeger, J. A., Nishihira, J., & Scholey, A. (2019). Effects of Oral Gamma-Aminobutyric Acid (GABA) Administration on Stress and Sleep in Humans: A Systematic Review. Frontiers in Neuroscience, 14. https://doi.org/10.3389/fnins.2020.00923 – A
  15. Hirokawa, K., Nishimoto, T., & Taniguchi, T. (2012). Effects of Lavender Aroma on Sleep Quality in Healthy Japanese Students. Perceptual and Motor Skills, 114(1), 111–122. https://doi.org/10.2466/13.15.PMS.114.1.111-122 -C 
  16. Kang, J., Kim, S. Y., Hwang, H., & Ji, J. (2013). The Effect of Probiotics on Prevention of Common Cold: A Meta-Analysis of Randomized Controlled Trial Studies. Korean Journal of Family Medicine, 34(1), 2-10. https://doi.org/10.4082/kjfm.2013.34.1.2 – A
  17. Lei, T., Shih, C., Liu, J., Lin, Y., & Yeh, L. (2017). Effect of Probiotics and Prebiotics on Immune Response to Influenza Vaccination in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients, 9(11). https://doi.org/10.3390/nu9111175 – A
  18. Lillehei, A. S., & Halcon, L. L. (2014). A systematic review of the effect of inhaled essential oils on sleep. Journal of alternative and complementary medicine (New York, N.Y.), 20(6), 441–451. https://doi.org/10.1089/acm.2013.0311 – A
  19. Mah, J., & Pitre, T. (2020). Oral magnesium supplementation for insomnia in older adults: A Systematic Review & Meta-Analysis. BMC Complementary Medicine and Therapies, 21. https://doi.org/10.1186/s12906-021-03297-z – A
  20. Mokhtari, V., Afsharian, P., Shahhoseini, M., Kalantar, S. M., & Moini, A. (2017). A Review on Various Uses of N-Acetyl Cysteine. Cell Journal (Yakhteh), 19(1), 11-17. https://doi.org/10.22074/cellj.2016.4872 – A
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  23. Panossian, A., Wikman, G., Kaur, P., & Asea, A. (2009). Adaptogens exert a stress-protective effect by modulation of expression of molecular chaperones. Phytomedicine : international journal of phytotherapy and phytopharmacology, 16(6-7), 617–622. https://doi.org/10.1016/j.phymed.2008.12.003 – 
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  28. 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 (Dordrecht, Netherlands), 75(1), 12–23. https://doi.org/10.1007/s11130-019-00771-5 – A
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