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Born Free
Getting started

Getting started


This protocol is a comprehensive framework which addresses how to quantify and remediate different aspects of chronic diseases that share mitochondrial dysfunction as a common feature. 

However, the protocol also spans over 250 printable pages - so it's also completely understandable if you find yourself feeling a bit overwhelmed by the volume of new information needing to be absorbed.. likely while still battling brain fog and energy envelope issues, chronic feelings of fight/flight and other challenges.

Removing some or all of these debilitating issues should help improve the absorption and retention of new information. The focus of this section is to order and integrate JUST the essential items needed to get started on stabilising the key metabolic pathways. You can integrate them using the order described below, also noted in the daily schedules / run-sheets provided at the end of this section.

Ideally after sending off your baseline tests, you may help stabilise critical parts of the metabolism and help avoid unwanted MCAS + other symptoms by;

 1. Pacing appropriately, to avoid low glycogen promoting the acidaemia-related spiral towards progressive electrolyte and mineral depletion, resulting in progressive baseline worsening (see 2.2.4 The importance of pacing).
2. Working on your lymph flow - (see 2.2.2 Lymphatic maintenance - this is especially important if addressing the nutrient deficiencies allows immune activity to initially increase, which is progressively more likely when these deficiencies are severe.)

Notes:
i) Failure to maintain lymphatic flow can result in compartment-specific pressure buildup, eg. intracranial pressure.
3. Consuming the suggested food items in 2.2.1 Diet, while also integrating the phases described in 2.2.3 Living without chronic dysbiosis - Gastrointestinal biofilms and pathogens. A new Meal Planner tool has also been added to help you reach targets safely.

Notes:
i) Eat strategically to ensure glycogen stores are being appropriately supported - this may easily be >150-180g of net carbohydrates / day, as glycogen synthesis / insulin sensitivity improves - absorbed across 3-6 meals / snacks. Carbohydrate needs reflect (immune) activity levels and other factors. A number of the supplements included below will help glycogen homeostasis.
ii) The initial goal is a low-inflammatory, low-histamine, low-oxalate diet. This will later expand to include a wide array of plants, their helpful polyphenols, microbiome nourishing fibres / starches and numerous other useful compounds, whilst accompanying targeted, staged probiotics that focus on butyrate production and epithelial integrity, before repopulating lactobacillus, bifidobacterium, oxalobacter and other helpful species. 

4. Stabilise the redox and mineral terrain. This includes VERY SLOWLY introducing :
        a) electrolytes, taken slowly over the day, by making a daily / weekly recipe of specific electrolytes and amino acids to put in a 500ml drink bottle and slowly sip / pour a "shot" into a glass, top up with water and drink between meals (see 4.3 DIY "sipper / shots"). You can start at eg. 1/8 daily doses and slowly increase. 

Resveratrol can be slowly added here (taken separately) 3x/day, to help protect against additional lactic acid being created by unblocking bottlenecks in glycolysis (correcting phosphate, magnesium, etc) while the TCA cycle is less efficient.

Liberally applying the magnesium gel after showering, can be highly effective for magnesium absorption and is included in the schedule.

Notes: 
i) Consuming too much at once may cause diarrhoea, headaches, nausea, water retention and/or rapid urination. 
ii) Calcium and to a lesser extent, potassium may temporarily increase adreneric / glutaminergic sensitivity and need to be increased more slowly than others. Calcium sensitivity needs to be tested and managed carefully. Adrenergic, dopaminergic and related auto-antibodies predict sensitivity and delay calcium repletion. Sodium phosphate can be used as an alternate phosphate source during careful calcium titration. (see 4.1 Electrolytes)
iii) Starting magnesium and/or phosphate can improve glucose uptake and glycogen synthesis. Experiencing symptoms that resemble hypoglycaemic events or diabetic "hangry" mood alterations may indicate more dietary carbohydrates are needed.
iv) This recipe can also be combined with eg. green or other tea, lemon juice, lime juice, acai, berry, etc for flavour. 
v) Shake before each use.

        b) antioxidants and mitochondrial cofactors (Vitamin C, Vitamin E, R-ALA, CoQ10, GSH donors like NAC), taken 2-3x/day. 

Notes:
i) These may need TINY doses, initially, eg. 50mg of Vitamin C, NAC.

        c) (usually less slowly) L-carnitine / acetyl L-carnitine, creatine (for fatty acid transport and ATP-PC pathway), uridine monophosphate (sublingually - ramping up from 10, to typically 50-100mg, 2x/day) and similar slowly ramp up of d-ribose, starting at 500mg, to 10g, in the daily DIY "sipper/shot" recipe. SLOWLY titrate a morning sublingual dose of inosine from 50-100mg (weeks 1-2) to 500mg. 

Notes:
i) Expect insulin sensitivity and glycogen synthesis to increase with uridine, D-ribose and inosine - be prepared to increase intakes of carbohydrates to facilitate glycogen synthesis and potentially sodium + other electrolytes, towards their daily targets. 
ii) Inosine is also an immune stimulant, and may trigger some initial immune activity - keep the dose low, eg. 50-100mg for the first 1-2 weeks.

        d) Adding mineral cofactors like zinc, copper, iron, manganese, selenium, iodine, lithium, rubidium, cobalt, boron, and molybdenum, etc. This helps balance the neurotransmitter synthesis pathway (and precursors), lowers the burden on ALDH and MAO pathways and reduces oxidative stress, allowing safer processing of neurotransmitter metabolites. (see 2.3.2 Remineralisation). 

Notes:
i) Many of the minerals require non-standard routes for absorption, eg. sublingual, liposomal, DMSO-carrier. 
ii) Remineralisation will be severely limited if acidaemia / acidosis is still present.

         e) Introducing B1 and B2 in active or near-active forms, such as FMN and TPP / cocarboxylase. These support mitochondrial redox balance, glycolysis, and the Pentose Phosphate Pathway. Depending on the severity of dysbiosis / acetaldehyde burden, the total daily B1 dosing can range from 50-600mg of the active form, cocarboxylase, starting from a low dose. 

Notes:
i) Compounded nutrients are available (see 4.2 Compounded nutrients) and replace a wide range of individual supplements. The compounded nutrients are potent, therefore starting at eg. 1/8th doses, may be helpful to soften / slow the metabolic shift when restoring severe deficiencies. 
ii) B vitamin titration options for patients with severe neuropsychiatric sensitivity are also discussed.
iii) Additional B1, in any form, can be added for further acetaldehyde adduct-forming and detoxification support, later - noting the impact of rapid removal of acetaldehyde -> endogenous morphine. (see 2.3.4 Rapid withdrawal, hypo/hypermetabolism) 
iv) Adding B1 can increase B9 transporter activity and SAMe availability, allowing some adrenergic signalling increase unless B2 and NAD+ are restored in balance - start slowly.

        f) Slowly layer in B5, B6 (as P5P), biotin, D-chiro inositol, B9 and B12 (as methylcobalamin or hydroxocobalamin) only after upstream redox stress is under better control. 

Notes:
i) B1, B9 and B12 can increase methylation -> SAMe availability, unblocking epinephrine synthesis at PNMT and also COMT activity, leading to hyper-adrenergic signalling if TOO MUCH is introduced quickly, ie. without sufficient B2 for MAO and NAD+ (and redox) for ALDH. 
ii) In the context of unresolved aldehyde or monoamine overload, these can also be disruptive (unless P5P is eg. dissolved in DMSO, bypassing impaired alkaline phosphatase (ALP) and pyridoxal kinase (PK) steps) and BH4 synthesis (dietary queuine - see "Vitamin Q deficiency").

NB. Reducing acetaldehyde and/or restoring NAD+:NADH status corrects a wide array of impaired metabolism, including the pathway issue which promotes endogenous morphine synthesis.
Stay keenly observant for rapid withdrawal symptoms and manage them proactively.

Then;
        g) Introducing NAD+ pool support (apigenin - P38 inhibitor), NAD+:NADH redox support (0.05-0.3mg of methylene blue, once per day), and

Notes:
i) Start at 50mcg of methylene blue per day and slowly increase until any metabolic shift is observed. Hold at that dose and look to decrease towards 50mcg, when appropriate.
ii) Expect and watch for alcohol / opioid withdrawal symptoms. Manage them proactively.

        h) Adding sublingual NAD⁺ / NADH (NOT precursors, for severe) at 5-10mg doses, 2x/day and increase to 20-40mg 2x/day. 

Notes:
i) Expect and watch for alcohol / opioid withdrawal symptoms. Manage them proactively.

5. Testing for and addressing blood-flow / hypoxia -> acidaemia issues - especially relating to chronic infection, thoracic outlet syndrome and cranial instability, affecting the CNS alarm signalling cascade (see 2.3.3 Blood-flow, hypoxia and fibrin-amyloid, 2.2.5 Slipped Rib Syndrome, costochondritis and chest pain and 2.2.6 Cortisol, limbic system, glycogen and IFN-γ).

6. Start working on identifying and addressing any/all other influences affecting histamine and/or sympathetic overdrive (see 2.2.6 Cortisol, limbic system, glycogen and IFN-γ). 
 
Notes:
i) Unrestricted, deep nasal breathing without localised inflammation is a basic requirement for parasympathetic signalling (see also 2.2.3 Living without chronic dysbiosis - Nasopharynx).


"Starter" daily schedule / run-sheet

Once you have sufficiently stabilised, you can continue onboarding and progressing through Stages 1, 2 and 3. The daily schedule options for the full protocol can be found in 2.3 Daily supplement schedule. 

However, to keep things more manageable for now - you can also download and print a simpler / more focused daily "starter" schedule / run-sheet - and there are two versions available:

You can choose this version (opens on a new page) if you intend on using the compounded nutrients, 
OR
you can choose this version (opens on a new page) if you intend on using separate store-bought supplements.

"Starter" product ordering links

If you are already committed to completing the whole protocol, the product ordering links for the primary pathway of the full protocol can be found in 5 Ordering products. However, you can also download a time-and-money saving spreadsheet of the starter items ONLY, before committing to the whole process:

For starter product ordering, you can simply choose your shipping region from the drop-down box and click on the Excel or CSV icon to download a spreadsheet of some starter items, with product ordering links and relevant information for preparation of time/effort-saving weekly recipes. This particular table is too complex to fit onto a webpage and easily manipulate, however works well in eg. Excel or Google Sheets, etc.