Re-establishing immune tolerance after bone chip removal

[Anthony Castore]

PHASE 1: ACUTE INFLAMMATION RESOLUTION (Weeks 1-4)

Goals: Eliminate DAMP signals, calm immune overactivation, stabilize gut barrier

– Thymosin Beta-4 Fragment: 200-500 mcg subQ daily. Promotes M1 to M2 macrophage shift, aids tissue repair.

– KPV Peptide: 500 mcg oral on an empty stomach 2xday Suppresses NF-B, IL-1, IL-6.

– Thymosin Alpha-1: 1.5 mg subQ twice weekly. Enhances regulatory T-cell activity and immune tolerance.

– Low-Dose Naltrexone (LDN): Begin at 1.5 mg nightly, titrate to 4.5 mg over 12 weeks. Blocks TLR4 and boosts Treg

populations.

– Tirzepatide: 2.5 mg subQ once weekly. Reduces IL-6, promotes M2 macrophage phenotype, enhances redox signaling.

– Larazotide Acetate: 0.5 mg three times daily, 15-30 minutes before meals. Restores gut tight junction integrity and reduces permeability.

– Omega-3 Fatty Acids (EPA/DHA): 2-3 g/day, divided with meals. Converts to resolvins and protectins to actively resolve inflammation. 1/2 Baby aspirin at night

– Curcumin BDMC: 500 mg twice daily with fat-containing meals. Selectively blocks NF-B and COX-2 pathways.

– Photobiomodulation (Red/NIR Light): 810-850 nm for 515 minutes daily over affected joint. Stimulates cytochrome c-oxidase, enhances mitochondrial function, and reduces inflammation.

– PEMF Therapy: 550 Hz, 2030 minutes/day. Supports vascular flow and synovial membrane repair.

– Optional Ivermectin: 3-6 mg weekly (physician-monitored). Promotes IL-10, reduces inflammatory signaling.

PHASE 2: IMMUNE RE-EDUCATION AND TISSUE REMODELING (Weeks 4-12)

Goals: Reinforce tolerance, rebuild extracellular matrix, support gut-immune-mitochondrial axis

– BPC-157: 250500 mcg subQ daily near affected joint or oral capsules 2x/day. Supports ligament, tendon, and endothelial healing.

– GHK-Cu: 2-5 mg subQ weekly or topical serum daily. Stimulates collagen and elastin production, reduces oxidative stress.

– UC-II (Undenatured Type II Collagen): 40 mg once daily on empty stomach. Promotes oral tolerance through GALT interaction.

– Lactulose: 5-10 mL/day, titrated based on bowel tolerance. Prebiotic for butyrate-producing microbes and SCFA stimulation.

– Butyrate (Tributyrin or Sodium Butyrate): 600-1200 mg/day, divided doses. Strengthens Treg function, reduces gut inflammation.

– Pentosan Polysulfate (PPS): 2 mg/kg subQ once weekly or oral if available. Promotes cartilage regeneration and reduces synovial inflammation.

– NAC + Glycine: 900 mg NAC + 2-4 g glycine per day. Enhances glutathione synthesis and supports redox homeostasis.

– Hyaluronic Acid (Oral): 100-200 mg/day. Lubricates joints and improves cartilage matrix integrity.

– Continue Tirzepatide weekly for metabolic and inflammatory support.

– Continue Omega-3s, Curcumin, and PEMF as needed based on inflammation level.

PHASE 3: SYSTEMIC IMMUNE RESET & LONG-TERM TOLERANCE (Months 3-6)

Goals: Deep immune tolerance, mucosal healing, metabolic homeostasis

– Continue Butyrate as tolerated (reduce to 600 mg/day for maintenance).

– Akkermansia muciniphila: 10^9 CFU/day as a targeted probiotic. Enhances mucin layer and gut epithelial barrier.

– IgY (Hyperimmune Egg): 12 scoops daily or capsule equivalent. Neutralizes gut pathogens and supports oral immune tolerance. (Xymogen)

– Anti-Inflammatory Diet: Rotated low-lectin, low-histamine, whole-food diet. Reinforces systemic tolerance.

– Epitalon: 10 mg subQ nightly for 10 days per month. Regulates pineal-immune signaling and reduces immune aging.

– Cerluten: 2 caps/day, 5 days per week. Supports neuroimmune axis through epigenetic regulation.

– Optional: RGTA (ReGeneraTing Agents) or Exosomes monthly for unresolved immune or tissue damage.

– Photobiomodulation and PEMF may be reduced to 3 sessions per week for maintenance.

MONITORING

– Labs every 12 weeks: CRP, IL-6, TNF-, IL-17, Galectin-3, Ferritin

– Weekly symptom tracking: Joint pain, mobility, stiffness

– HRV or VO2 Max trends: Evaluate systemic recovery and redox status

 

 

[Anthony Castore]

Case Summary: Multisystem Dysfunction Following Viral Event and History of Anemia with Renal Involvement

Submitted by: Anthony Castore, SSRP Fellow & Strength Coach

Background & Clinical Context

First and foremost, I want to extend my deepest gratitude to Dr. Seeds, the SSRP team, and our extraordinary network of clinicians and colleagues. It is a privilege to be part of this community, and I welcome any insight—critical or confirmatory—as I continue to learn and improve.

Approximately three years ago, I experienced a significant health event that resulted in anemia and persistent renal complications. Although there have been brief periods of improvement, my iron metabolism and renal markers have remained suboptimal, as reflected in the labs I’ve submitted. Despite following what I believe to be a thoughtful, precision-based protocol, my recovery capacity has never fully returned. I maintain a lean body composition (consistently under 10% body fat via InBody), a VO₂ max of 64, and a structured diet rich in protein, fiber, fruits, vegetables, and fermented foods. Nonetheless, I frequently feel inflamed, under-recovered, and mentally depleted.

I’m still a meathead at heart—health is my primary goal, but I’ve always been fascinated by the pursuit of muscle and performance. That drive, while a gift, also becomes a trap. I have a hard time reading about a compound’s potential benefits without wanting to add it to my protocol. The bigger issue is that with so many layers in play, I often forget to rotate things out. Between the supplements, peptides, and variables I’m trying to micromanage, I lose sight of what’s actually working. This recent experience has been a powerful reminder to simplify, focus, and build from what matters most.

Prior to 2022, I would fall ill roughly once every six months. Since then, I feel as though my immune system is constantly fighting off something—despite using diverse interventions to support microbial health, including high-dose tributyrin (~2000 mg/day). My SCFA production remains low. My energy is unstable, cognitive function is blunted, and what was once a photographic memory now feels like a foggy echo of my former self. Strength and muscle mass are visually intact, but I crash hard after training and often require 5–6 days to recover from just a few intense workouts.

Recent Event

On June 26th, 2025, I experienced a sudden and severe decompensation. My Oura ring showed a consistent elevation in body temperature (~0.6°F above baseline) for two weeks prior. That Monday, I awoke dizzy and disoriented but, being stubborn, still trained intensely—squatting 600 lbs for seven reps. Later that day, I developed dyspnea and assumed it was positional vertigo. I attempted the Epley maneuver with no relief.

By Wednesday morning, I collapsed while walking my dog and was unable to breathe. Emergency services were called, and I was intubated. Labs revealed profound metabolic acidosis (CO₂ at 17), hyperkalemia (K⁺ at 6.0), and hypophosphatemia. My clinical picture was consistent with redox collapse, likely triggered by systemic inflammation, mitochondrial dysfunction, and impaired acid-base regulation.

Since being discharged, I’ve noticed an unusual sensory change: an incredibly heightened sense of smell and taste, which began immediately following the ICU event. It has been persistent and notable enough to mention, as I wonder whether it reflects neuroinflammatory changes, vagal involvement, or an oxidative stress response in the olfactory pathways.

Laboratory & Clinical Findings

• Renal Dysfunction: GFR fluctuating between 40s–60s, proteinuria, glycosuria, and a rising BUN/creatinine ratio.
• Inflammation: Elevated IL-6, persistently high hsCRP, and homocysteine suggest chronic inflammation and methylation strain.
• Lipid Dysfunction: Total cholesterol 309, LDL 239, HDL 24, triglycerides 256—indicating hepatic overdrive and poor lipid handling.
• Oxygen Utilization: High hemoglobin, hematocrit, and RBCs may reflect compensatory erythropoiesis or poor oxygen extraction/utilization.
• Mitochondrial Strain: Noted decline in phospholipid integrity (Neuro & Glia markers via ProdromeScan) and DHA plasmalogens.

Working Theory

I suspect this event was precipitated by a combination of unresolved mitochondrial dysfunction, chronic inflammatory signaling, and possibly viral insult, culminating in acute redox collapse. The sense of acidity I reported subjectively aligns with suppressed bicarbonate, low CO₂, and rising uric acid. My working hypothesis is that my system lacks the mitochondrial resilience to buffer against additional immune and metabolic strain, resulting in systemic decompensation under load.

Proposed Interventions for Review

Given this framework, I’m exploring a tiered recovery protocol and would value feedback on sequencing, dosing, and omission:

• SS-31 (Elamipretide): Daily IV or subQ dosing for cristae stabilization and reduction of electron leakage from Complex I/III. I have 30 x 100 mg vials available.
• ARA 290: SubQ dosing 2–3x/week to modulate inflammatory signaling (EPOR-CD131) and support renal and neurovascular tissue repair.
• Cerebrolysin: IM or IV to address cognitive symptoms, neuroinflammation, and support synaptic plasticity and mitochondrial biogenesis post-ICU.
• Adjunctive Stack:
  • Methylation Support: TMG, 5-MTHF, Methyl B12
  • Mitochondrial Cofactors: Acetyl-L-Carnitine, PQQ
  • Phospholipids: Prodrome Neuro and Glia
  • Redox Modulation:Idebenone
  • Fatty 15
  • PC complex
  • Bodybio PC
  • B Supreme
  • ADK
  • Medications:
  • Cytomel
  • Synthroid
  • Jatenzo
  • Ezibitimibe
  • Cialis
  • Telmisarten
  • Farxiga
  • Tributryn
  • Ketone Ester Ke4

Request for Guidance

Does this framework appear sound, or am I overlooking a more foundational issue? Is my interpretation of redox collapse and mitochondrial dysfunction consistent with the labs and clinical progression? Would you suggest prioritizing fewer variables and building from a simpler foundation?

I’ve had to come to terms with the fact that I’ve likely been trying to fix too many things at once. This recent event served as a much-needed reminder of the importance of precision, sequencing, and patience. I am deeply committed to getting this right—not just for myself, but for the many clients and colleagues I serve who face similar challenges.

With deep respect and gratitude, I invite any and all feedback, critiques, or suggestions. I am here to learn, and I trust the wisdom of this community more than any protocol I could write on my own.

Gratefully,

Anthony Castore

SSRP Fellow | Strength Coach | Student of the Process

 

[Anthony Castore]

Case Summary: Multisystem Dysfunction Following Viral Event and History of Anemia with Renal Involvement

Submitted by: Anthony Castore, SSRP Fellow & Strength Coach

Background & Clinical Context

First and foremost, I want to extend my deepest gratitude to Dr. Seeds, the SSRP team, and our extraordinary network of clinicians and colleagues. It is a privilege to be part of this community, and I welcome any insight—critical or confirmatory—as I continue to learn and improve.

Approximately three years ago, I experienced a significant health event that resulted in anemia and persistent renal complications. Although there have been brief periods of improvement, my iron metabolism and renal markers have remained suboptimal, as reflected in the labs I’ve submitted. Despite following what I believe to be a thoughtful, precision-based protocol, my recovery capacity has never fully returned. I maintain a lean body composition (consistently under 10% body fat via InBody), a VO₂ max of 64, and a structured diet rich in protein, fiber, fruits, vegetables, and fermented foods. Nonetheless, I frequently feel inflamed, under-recovered, and mentally depleted.

I’m still a meathead at heart—health is my primary goal, but I’ve always been fascinated by the pursuit of muscle and performance. That drive, while a gift, also becomes a trap. I have a hard time reading about a compound’s potential benefits without wanting to add it to my protocol. The bigger issue is that with so many layers in play, I often forget to rotate things out. Between the supplements, peptides, and variables I’m trying to micromanage, I lose sight of what’s actually working. This recent experience has been a powerful reminder to simplify, focus, and build from what matters most.

Prior to 2022, I would fall ill roughly once every six months. Since then, I feel as though my immune system is constantly fighting off something—despite using diverse interventions to support microbial health, including high-dose tributyrin (~2000 mg/day). My SCFA production remains low. My energy is unstable, cognitive function is blunted, and what was once a photographic memory now feels like a foggy echo of my former self. Strength and muscle mass are visually intact, but I crash hard after training and often require 5–6 days to recover from just a few intense workouts.

Recent Event

On June 26th, 2025, I experienced a sudden and severe decompensation. My Oura ring showed a consistent elevation in body temperature (~0.6°F above baseline) for two weeks prior. That Monday, I awoke dizzy and disoriented but, being stubborn, still trained intensely—squatting 600 lbs for seven reps. Later that day, I developed dyspnea and assumed it was positional vertigo. I attempted the Epley maneuver with no relief.

By Wednesday morning, I collapsed while walking my dog and was unable to breathe. Emergency services were called, and I was intubated. Labs revealed profound metabolic acidosis (CO₂ at 17), hyperkalemia (K⁺ at 6.0), and hypophosphatemia. My clinical picture was consistent with redox collapse, likely triggered by systemic inflammation, mitochondrial dysfunction, and impaired acid-base regulation.

Since being discharged, I’ve noticed an unusual sensory change: an incredibly heightened sense of smell and taste, which began immediately following the ICU event. It has been persistent and notable enough to mention, as I wonder whether it reflects neuroinflammatory changes, vagal involvement, or an oxidative stress response in the olfactory pathways.

Laboratory & Clinical Findings

• Renal Dysfunction: GFR fluctuating between 40s–60s, proteinuria, glycosuria, and a rising BUN/creatinine ratio.
• Inflammation: Elevated IL-6, persistently high hsCRP, and homocysteine suggest chronic inflammation and methylation strain.
• Lipid Dysfunction: Total cholesterol 309, LDL 239, HDL 24, triglycerides 256—indicating hepatic overdrive and poor lipid handling.
• Oxygen Utilization: High hemoglobin, hematocrit, and RBCs may reflect compensatory erythropoiesis or poor oxygen extraction/utilization.
• Mitochondrial Strain: Noted decline in phospholipid integrity (Neuro & Glia markers via ProdromeScan) and DHA plasmalogens.

Working Theory

I suspect this event was precipitated by a combination of unresolved mitochondrial dysfunction, chronic inflammatory signaling, and possibly viral insult, culminating in acute redox collapse. The sense of acidity I reported subjectively aligns with suppressed bicarbonate, low CO₂, and rising uric acid. My working hypothesis is that my system lacks the mitochondrial resilience to buffer against additional immune and metabolic strain, resulting in systemic decompensation under load.

Proposed Interventions for Review

Given this framework, I’m exploring a tiered recovery protocol and would value feedback on sequencing, dosing, and omission:

• SS-31 (Elamipretide): Daily IV or subQ dosing for cristae stabilization and reduction of electron leakage from Complex I/III. I have 30 x 100 mg vials available.
• ARA 290: SubQ dosing 2–3x/week to modulate inflammatory signaling (EPOR-CD131) and support renal and neurovascular tissue repair.
• Cerebrolysin: IM or IV to address cognitive symptoms, neuroinflammation, and support synaptic plasticity and mitochondrial biogenesis post-ICU.
• Adjunctive Stack:
  • Methylation Support: TMG, 5-MTHF, Methyl B12
  • Mitochondrial Cofactors: Acetyl-L-Carnitine, PQQ
  • Phospholipids: Prodrome Neuro and Glia
  • Redox Modulation:Idebenone
  • Fatty 15
  • PC complex
  • Bodybio PC
  • B Supreme
  • ADK
  • Medications:
  • Cytomel
  • Synthroid
  • Jatenzo
  • Ezibitimibe
  • Cialis
  • Telmisarten
  • Farxiga
  • Tributryn
  • Ketone Ester Ke4

Request for Guidance

Does this framework appear sound, or am I overlooking a more foundational issue? Is my interpretation of redox collapse and mitochondrial dysfunction consistent with the labs and clinical progression? Would you suggest prioritizing fewer variables and building from a simpler foundation?

I’ve had to come to terms with the fact that I’ve likely been trying to fix too many things at once. This recent event served as a much-needed reminder of the importance of precision, sequencing, and patience. I am deeply committed to getting this right—not just for myself, but for the many clients and colleagues I serve who face similar challenges.

With deep respect and gratitude, I invite any and all feedback, critiques, or suggestions. I am here to learn, and I trust the wisdom of this community more than any protocol I could write on my own.

Gratefully,

Anthony Castore

SSRP Fellow | Strength Coach | Student of the Process

 

[Anthony Castore]

Labs

[tim blend]

hey anthony, i am still a novice regarding prodrome scan results, and i am sincerely sorry you are going through this, but yours seem to have improved to some degree. PC improved dramatically, lipid profile better but ceramides and adrenal compounds are worse along with renal function which may represent some degree of dehydration. what major changes in diet and supplements changed your scan? I realize you are on many foor various reasons and may be hard to differentiate.

I took an interest because I was asked to tried a 6y.o. child with MIS-C and some of your markers and symptoms were similar.

Her parents came to our clinic because we recently started with TruDOSE therapy which they are very interested in doing. This child has spent the last 3 years post covid with every imaginal biological and immunosuppressant including freqent steroid brounds rendering her cushingoid (iatrogenic). Any suggestions or other physicians with experience would be humbly appreciated.

and wishing you the best.

[tim blend]

adrenic not adrenal, also look into trudose website and give me your thoughts or opinion.

Tim

[Author]

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