My method for prevention and control of my POIS symptoms - 80% to 100% effective

[Quantum]

Quantum,

Many thanks for your writing on the role of mast cell activation and IDO/TDO in POIS. I learned about your regimen from nightingale, and have got very good results. By trial and error, I am on a simplified pre-pack

Celebrex
Quercetin 500mg / Bromelain
Peppered curcumin 
5-HTP 50mg 

After pack
Magnesium (this one can be taken after an O)
Zinc (in the form of ZMA)

My symptoms in the T+48hr hrs are completely under control with these supplements.

Hi Romies, and welcome to the forum.

Thanks for registering and sharing your results, and thanks for your positive comments about my hypothesis on the role of mast cells and IDO/TDO upregulating in POIS.    I am glad that it has helped you get relief for your symptoms.   

Your simplified pre-pack is interesting:  a TDO inhibitor, a IDO inhibitor, and a COX-2 inhibitor, and all three have anti-inflammatory properties ( and the fourth also, considering the bromelain in the quercetin preparation ).  If you have added 5-HTP, I suppose you may also have some emotional symptoms when in POIS, or some hypotension. 

Magnesium is very helpful for me too, but never tried ZMA  ( I sometime take zinc, but tends to give me nausea a lot, so I have not included it in my pre-pack)


If you agree to, you can answer the following questions, which can be of help to better document your results:

You mention brain fog, and fatigue.  Do you also have emotional symptoms like anxiety, irritability, and mood swings ?   Do you have other major symptoms ?

Your symptoms are now down to a 48 hours duration with this pre-pack and were lasting longer before, or they are totally gone, and where lasting 48 hours before ?


You are right about the potential cardio-vascular effects of Celebrex ( celecoxib).  That is why it is on prescription only, here, in Canada, and elsewhere too.


Considering your exercise induced fatigue, similar to mine, and your good results with TDO/IDO inhibitors, I will add you in my POIS types chart as a reference member in the same type as myself and G-man ( see http://poiscenter.com/forums/index.php?topic=2338.msg19448#msg19448 ). 
 

[romies]

Quantum,

Thank you for your kind words. I learned a lot from your posts. 

Your simplified pre-pack is interesting:  a TDO inhibitor, a IDO inhibitor, and a COX-2 inhibitor, and all three have anti-inflammatory properties ( and the fourth also, considering the bromelain in the quercetin preparation ).  If you have added 5-HTP, I suppose you may also have some emotional symptoms when in POIS, or some hypotension. 

5-htp gives me noticeable energy within the 48hrs after an O. I found as long as I have curcumin+quercetin+celebrex, even if I forgot taking 5-htp, I can gain energy back with a 5-htp tablet within 1 hr. Without curcumin/quercetin/celebrex, 5-HTP helps much less. I think this support your hypothesis of tryptophan depletion and excessive kynurenic acid

5-htp mostly solve the depressive mood issue during POIS period. and lack of energy.

I take the 10hr time-released 5-htp, since its half life is only 2.2-7.4 hrs. also to minimize the risk of cardio-fibrosis at high doses.

Magnesium is very helpful for me too, but never tried ZMA  ( I sometime take zinc, but tends to give me nausea a lot, so I have not included it in my pre-pack)

ZMA is strictly before sleep with a nearly empty stomach. Normal dosage is 3 cap for men, but I usually just take 1 cap. I double the dose after an O to 2 caps. Zinc raises T-levels and modulate NMDR receptors (mostly inhibitory) as well. see https://www.ncbi.nlm.nih.gov/pubmed/21504727

You mention brain fog, and fatigue.  Do you also have emotional symptoms like anxiety, irritability, and mood swings ?   Do you have other major symptoms ?

I have depressive moods, irritability, and anxiety during POIS period. and flu-like sore throat symptoms (resolved with NAC supplements). I have documented the evolution of my regimens over nakedscientist forum with the same id a few years ago, a bit similar to Kurtosis' symptoms. 

I respond to Methyl-folate and NADH quite well (I am an A1298C homozygote). But they only solve 40-50% of my POIS symptoms, not as reliable as curcumin/quercetin/celebrex combo.

I also respond to Claritin-D 24hrs. I used to take it after an O, but it is really the pseudoephedrine masking the cognitive/mood POIS symptoms for me. It only works for about 24 hrs and then I would be exhausted. Claritin-D 12 hrs does not work as well. Regular Claritin shows little effect.

Your symptoms are now down to a 48 hours duration with this pre-pack and were lasting longer before, or they are totally gone, and where lasting 48 hours before ?

Completely gone now. They used to last at least 48 hrs. If i have multiple-O in one night, it has lasted as long as 5-7 days before.

You are right about the potential cardio-vascular effects of Celebrex ( celecoxib).  That is why it is on prescription only, here, in Canada, and elsewhere too.

Any ibuprofen extended release OTC in North America? I might give that a try. Celebrex has been shown as a mast-cell stabilizer. I am not aware of ibuprofen has shown that effect in particular.

Quercetin moderately inhibits CYP2C8, CPY2C9, CYP2D6, CYp3A4
Curcumin + bioperine moderately inhibits CYP2D6, CYP1A2 CYP3A4
    Curcumin is also a dose-dependent MOAI (https://www.ncbi.nlm.nih.gov/pubmed/18766332), but our dosage is far lower than the ones used in the research.

So I assume Quercetin+Curcumin will make the half life of Celebrex even longer.

Considering your exercise induced fatigue, similar to mine, and your good results with TDO/IDO inhibitors, I will add you in my POIS types chart as a reference member in the same type as myself and G-man ( see http://poiscenter.com/forums/index.php?topic=2338.msg19448#msg19448 ).

Looks good. Thanks for all the work in organizing the different types.

My exercise induced fatigue/brain fog used to be really bad, that even a strong cup of coffee cannot wake me up from the dazed state within the T+24 hr period. But with same pre-pack, I was really amazed that I did not feel anything cognitive hangover from my workout the day after.

[fsol]

I'm adding to this post to let you know about my experiences with Quantum's pre pack.

I've been using the pre pack 4 times now and I have positive results as well. The 80% relief is accurate in my case. Until now I've been taking a daily dose + pre pack consisting of b1, b6, b12, magnesium, zinc and gingko biloba but Quantum's pre pack is for me more effective. Plus, I don't have to take it on a daily basis.

So far, the only thing I'm going to change in the pack, is to switch the green tea extract for caffeine free green tea extract, as I'm a light sleeper and feel that the caffeine affects my sleep. It's still early in the testing and more changes could come, but for now this pack seems to work very well.

This is the closest I've come to being POIS free after O, and I'm very happy to be feeling this good. I feel that the last 20% might come down to things like a healthy diet, meditation, exercise and a general balance and well being of the mind. These things are important to work on as well.

Thank you Quantum for your testing, advice and hard work on this pre pack!

[Quantum]

Thanks you very much, fsol, for this feedback, and for your kind words.   I am very happy for you that you have achieved a higher level of relief with my pre-pack method

I am happy to see that G-man, romies and you have as good results as I have with this pre-pack method, so it shows that it is a valuable approach and was not just "my thing".

I wish you to find the necessary adjustments that will bring you an even higher level of relief.  Keep us updated on your progress, and have a nice POIS-free day !


(p.s.:  I will include you as a reference member in my POIS Types Chart for the Pre-pack type /  IDO/TDO/NMDAr blockers+ anti-oxidants type )

[mellivora]

I've just been re-reading this thread and am interested in trying your pre-pack Quantum. I'm curious to know if anyone has tried Quantum's pre-pack WITHOUT noticeable effects.

(Niacin didn't do anything for my symptoms either Quantum. I agree meditation could be effective if the vagus nerve is involved. Regardless, I found it beneficial generally in life though have not maintained a routine for a while. Its a good reminder to get back to it.

Thanks for sharing as always

[Quantum]

Thanks for your comments, Mellivora.  Great to hear a bit from you, too.

I am not sure that, to date, that many have tried my pre-pack method,maybe because it requires 9 to 10 different products, so it is not simple.  Unless someone experiments and develop is own simplified version, like romies have done.   

If you try this pre-pack method, be sure to let us know, whatever the results you get.


Regular meditation, yes, is great for many aspect of health and quality of life, as proven by many scientific studies.  It is good for stress, for blood pressure, for anxiety, for sport performance, for learning, and so on.  Even as little as 5 to 10 mins every day is ok.  It takes about 4 to 6 weeks before noticing cumulative benefits.   Skipping a day form time to time is no worry, but it has to be fairly regular to keep the ball rolling - it is like a momentum you build.  In fact, it does build up a theta-alpha default resonance in the brain, and each day, when meditating, you kind of recharge, reinforce this calmness pattern in your neuronal circuits.
 

[Quantum]

Hi everyone, just a short update to let you know that my pre-pack is still effective for me after more than 2 years

I still have the same composition.  It happens that, when I am on a "tight schedule" and I really need to avoid any symptoms, that I add up a few other things to my pre-pack, like Naprosyn  ( a nsaid), but I avoid it as much as possible an stick to my usual pre-pack.


Because of my pre-pack being efficient, I could say now that I have more symptoms when I have a NE ( before my pre-pack, the symptoms after a NE were relatively lower than after "waking state" release), because I cannot take anything in advance for it.  It doesn't happen very often, but whenever it happens, I take my pack as soon as I can, when I become aware of the situation ( I always have a bottle by my bedside with a complete "pre-pack" in it, prepared in advance ).  I try to manage with precision the time between my releases so that I don't have to go through a NE, but my body and mind do not always collaborate and sometime a NE occurs before my "due date".   Well, that's annoying, but it is way better than what I had to go through for most of my life, with decades where I was vulnerable to full POIS anytime !

[romies]

I still have the same composition.  It happens that, when I am on a "tight schedule" and I really need to avoid any symptoms, that I add up a few other things to my pre-pack, like Naprosyn  ( a nsaid), but I avoid it as much as possible an stick to my usual pre-pack.


Because of my pre-pack being efficient, I could say now that I have more symptoms when I have a NE ( before my pre-pack, the symptoms after a NE were relatively lower than after "waking state" release), because I cannot take anything in advance for it.  It doesn't happen very often, but whenever it happens, I take my pack as soon as I can, when I become aware of the situation ( I always have a bottle by my bedside with a complete "pre-pack" in it, prepared in advance ).  I try to manage with precision the time between my releases so that I don't have to go through a NE, but my body and mind do not always collaborate and sometime a NE occurs before my "due date".   Well, that's annoying, but it is way better than what I had to go through for most of my life, with decades where I was vulnerable to full POIS anytime !

In addition to having the pre-pack at the night stand and taking it upon waking after a NE,  I now have a single-tablet generic Claritin-D 24 hrs upon waking in the morning, which reduce the cognitive/emotional symptoms to less than 10%.
    Claritin-D 24 hrs is the most reliable mild 24-hr timed-release of pseudoephedrine, that boosts my nor-epinephrine levels, and allow me to function after an NE.

Most of time, I only need a single Claritin-D dose after NE. If the symptoms persist on the 2nd day (rarely happens), I take a 2nd dose.

I have tried Claritin-D 12 hrs and many other OTC meds containing pseudoephedrine, but none provides the smooth and lasting effect like Claritin-D 24hrs. You may also want to experimenting with different brands. I found even for the 24-hr formulation, there is perceivable difference in how the med is released overtime.

I don't recommend taking pseudoephedrine often. It has many side effects, such as increasing blood pressure.

[rainman]

Quantum, thank you for your contributions to this forum and to all of the POIS sufferers.

Just to give a little background about myself, and to share some of the similarities I see between us.

I am in my late 30's. I have had POIS symptoms probably for the last 10-15 years, but because the symptoms were getting worse in the last few years. It led me to research what my problem was, and I found this forum.

My biggest symptoms are a combination of the physical and emotional. On the physical side, I would get sinus headaches and post-nasal drip, which I could address with advil cold and sinus. But, the bigger challenge for me has been the brain fog, and the emotional/depressive symptoms.

In my teenage years and early 20's, I also dealt with Social/General Anxiety issues. I never got professional help for that. I found love in my early 20's (got married), and that pretty much addressed any anxiety issues I had. But, POIS related symptoms were still a challenge, as it can completely change your current perspective on life. Everything can be going great, but you start looking for issues which really don't exist. To add, because I had difficulty creating relationships with the opposite sex when I was younger, I feel like I probably resorted more to masturbation. I dont think it was extreme, probably just a daily routine. Not sure if that has caused me to have more issues or not as I grow older.

Here is where I am at right now. I am running a fairly successful business, and a lot people depend on me to perform. In addition to that, I don't want to put myself in a position that I can also hurt my wife when I have an episode. In the last 1 to 2 years, my solution has been to completely abstain from having any releases (I have my wife's support here). The problem I have though, are the Nocturnal Emissions that are out of my control. I have at least 1 every few months.

I have already purchased all of the supplements in your PRE-PACK. Here is my question. Because my problem right now is due to NE's or any type of premature ejaculation. Is it an option to take your PRE-PACK on a daily basis, that if an NE does occur, I am already covered for the day?

Thank you,
Rainman

[Quantum]

Hi Rainman,

Thanks for your good words about my contributions here.

About taking the pre-pack every day, it was not what I had in mind, because the body tends to develop tolerance to any supplement over time, so I wanted to keep the effect "fresh" when needed. 

My way to deal with NE is to have a pre-pack always ready, with water, at my bedside, so as soon as I realize I had a NE, I take my pre-pack.  It still help a lot with POIS, even if a little bit less than when I have the possibility to take my pre-pack 30 minutes before release.  However, I always had less symptoms following a NE than a "waking state" release, so all in all, taking my pre-pack just after a NE is almost as efficient as taking it before a waking state release.

I usually wake up right after a NE, so it allows me to take my pre-pack.  If I realize it only later, upon awakening, I take my pre-pack anyway, it is always better than not taking it ( even 2 to 3 hours after, I can have as much as 50% relief).  My POIS has a onset daily of a few hours, so it is never too late to take my pre-pack, but it is definitively more efficient when taken before release.


However, I do take omega-3 almost every day. You could try a hybrid approach and take some supplements everyday, but not all of them.  This will keep some edge for when really needed.

Thanks for joining the forum, and for sharing your POIS story.  If you have any question about how I use my pre-pack, don't hesitate to ask. 

[rainman]

Quantum,

Thank you for the advice.

Since I started taking your PRE-PACK as a daily supplement routine for the last week or so. I do feel much more energized. I was not taking any other supplements prior to this. So whatever is giving me that boost, I don't mind continuing with it.

If I do go with a trimmed down version of your PRE-PACK for a daily routine. What would you recommend that I keep taking daily? The rest I would just reserve post-NE release.

One more question. Let's say you take your PRE-PACK in the morning. But, you have a release 5 hours later. Is the affect just as good as taking it 1 hour prior to release?

Thanks,
Rainman

[Quantum]

Hi Rainman,

I cannot tell you what you should take or not ( it is against forum rules), as it is a personal choice, but I can share what I would do for myself.

First, your question made me realized that I didn"t mentioned the slight change I have done to my pre-pack a few months ago.  I have reduced magnesium to 1 tablet instead of 2 ( to avoid any chance to have loose stool the following day), and have "replaced" it by a capsule of Omega-3 ( 600mg EPA, 300mg DHA).  I have changed my post at the beginning of this thread to reflect this small change.  Like I said, I was taking Omega-3 fatty acids quite regularly, and often after release when some residual symptoms, but decided to take it before, and made it a part of my pre-pack.

My pre-pack is now:

1 x Quercetin 500mg / Bromelain 750GDU (TDO inhibitor, antioxidant, anti-allergy, mast cells stabilizer )
1x Peppered curcumin  (curcuma longa 400 mg + piperin 5mg) (IDO inhibitor , anti-inflammatory, antioxidant, mast cells stabilizer, anxiolytic )
1 x 5-HTP 50mg  ( serotonin precursor )
1 x Green tea extract 200mg ( antioxidant,  raises blood pressure, potentiation of 5-HTP in the brain by inhibiting its peripheral metabolism by Dopadecarboxylase , NMDAR blocker, mast cells stabilizer [EGCG] )
1 x Magnesium 100mg / tablet (NMDAR blocker, potassium regulator)
2 x Flaxseed oil,  1000mg/caps ( NMDAR blocker, antioxidant )
1 x Omega-3 triple concentration, 600 mg EPA/ 300 mg DHA ( emotional support/anxiolytic, ant-inflammatory effect )
1 x Lycopene  10mg (antioxidant having an affinity for the prostate )
1 x L-Theanine 250mg (NMDAR blocker, and supposed mast cells stabilizer )
1 x potassium citrate ( electrolytic rebalancing) ( IMPORTANT WARNING for all members:  I personally have a tendency to low potassium , = hypokalemia. This is a personal condition, so, do not take potassium supplements without the advice of your health professional,  if you take too much of it for your own needs, it can be dangerous, and can even cause fatal cardiac arrhythmia if you take too much,  This potassium intake may be related to a very personal condition, so I am not sure at all that it is needed for others)

All this taken, like mentonned in my first post, with 2 drops of rosemary essential oil, when the situation can allow me to do so, like for a planned release ( rosmarinic acid act as an IDO inhibitor, and also has gaba-enhancing properties through GABA transaminase inhibition, and rosemary also contains luteolin, a mast cells stabilizer ).

So, that being said, if I was to take a part of this daily, I would go with Omega-3, flaxseed oil, and peppered curcumin, and L-theanine if I happen to feel anxious.  The first 2 are lipophilic/oil, so their good effect cumulates with time.  Curcumin/turmeric is a good overall addition to a healthy lifestyle, and thousands of years of daily consumption in India have been proven safe and beneficial for health.

I already take quercetin/bromelain in my sport pre-pack, 2 times a week, and take it in my pre-pack in addition, but it is so effective and helpful that I wouldn't take every single day, I want it to keep an edge and make a difference when I take it.


I would not do separate pre-pack without the "daily" part, I would only use my whole pre-pack anyway, because, first of all, omega-3, flaxseed and curcumin are safe at those doses, even if 2 times the same day, and because I take my pre-pack either early in the morning or in the evening, when a release is planned, or during the night, in case of a NE, so if I want to skip a daily supplementation at breakfast, I can, knowing I have already taken those 3 in the pre-pack.

See what fits for you, and take to time to adjust your protocol to your own situation.

I am glad that you already feel energized, and I am not surprised.  It already happened once that I had an emergency call between the time I took my pre-pack, and the planned release.  I had to go, so no release.  I felt too much energy, for the remaining part of the dauy, from the pre-pack, and realized how hard I was struck by POIS so that I need that much supplements just to be functional and normal, but not energized, just normal, after a release.

[rainman]

Thank you Quantum for the detailed response.

[Quantum]

You are very welcomed.

I can mention that, living up North, with long winter with not much sunlight, I take 1000ui of vitamin D daily, but that is not for POIS, but for general health, to counteract lack of sunlight.  However, vit D is good for auto-immune problems, so it does not hurt.


Let me know after a while about the results you get, Rainman.

[rainman]

Quantum,

I will keep you posted. I need to muster the courage to take the PRE-PACK and plan a release. To see what happens. Since I have not had an NE yet.

Btw, at one point you had mentioned you take Taurine as well. Is that still part of your normal routine?

Thanks,
Rainman

[Quantum]

Hi Rainman,

No, taurine is not part of my normal routine.  I use it when there are some POIS "leftover" symptoms even if I took my pre-pack properly, among other products I have as a second line of defense ( with others like pine bark extract, pomegranate extract, Moducare,  vitamin C, ....).

I used to take it more often because I was more anxious ( taurine is a NMDS receptor blockers, which help with anxiety).  Well, after 10 years of psychotherapy, my baseline level of anxiety have decreased, and after 3 years of having found this forum and having developed my pre-pack,  anxiety is kept at bay, usually, now, so I need less supplement in order to control my anxiety.  And, at over 50, sex is less important in my relationship with my wife, and she really prefers when I stay myself ( I used to undergo a significant personality change during POIS), so she doesn't insist a lot for frequent sexual activity.  Less releases means less anxiety to manage, for me. In the last 3 years, she almost never saw the "anxious and exhausted madman" I become in POIS, and I think she is really ready to some compromise in order to never see him again.

[rainman]

Hi Quantum,

It's amazing. The way you describe your symptoms and relationship with your wife. It is almost identical to my situation. My wife rather have a stable/dependable man. Rather than someone who can easily change with the wind (I become an entirely different person, who cannot function like I normally do). On top of all of that, why have additional factors that can affect your ability to be successful at whatever you want to do professionally.

I feel really bad for those out there who have this problem, but do not know what it is. I hope one day your work get's the recognition it deserves, or those in the medical/scientific community wake up to realize this is a real problem men have to deal with.

Thanks again. You made a difference in my life.

[Quantum]

Thanks for your appreciative words, Rainman.

I hope your testing with pre-pack supplementation will lead to a good control of your POIS symptoms, so that your life and relationship will be easier to manage.

[positive_guy]

"1 x Quercetin 500mg / Bromelain 750GDU (TDO inhibitor, antioxidant, anti-allergy, mast cells stabilizer )"

Does that mean that one should take either Quercetin or Bromelain, or both of them?

[Quantum]

"1 x Quercetin 500mg / Bromelain 750GDU (TDO inhibitor, antioxidant, anti-allergy, mast cells stabilizer )"

Does that mean that one should take either Quercetin or Bromelain, or both of them?

Hi positive_guy,

The bromelaim in the preparation I take is there mostly to enhance quercetin absorption, because quercetin is not very well absorbed when on its own.  So, the properties listed after are those of quercetin.  Nevertheless, bromelain is a good natural anti-inflammatory in itself, so it is a valuable add-on.

I have listed the exact active ingredients of what I take in my pre-pack, to be accurate in my report of what works for me.    About the quercetin/bromelain, I suggest you include quercetin if it is safe for your condition and what you already take, and if the preparation you take also contains bromelain, I think it's a plus.

The quercetin/bromelain I take is very helping for me, both for POIS, and after post-sport fatigue.  I think I have already linked to the exact preparation I take, but can do it again here:  https://www.vitacost.com/vitacost-quercetin-bromelain-120-capsules   ( I have no commercial interests with Vitacost, though, I just link to it for informational purpose, and because my experience with them is that they have good prices, reliable delivery, and a good customer service ).