This protocol was developed for practitioners using Fullscript in Canada and the templates cannot be applied to accounts operating outside of Canada

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 (Canada)

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)

Glutamine

15–30 g daily.

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)

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)

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)

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)

Vitamin D3+K2

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

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 protocol on Fullscript
References
  1. Besten, G. D., Gerding, A., Van Dijk, T. H., Ciapaite, J., Bleeker, A., Van Eunen, K., Havinga, R., Groen, A. K., Reijngoud, D., & Bakker, B. M. (2015). PLoS ONE, 10(8), e0136364. https://doi.org/10.1371/journal.pone.0136364 
  2. Blumberg, J., Bailey, R., Sesso, H., & Ulrich, C. (2018). Nutrients, 10(2), 248. https://doi.org/10.3390/nu10020248 
  3. Bray, G. A., Qi, L., & Sacks, F. M. (2024). Nutrients, 16(14), 2358. https://doi.org/10.3390/nu16142358 
  4. Cotter, L. A., Arendt, H. E., Cass, S. P., Jian, B. J., Mays, D. F., Olsheski, C. J., Wilkinson, K. A., & Yates, B. J. (2004). Journal of Applied Physiology, 96(3), 923–930. https://doi.org/10.1152/japplphysiol.01013.2003 
  5. Dion, C., Chappuis, E., & Ripoll, C. (2016). Nutrition & Metabolism, 13(1). https://doi.org/10.1186/s12986-016-0086-x 
  6. Eshima, H. (2021). Frontiers in Physiology, 12. https://doi.org/10.3389/fphys.2021.758316 
  7. Han, D., Fang, X., Su, D., Huang, L., He, M., Zhao, D., Zou, Y., & Zhang, R. (2019). Scientific Reports, 9(1). https://doi.org/10.1038/s41598-019-55507-x 
  8. Harmon, K. K., Stout, J. R., Fukuda, D. H., Pabian, P. S., Rawson, E. S., & Stock, M. S. (2021). Nutrients, 13(6), 1825. https://doi.org/10.3390/nu13061825 
  9. Hira, T., Trakooncharoenvit, A., Taguchi, H., & Hara, H. (2021). International Journal of Molecular Sciences, 22(12), 6623. https://doi.org/10.3390/ijms22126623 
  10. Huang, S., Shen, Y., Ou, C., Tang, I., Yang, H., Kao, Y., Chang, W., & Chang, T. (2022). Food Science and Technology Research, 29(2), 129–140. https://doi.org/10.3136/fstr.fstr-d-22-00116 
  11. Jeromson, S., Gallagher, I., Galloway, S., & Hamilton, D. (2015). Marine Drugs, 13(11), 6977–7004. https://doi.org/10.3390/md13116977 
  12. Jimenez-Gutierrez, G. E., Martínez-Gómez, L. E., Martínez-Armenta, C., Pineda, C., Martínez-Nava, G. A., & Lopez-Reyes, A. (2022). Cells, 11(15), 2359. https://doi.org/10.3390/cells11152359 
  13. Kim, L. S., Burkholder, P. M., & Waters, R. F. (2002). Complementary Health Practice Review, 7(3), 221–229. https://doi.org/10.1177/153321010200700305 
  14. Kim, Y., Hong, K., Han, K., Park, Y. C., Park, J., Kim, K., & Kim, B. (2020). Nutrients, 12(9), 2856. https://doi.org/10.3390/nu12092856
  15. Kreider, R. B., & Stout, J. R. (2021). Nutrients, 13(2), 447. https://doi.org/10.3390/nu13020447 
  16. Kuang, X., Liu, C., Guo, X., Li, K., Deng, Q., & Li, D. (2020). Food & Function, 11(4), 3280–3297. https://doi.org/10.1039/c9fo03063h 
  17. Mafi, F., Biglari, S., Afousi, A. G., & Gaeini, A. A. (2018). Journal of Aging and Physical Activity, 27(3), 384–391. https://doi.org/10.1123/japa.2017-0389 
  18. McDonald, C., Henricson, E., Oskarsson, B., Aguilar, C., Nicorici, A., Joyce, N., Reddy, D., Wagner, A., deBie, E., Goude, E., Abresch, R., Villareal, F., Perkins, G., Hathout, Y., Dugar, S., & Schreiner, G. (2015). Neuromuscular Disorders, 25, S314–S315. https://doi.org/10.1016/j.nmd.2015.06.456 
  19. Meek, C. L., Lewis, H. B., Vergese, B., Park, A., Reimann, F., & Gribble, F. (2015). Peptides, 77, 38–46. https://doi.org/10.1016/j.peptides.2015.10.008 
  20. Miguéns-Gómez, A., Casanova-Martí, À., Blay, M. T., Terra, X., Beltrán-Debón, R., Rodríguez-Gallego, E., Ardévol, A., & Pinent, M. (2021). Nutrition Research Reviews, 34(2), 259–275. https://doi.org/10.1017/s0954422421000019 
  21. Moon, J., & Koh, G. (2020). Journal of Obesity & Metabolic Syndrome, 29(3), 166–173. https://doi.org/10.7570/jomes20028 
  22. Pazarci, Ö., Dogan, H. O., Kilinc, S., & Çamurcu, Y. (2019). Medical Principles and Practice, 29(3), 219–224. https://doi.org/10.1159/000502132 
  23. Ramirez-Sanchez, I., Maya, L., Ceballos, G., & Villarreal, F. (2010). Hypertension, 55(6), 1398–1405. https://doi.org/10.1161/hypertensionaha.109.147892 
  24. Rathmacher, J. A., Pitchford, L. M., Khoo, P., Angus, H., Lang, J., Lowry, K., Ruby, C., Krajek, A. C., Fuller, J. C., & Sharp, R. L. (2020). The Journals of Gerontology Series A, 75(11), 2089–2097. https://doi.org/10.1093/gerona/glaa218 
  25. Shimoda, H., Hitoe, S., Nakamura, S., & Matsuda, H. (2015, June 1). https://pmc.ncbi.nlm.nih.gov/articles/PMC4502735/ 
  26. Smith-Ryan, A. E., Cabre, H. E., Eckerson, J. M., & Candow, D. G. (2021). Nutrients, 13(3), 877. https://doi.org/10.3390/nu13030877 
  27. Vasim, I., Majeed, C. N., & DeBoer, M. D. (2022). Nutrients, 14(3), 631. https://doi.org/10.3390/nu14030631
  28. Volpi, E., Sheffield-Moore, M., Rasmussen, B. B., & Wolfe, R. R. (2001). JAMA, 286(10), 1206. https://doi.org/10.1001/jama.286.10.1206 
  29. Walker, E. G., Lo, K. R., Pahl, M. C., Shin, H. S., Lang, C., Wohlers, M. W., Poppitt, S. D., Sutton, K. H., & Ingram, J. R. (2022). American Journal of Clinical Nutrition, 115(3), 925–940. https://doi.org/10.1093/ajcn/nqab418 
  30. Walker, E., Lo, K., & Gopal, P. (2023). Medicine and Pharmacology. https://doi.org/10.20944/preprints202309.0416.v1 
  31. Walker, E., Lo, K., Tham, S., Pahl, M., Lomiwes, D., Cooney, J., Wohlers, M., & Gopal, P. (2019). Nutrients, 11(11), 2754. https://doi.org/10.3390/nu11112754 
  32. Wang, Y., & Wu, R. (2022). Disease Markers, 2022, 1–7. https://doi.org/10.1155/2022/5653739 
  33. Wilson, G. J., Wilson, J. M., & Manninen, A. H. (2008). Nutrition & Metabolism, 5(1). https://doi.org/10.1186/1743-7075-5-1 
  34. Wu, J., Saovieng, S., Cheng, I., Jensen, J., Jean, W., Alkhatib, A., Kao, C., Huang, C., & Kuo, C. (2019). Journal of Functional Foods, 58, 27–33. https://doi.org/10.1016/j.jff.2019.04.032 
  35. Wu, J., Saovieng, S., Cheng, I., Liu, T., Hong, S., Lin, C., Su, I., Huang, C., & Kuo, C. (2018). Journal of Ginseng Research, 43(4), 580–588. https://doi.org/10.1016/j.jgr.2018.06.002 
  36. Wu, S., Chen, K., Hsu, C., Chen, H., Chen, J., Yu, S., & Shiu, Y. (2022). Nutrients, 14(6), 1255. https://doi.org/10.3390/nu14061255 
  37. Wu, S., Jia, W., He, H., Yin, J., Xu, H., He, C., Zhang, Q., Peng, Y., & Cheng, R. (2023). Nutrients, 15(21), 4569. https://doi.org/10.3390/nu15214569 
  38. Zhang, L., Wang, Y., Sun, Y., & Zhang, X. (2023). Nutrients, 15(10), 2277. https://doi.org/10.3390/nu15102277
  39. Zhang, S., Miller, D. D., & Li, W. (2021). International Journal of Molecular Sciences, 22(4), 2128. https://doi.org/10.3390/ijms22042128