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 D-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
D
Non-RDBPC human or In-vivo animal trials
 

This template, developed in partnership with OvationLab, highlights the benefits of fasting and other specialty nutritional interventions, such as time-restricted feeding and the fasting-mimicking diet. These approaches can improve metabolic markers, reduce inflammation, enhance the oxidative stress response, and positively influence gut microbiome composition, thereby supporting overall metabolic health. (Vasmin 2022)(Wang 2022)(Zhang 2023)

Metabolic processes involved in fasting include: 

  • Activated autophagy
  • Decreased inflammation
  • Increased antioxidant production
  • Increased BDNF (neuroplasticity)  
  • Increased DNA repair 
  • Metabolic flexibility (metabolic switching between utilizing glucose and FA-derived ketones as fuel sources for the body)
  • Normalized insulin and glucose (Vasim 2022)(Wang 2022)

Foundational supplementation 

Protein

Start with a general dose of 10–20 g daily of plant-based or whey protein (although dosages are typically in the 20–40 g range).

  • Healthy adults engaging in minimal physical activity should aim for at least 0.8 g of protein per kg of body weight per day to meet the recommended dietary allowance (RDA) of protein to avoid deficiency. This translates to about 10–15% of total daily energy expenditure.  
  • Daily protein intake should be adjusted depending on age, physical activity, and metabolic health goals. Studies suggest that a high-protein diet consisting of 1.07–1.6 g of protein per kg of body weight daily (27–35% of total daily energy expenditure) provides enhanced weight-loss effects while preserving fat-free mass. (Bray 2024)(Moon 2020)
  • GLP-1 secretion is enhanced by all forms of dietary proteins—from whole proteins to peptides and amino acids—each interacting with unique or unknown cellular mechanisms based on their structure. (Hira 2021)(Miguéns-Gómez 2021)(Volpi 2001)
Protein in the Fullscript catalog

Glutamine

A 15–30 g dose is required to leverage glutamine’s beneficial metabolic effects as a GLP-1 enhancer. (Meek 2016)

  • A review article summarizing findings from multiple animal, cell model, and human studies investigated the effects of various food factors, such as amino acids, including glutamine, on GLP-1 secretion and their potential impact on glucose metabolism. Glutamine, in particular, was shown to elevate cytosolic calcium and cell adenosine 3′,5′-cyclic monophosphate (cAMP) in enteroendocrine L cells, promoting GLP-1 secretion in experiments. This suggests that glutamine could play a role in improving glucose tolerance by stimulating GLP-1 secretion. However, the study also notes that effective doses of glutamine (15–30 g) are needed to achieve beneficial metabolic effects in humans, as lower doses have not consistently led to significant metabolic improvements. (Meek 2016)
Glutamine in the Fullscript catalog

Multivitamin, multimineral 

Dosing may vary depending on the specific product and should be tailored to the individual’s nutritional needs and goals, such as nutrient repletion or metabolic support. Healthcare providers should consult product-specific guidelines and adjust the dosage based on the patient’s unique requirements and response. 

  • Multivitamin and multimineral supplements can provide essential nutrients that may be deficient in individuals with metabolic syndrome, potentially improving overall metabolic health and aiding in managing related conditions such as insulin resistance, dyslipidemia, and hypertension. Judicious supplementation may support metabolic functions, enhance antioxidant defense, and promote cardiovascular health, offering a valuable addition to lifestyle and dietary interventions to help manage metabolic disorders. (Blumberg 2018)
Multivitamin Multimineral in the Fullscript catalog

Omega-3 fatty acids (EPA/DHA)

2 g of combined EPA/DHA daily (adjust dose based on testing)  

  • Omega-3 fatty acids may offer therapeutic benefits by minimizing muscle loss and inflammation associated with secondary sarcopenia through their ability to modulate proteolytic pathways that result in skeletal muscle regeneration. (Jimenez-Gutierrez 2022)(Smith 2015)
Omega-3 fatty acids in the Fullscript catalog

Soluble fiber 

5–10 g daily

  • Soluble fibers, including guar gum and larch arabinogalactan, can support metabolic health by moderating energy intake, stabilizing postprandial blood glucose levels, and improving satiety, ultimately addressing risk factors for obesity, hyperglycemia, and hypercholesterolemia. These ingredients are resistant to digestion and promote beneficial gastrointestinal microflora and short-chain fatty acid (SCFA) production, supporting a healthy gut environment that favors comprehensive metabolic health. (den Besten 2015)(Dion 2016)(Kim 2002)(Wu 2023)
Soluble fiber in the Fullscript catalog

Vitamin D3+K2

5,000 IUs (adjust dose based on testing) plus 25–95 mcg daily (depending on dose of vitamin D)

Vitamin D3+K2 in the Fullscript catalog

Specialty supplements

Amarasate® 

Reduced calorie days during alternate day and 5:2 fasting (500–600 calories daily):

125 mg once daily initially, gradually increasing to 500 mg daily

Time-restricted eating:

125–250 mg during fasting periods at four-hour intervals (e.g., If the TRE window is from 12–8 p.m., take Amarasate® in the morning.)

Water-only fasting:

125–250 mg an hour before normal meal times

  • Amarasate®, an extract of New Zealand hops, has been shown to enhance the body’s natural GLP-1 and cholecystokinin (CCK) hormone levels. This provides an effective, natural appetite control mechanism compared to the constant and supra-physiological hormone levels achieved by current anti-obesity medications. (Walker 2019)(Walker 2022)(Walker 2023)
  • Amarasate® has been shown to significantly reduce hunger and food cravings during fasting. In randomized, double-blind, cross-over studies, Amarasate® administered at hours 16 and 20 of a 24-hour water-only fast experienced a 10% reduction in hunger. These findings support its potential to aid individuals in completing intermittent fasting periods more comfortably. (Walker 2019)(Walker 2023) 
Amarasate® in the Fullscript catalog

Creatine monohydrate 

5 g daily

Creatine monohydrate in the Fullscript catalog

Strength combination

Beta‐hydroxy‐beta‐methylbutyrate (HMB)

2,000 mg daily

  • HMB is a metabolite of the essential amino acid leucine. It has been shown to effectively mitigate age-related declines in lean mass, while also enhancing muscle strength and functionality in older adults. These benefits may be enhanced with vitamin D3 supplementation. (Flakoll 2003)(Rathmacher 2020)(Wilson 2008) 

Calcium

240 mg daily

  • An increase of 300 mg daily in calcium intake is associated with a 7% reduction in the relative risk of developing metabolic syndrome, highlighting calcium’s potential role in improving metabolic health. Additionally, calcium supports muscle protection by promoting proper muscle function, which is particularly beneficial in managing metabolic diseases. (Eshima 2021)(Han 2019)(Kim 2020)

Epicatechin (green tea leaf extract)

400 mg daily

  • Found in dark chocolate, green tea, and certain fruits, this flavonoid has been shown to promote muscle growth and enhance exercise performance through mechanisms that include inhibiting myostatin and supporting nitric oxide production. (Mafi 2019)(McDonald 2015)(Ramirez-Sanchez 2010)

PurpleForce® purple tea (Camellia sinensis) leaf extract

100 mg daily

  • PurpleForce® contains anthocyanins, catechins, flavonoids, and other polyphenols that may improve antioxidant activity, supporting muscle recovery and mitigating muscle damage. (Shimoda 2010)  

AstraGin® (Astragalus membranaceus and Panax notoginseng)

50 mg daily

  • Containing extracts of Astragalus membranaceus and Panax notoginseng, AstraGin® supports improved absorption of amino acids, vitamins, and minerals, while also supporting the integrity of the intestinal barrier. (Chang 2022)

Senactiv® (Panax notoginseng and Rosa roxburghii extracts, Astragalus membranaceus and Panax notoginseng root extracts)

50 mg daily

  • Senactiv® supports muscle growth and recovery by enhancing mitochondrial function and reducing oxidative stress. (Wu 2018)(Wu 2019)
Strength combination in the Fullscript catalog

Disclaimer

The Fullscript 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 protocol on Fullscript
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