Small Nerve Fiber Neuropathy S/P covid vaccine and NAD dosing

[PATRICK FREE]

I am currently treating a 39 y/o male with a 1.5-year hx of generalized fatigue, brain fog, and weakness with a dx of Small Nerve Fiber Neuropathy (SNFN) s/p covid 19 vaccination. We have administered a 3-month senolytic protocol and are now in our second phase of treatment, which includes improving mitochondrial and cell efficiency, and includes the use of NAD and other mitochondrial precursors orally, on a daily basis, and IV NAD+ infusions. The patient is also being seen by UC Irvine’s long haul covid clinic and it was recommended to him to have NAD IV infusion therapy twice weekly for 4 weeks but was not given a specific dose. In our clinic, we typically start with 250mg IV and titrate up to 1gm as tolerated. In the given patient scenario, would any of you recommend a specific dosing protocol for this patient? Would titrating up to 1gm be ultimately necessary? Would a SQ protocol be equally efficacious?  Thank you for your time.

[Kristelle Reyes]

Hello @byurthgmail-com and  @cpaigepaigemd-com, would love to have your insights here. Thank you! 🙂

[Mitchell Fleisher, M.D., D.Ht., D.A.B.F.M.]

Patrick,

This case of Small Nerve Fiber Neuropathy may respond well to the following:

TA1 0.25 ml SQ QAM for 6 weeks

TB4 0.25 ml SQ QAM for 6 weeks

BPC-157 500 mcg po BID for 12 weeks

After 6 weeks, give ARA-290 0.5 ml BID for 8-12 weeks depending upon response

Also, give these agents:

R-Lipoic Acid 100 mg 4 capsules TID

ProdromeGlia 2 ml BID in food

Best, Mitch

 

[PATRICK FREE]

Good evening Dr. Fleisher. Thank you for your response. I have implemented nearly that exact protocol in regard to the TA1, TB4, and BPC-157, and just started the ARA-290. He also has severe fatigue, in which he is unable to complete a full day of work without naerly falling asleep and having to take a nap. He has been on oral NMN, with other mitochondrial enhancers/precursors such as L-carnitine, Alpha lipoic acid etc;  and I was giving him intermittent IV NAD infusions. I have not had a chance to watch the NAD conference up to this point, and my question may be answered within that seminar, but is there a recommended NAD+ dosing that one might use in this scenario?

I typically start low at 250mg and increase every two to four weeks, up to one gram, depending on response and symptoms. I am confident there has been a low CD38 load prior to the infusions, as he has been on a 2-3 month senolytic protocol. Thank you.

[William Seeds, MD]

Hello @free703msn-com

 

We did cover NAD extensively in the previous mastermind, which I highly recommend if you’re using it extensivly in your clinic, but ultimately the takeaway was that studies show that NAD in the long run is not the ideal treatment method. We actually had a lot of attendees asking…so we came to NAD summit to learn not to use it?

 

To qualify that though, NAD can be used in select situations and is great for a reset, but extended use does not benefit the patient and instead, potentially negatively impacts the immune system so it’s greeat you have ta-1, tb4 as part of your protocol. Additionally, lifestyle changes to endogenously promote NAD naturally so that the NAD/NADPH ratios are aligned is another tool to utilize…along with NAD precursors.

 

Here is a guide on what to do for lifestyle changes – https://ssrpm1.s3.us-east-2.amazonaws.com/SSRP+Mastermind+7/Lecture+Give+Aways/NAD%2B+Patient+Education+(2).pdf

You also will want to include tryptophan and ketone esters, 5 amino 1mq – 150mg in the AM

 

hope that helps!

 

[Miguel Bertonatti]

Hi Michael, your link does not work. Thank you for the information.

[Leonid Gordin]

Hello Michael, I  was reading this post with interest. Would you please try to attach the link again because this one does not work. Thank you . Leonid

[Anabell De Leon]

Hello everyone:

My name is Anabell and I am new to the member platform.

What do you think about  ALA infusion for neuropathy?  I also would like to ask if anyone has patients requesting 1000mg NAD+ infusions and how you handle that.  Thank you

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