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

[Rock76]

Quercetin seems really interesting, but I am reading this
https://www.mountsinai.org/health-library/supplement/quercetin

"Preliminary evidence suggests that a byproduct of quercetin can lead to a loss of protein function. Very high doses of quercetin may damage the kidneys. You should take periodic breaks from taking quercetin. At doses greater than 1 g per day, there have been reports of damage to the kidneys."

If more than 1g can be bad, I don't feel completely safe at half a gram, especially long term.
Also I have read elsewhere that it has a diuretic effect and that it can cause tingling/neuropathy.

Any concern in your opinion?

In my own experience, I never used it daily.  I use it in my pre-pack, and whenever I have allergy symptoms, combined with Vitamin C ( it is very effective for runny nose and sneezing).  The formula I used never caused me any harm ( 500mg Q with bromelain added).
So, maybe better not taking the phystosome formula, after all, because it would equal to a large intake.  My regular, 500mg capsules, are ok for me.   

My approach, as illustrated by my pre-pack method, is too take a ibt of many substances rather than a lot of a single or a few substances.  This approach is based on the fact that many side effects are dose-dependent, meaning that they get worse as the dose increase.  By using low to normal doses with anything, I play safe.

Yes I was thinking the same, the phytosome one could be really dangerous.

Still regarding 'normal' quercetin (not phytosome) There's no long term data, If it can be harmful short-term at 1g+, maybe it's dangerous too at 250-500mg long term, We just don't know, I am not feeling completely comfortable with the 'normal' 500mg one even if just once-twice a week.
I will probably try it anyway soon.

[Rock76]

Can you help me understand if Quercetin raises or lowers vitamin b6 and b12 ? and how much ?

I seem to remember a website where it was said they were lowered but I can't find it anymore.
I have found here
https://www.liebertpub.com/doi/full/10.1089/act.2018.29197.mho
that it inhibits CYP3A4, don't know if it matters

[Quantum]

Can you help me understand if Quercetin raises or lowers vitamin b6 and b12 ? and how much ?

I seem to remember a website where it was said they were lowered but I can't find it anymore.
I have found here
https://www.liebertpub.com/doi/full/10.1089/act.2018.29197.mho
that it inhibits CYP3A4, don't know if it matters

To my knowledge, there is no interaction between vitamin b6 and b12, and quercetin.

CYP3A4 is not an issue with B vitamins, but there will be an interaction with the drugs eliminated by this liver enzyme.  However, quercetin is only a weak inhibitor fo CYP3A4 ( see https://en.wikipedia.org/wiki/CYP3A4#Ligands for details)

[Rock76]

Can you help me understand if Quercetin raises or lowers vitamin b6 and b12 ? and how much ?

I seem to remember a website where it was said they were lowered but I can't find it anymore.
I have found here
https://www.liebertpub.com/doi/full/10.1089/act.2018.29197.mho
that it inhibits CYP3A4, don't know if it matters

To my knowledge, there is no interaction between vitamin b6 and b12, and quercetin.

CYP3A4 is not an issue with B vitamins, but there will be an interaction with the drugs eliminated by this liver enzyme.  However, quercetin is only a weak inhibitor fo CYP3A4 ( see https://en.wikipedia.org/wiki/CYP3A4#Ligands for details)

Thank you. I asked because last year I developed a neuropathy (electric zap in 1 foot and a feeling of light internal trembling all over the body) after consuming an excessive amount of vitamin B6.
I was extremely worried when those symptoms started. I consumed 50mg a day which seemed very safe according to the US FDA daily upper limit of 100 mg, but later I found out that in Europe the upper limit is only 25mg and in UK even lower at just 10mg, so there seem to be major concerns about this Vitamin B6 which incredibly the US FDA doesn't know/understand.

Luckily my neuropathy resolved after some months but I have been in contact with people with B6 toxicity who had it for years and can't get out, like a neurological permanent damage.   

So I'd like to try quercetin for my POIS but after reading it might create tingling/neuropathy I am a bit worried. I have also found out quercetin significantly inhibits iron absorption, which by itself can create anemia and neuropathy, yes I guess this can be fixed by iron supplements but overall I am bit worried.

[BoneBroth]

Last months I also have got "electric zap" in my left foot under the heel and forward and also a tingling feeling in the skin of in my left leg. I've been taking B-complex with 25 mg, sometoimes I take it three times a day (75 mg). But the symptoms doesnt come when I've been out of POIS for a longer time (and still take the B-complex). I'm not so sure it's the vitamin B6 thats the bad guy here. Maye its the sublingual B12/folate (which skyrocked at at blood analyse). Or maybe POIS'ers are more prone to B6-excess then others. Or maybe a leaky gut absorb more of some vitamins. Well, my experience and gut feeling sais that there is much more likely to experience symptoms from deficiencies then excess.

[berlin1984]

P5P is supposed to be safer than normal B6.
i have a B-complex with "active" forms containing (for example) P5P instead of B6.

[Rock76]

P5P is supposed to be safer than normal B6.
i have a B-complex with "active" forms containing (for example) P5P instead of B6.

Supposed to be safer but it's not, P5P is what I got toxic from, and many people I am in contact with on some B6 groups got toxic from P5P, basically both forms are toxic

it seems many US researchs on B6/P5P are faulty and the FDA still has an upper limit of 100mg
which is largely different from Europe (25mg) and UK (10mg)

[Rock76]

Last months I also have got "electric zap" in my left foot under the heel and forward and also a tingling feeling in the skin of in my left leg. I've been taking B-complex with 25 mg, sometoimes I take it three times a day (75 mg). But the symptoms doesnt come when I've been out of POIS for a longer time (and still take the B-complex). I'm not so sure it's the vitamin B6 thats the bad guy here. Maye its the sublingual B12/folate (which skyrocked at at blood analyse). Or maybe POIS'ers are more prone to B6-excess then others. Or maybe a leaky gut absorb more of some vitamins. Well, my experience and gut feeling sais that there is much more likely to experience symptoms from deficiencies then excess.

you better stop the B6 immediately, When I took it (it was P5P which in theory is much safer but it's not) I used 50mg daily, for 1 month I felt like 20 years younger, incredible really, then the problems started

maybe people with POIS are more prone, yes

[BoneBroth]

Pyridoxine hydrochloride is the form of B6 I take (in a mix of all B-vitamins). According to the naturopathic doctors:

Recommended daily dose: 1-2,5 mg.
Optimal daily dose: 10-100 mg.
Terapeutic daily dose: 100-500 mg.

[Progecitor]

Can you help me understand if Quercetin raises or lowers vitamin b6 and b12 ? and how much ?

I seem to remember a website where it was said they were lowered but I can't find it anymore.
I have found here
https://www.liebertpub.com/doi/full/10.1089/act.2018.29197.mho
that it inhibits CYP3A4, don't know if it matters

In regard of CYP3A4 this may also need to be considered :

Prostate cells also express CYP3A4 that can inactivate T by conversion to mainly 6BOH-T (with 2B-, 15a/B- and 11B-hydroxyl side product formation and a decrease of CYP3A4 expression is observed in prostate cancer.
https://www.sciencedirect.com/science/article/pii/S0303720717304525

[Rock76]

Can you help me understand if Quercetin raises or lowers vitamin b6 and b12 ? and how much ?

I seem to remember a website where it was said they were lowered but I can't find it anymore.
I have found here
https://www.liebertpub.com/doi/full/10.1089/act.2018.29197.mho
that it inhibits CYP3A4, don't know if it matters

In regard of CYP3A4 this may also need to be considered :

Prostate cells also express CYP3A4 that can inactivate T by conversion to mainly 6BOH-T (with 2B-, 15a/B- and 11B-hydroxyl side product formation and a decrease of CYP3A4 expression is observed in prostate cancer.
https://www.sciencedirect.com/science/article/pii/S0303720717304525

and what does that mean ?

[Rock76]

Pyridoxine hydrochloride is the form of B6 I take (in a mix of all B-vitamins). According to the naturopathic doctors:

Recommended daily dose: 1-2,5 mg.
Optimal daily dose: 10-100 mg.
Terapeutic daily dose: 100-500 mg.

I used to read US FDA limits only, but after what happened I don't trust US upper limits anymore, I prefer European, which are in many cases lower, stricter and obviously safer.  (I live in Italy)

[demografx]

…I don't trust US upper limits [dosing] anymore…

Me, neither. I followed my OTC meds’ upper (and unsafe!) limit dosing and recently landed in the hospital’s Emergency Room, unable to walk a straight line without falling.

[Progecitor]

Can you help me understand if Quercetin raises or lowers vitamin b6 and b12 ? and how much ?

I seem to remember a website where it was said they were lowered but I can't find it anymore.
I have found here
https://www.liebertpub.com/doi/full/10.1089/act.2018.29197.mho
that it inhibits CYP3A4, don't know if it matters

In regard of CYP3A4 this may also need to be considered :

Prostate cells also express CYP3A4 that can inactivate T by conversion to mainly 6BOH-T (with 2B-, 15a/B- and 11B-hydroxyl side product formation and a decrease of CYP3A4 expression is observed in prostate cancer.
https://www.sciencedirect.com/science/article/pii/S0303720717304525

and what does that mean ?

I don't actually know how important this is. It only means that quercetin by inhibiting CYP3A4 may somewhat reduce the inactivation of testosterone. CYP3A4 also has a complex role in vitamin D metabolism.

Second, there was a highly significant correlation of 24-hydroxylase activity of 1aOHD2 with CYP3A4-mediated testosterone 6B-hydroxylase activity in a panel of 12 characterized human liver microsomes. The liver microsomes with the highest testosterone 6B-hydroxylase activity had the highest 24-hydroxylase activity. Third, dose-response studies showed that 24-hydroxylase activity in hepatic microsomes and recombinant CYP3A4 was inhibited in parallel by ketoconazole, a-naphthoflavone, isoniazid, and troleandomycin, known inhibitors of CYP3A enzymes.
We reported previously that CYP3A4 25-hydroxylates vitamin D2 and not vitamin D3. That the patient responded to modest pharmacologic doses of vitamin D2 by increasing serum 25OHD and serum calcium and healing the bone disease is attributed to 25-hydroxylation of the vitamin by CYP3A4.
https://academic.oup.com/jcem/article/90/2/1210/2837019?login=true#53049631

Importantly, induction of CYP3A4 in the small intestine could cause local tissue vitamin D deficiency and possibly directly affect intestinal calcium absorption.
https://sci-hub.se/https://www.sciencedirect.com/science/article/abs/pii/S0960076012001689

These data suggest that 1,25D3-dependent, VDR-mediated induction of CYP3A4 may constitute a chemoprotective mechanism for detoxification of enteric xenobiotics and carcinogens.
https://www.sciencedirect.com/science/article/abs/pii/S0006291X02027420

I couldn't find any indication between CYP3A4 and vitamin Bs, however it may worth considering that both testosterone and vitamin D have a correlation with vitamin Bs.

Vitamin b6 deficient animals have either a reduced rate of synthesis of testosterone or an increased rate of metabolic clearance compared with vitamin b6 supplemented controls, and this appears to be associated with enhanced target organ response to the hormone.
https://www.sciencedirect.com/science/article/abs/pii/0022473184903480

Vitamin D deficiency changes the intestinal microbiome reducing B vitamin production in the gut. The resulting lack of pantothenic acid adversely affects the immune system, producing a "pro-inflammatory" state associated with atherosclerosis and autoimmunity.
https://www.sciencedirect.com/science/article/abs/pii/S0306987716303504

[psy]

Hi Quantum,

I'm here on behalf of my husband with POIS. We are trying to conceive so ejaculating multiple times in a week during the ovulatory period is significantly affecting him. He is going to try your pre-pack for the first time. Do you use it if you ejaculate multiple days in a row or in a week? Thanks

[Quantum]

Hi Quantum,

I'm here on behalf of my husband with POIS. We are trying to conceive so ejaculating multiple times in a week during the ovulatory period is significantly affecting him. He is going to try your pre-pack for the first time. Do you use it if you ejaculate multiple days in a row or in a week? Thanks

Hi psy,
For years, I have avoided ejaculating multiple days in a row, because POIS symptoms are cumulative.  I have kept at least 3 days between 2 ejaculations, otherwise I feel very bad and stay in a deep POIS state for longer than usual.  And that is exceptional, I prefer no more than once a week, and once every 2 to 3 weeks is preferable now that I am over 50.  I do not know what are your husband's POIS symptoms and their severity, and I do not know how well he would respond to my pre-pack, so I cannot tell you if he can handle more than twice in 3 days.

You will have to experiment with this.  If he never tried the pre-pack before, I suggest he first try it for only one release, then see if it is helping him.   Then, try twice and 3 days, and maybe the month after, if everything went pretty well, you could try a little more than that, etc... 


In order to reduce the number of ejaculations needed during your ovulatory period, I suggest you use ovulation tests ( LH home tests), so that you know the exact day of your ovulation, which will reduce the need for numerous ejaculations.   At any rate, ask your health professional to help and guide you with this project.

I wish you the best for you two and for the future baby !

[psy]

Hi Quantum, thanks for getting back to me. I am responding now because he has trialed your pre-pack and so far we are quite happy with the results! His POIS symptoms tend to be quite severe (they've increased in severity and duration over time), lasting around 7 days at baseline, with extreme fatigue, cognitive symptoms where it is difficult to make decisions, emotional symptoms of irritability/depressed mood/anxiety, and significant neck pain. He has found his POIS symptoms cumulative as well which is what made trying to get pregnant even worse than just one off. He has taken duloxetine 30 mg daily which has helped significantly prior to this in reducing sex drive and increasing ability to engage in sexual activity without going to orgasm, and reduction in pain. Previous months of trying to get pregnant he has trialed and found some benefit with Tramacet though only for managing the pain.

This was his experience:

The pre-pack of supplements (what I had at home/could find in the pharmacy) he used included: Quercetin 500 mg, turmeric curcumin 500 mg (black pepper 3 mg), green tea extract 315 mg, magnesium 167 mg (with Calcium 333 mg, vitamin D3 200 IU), flaxseed oil 1000 mg x2, lycopene 10 mg and sleep supplement 'Olly' x2 of melatonin 1.5 mg/L-theanine 50 mg/Chamomile/Passionflower/Lemon balm. I excluded the 5-HTP given he is on duloxetine (SNRI) and was potentially going to take Tramacet (also serotonergic).

Day 0: He took the pre-pack prior to sex and noticed afterward it didn't feel like he usually describes it as a poison coming over him. Went to sleep.

Day 1: He experienced about 70-80% reduction in symptoms overall, mostly feeling just fatigue and some cognitive symptoms but not as badly. He tried taking ginkgo biloba and taurine a few times during the day which he thought may have been partially helpful. Any time he had a nap he has a reduction in symptoms as well.

He took the pre-pack again as we were having sex in our fertile window.

Day 2: He was experiencing more pain this day so started taking Tramacet (tramadol 37.5 mg/acetaminophen 325 mg) - took a total of 2 tablets throughout the day in halves. Supplemented again with ginkgo biloba and taurine. Overall feeling worse than day 1 but not as bad as usual POIS symptoms. Taking the sleep supplements at night.

Day 3: He managed mainly with Tramacet total of 2 tablets. Pain was at 50% of usual symptoms. Taking the sleep supplements at night.

Day 4 (today): Only took 1 tablet of Tramacet. In the morning was at 30% of usual symptoms. Tried out some flaxseed oil supplement, taurine, lycopene, green tea extract. Overall experiencing only 10 % of usual symptoms. 

The pre-pack in particular and perhaps (more difficult to say) the other supplements have been huge in reduction of symptom severity and duration along with intermittent Tramacet use and regular naps. Unfortunately he has to ejaculate again tomorrow as a semen analysis is required so we can see a fertility clinic (considering if he can freeze some sperm so we can do IUI and he doesn't have to experience as many symptoms), so obviously more significant symptoms will be returning. We are definitely in touch with our GP, sexual medicine clinic, and fertility clinic! All helpful. I will report back down the road how the pre-pack continues to work for him and how we end up tweaking things.

Thanks for your engagement in the forum and your own trial and error to get you to a place where you can help others with your own experiences.

[Quantum]

Hi Quantum, thanks for getting back to me. I am responding now because he has trialed your pre-pack and so far we are quite happy with the results! His POIS symptoms tend to be quite severe (they've increased in severity and duration over time), lasting around 7 days at baseline, with extreme fatigue, cognitive symptoms where it is difficult to make decisions, emotional symptoms of irritability/depressed mood/anxiety, and significant neck pain. He has found his POIS symptoms cumulative as well which is what made trying to get pregnant even worse than just one off. He has taken duloxetine 30 mg daily which has helped significantly prior to this in reducing sex drive and increasing ability to engage in sexual activity without going to orgasm, and reduction in pain. Previous months of trying to get pregnant he has trialed and found some benefit with Tramacet though only for managing the pain.

This was his experience:

The pre-pack of supplements (what I had at home/could find in the pharmacy) he used included: Quercetin 500 mg, turmeric curcumin 500 mg (black pepper 3 mg), green tea extract 315 mg, magnesium 167 mg (with Calcium 333 mg, vitamin D3 200 IU), flaxseed oil 1000 mg x2, lycopene 10 mg and sleep supplement 'Olly' x2 of melatonin 1.5 mg/L-theanine 50 mg/Chamomile/Passionflower/Lemon balm. I excluded the 5-HTP given he is on duloxetine (SNRI) and was potentially going to take Tramacet (also serotonergic).

Day 0: He took the pre-pack prior to sex and noticed afterward it didn't feel like he usually describes it as a poison coming over him. Went to sleep.

Day 1: He experienced about 70-80% reduction in symptoms overall, mostly feeling just fatigue and some cognitive symptoms but not as badly. He tried taking ginkgo biloba and taurine a few times during the day which he thought may have been partially helpful. Any time he had a nap he has a reduction in symptoms as well.

He took the pre-pack again as we were having sex in our fertile window.

Day 2: He was experiencing more pain this day so started taking Tramacet (tramadol 37.5 mg/acetaminophen 325 mg) - took a total of 2 tablets throughout the day in halves. Supplemented again with ginkgo biloba and taurine. Overall feeling worse than day 1 but not as bad as usual POIS symptoms. Taking the sleep supplements at night.

Day 3: He managed mainly with Tramacet total of 2 tablets. Pain was at 50% of usual symptoms. Taking the sleep supplements at night.

Day 4 (today): Only took 1 tablet of Tramacet. In the morning was at 30% of usual symptoms. Tried out some flaxseed oil supplement, taurine, lycopene, green tea extract. Overall experiencing only 10 % of usual symptoms. 

The pre-pack in particular and perhaps (more difficult to say) the other supplements have been huge in reduction of symptom severity and duration along with intermittent Tramacet use and regular naps. Unfortunately he has to ejaculate again tomorrow as a semen analysis is required so we can see a fertility clinic (considering if he can freeze some sperm so we can do IUI and he doesn't have to experience as many symptoms), so obviously more significant symptoms will be returning. We are definitely in touch with our GP, sexual medicine clinic, and fertility clinic! All helpful. I will report back down the road how the pre-pack continues to work for him and how we end up tweaking things.

Thanks for your engagement in the forum and your own trial and error to get you to a place where you can help others with your own experiences.

Hi Psy,
I am very happy to read that my pre-pack method has been helpful for your husband and has reduced the severity and duration of his symptoms !   70% to 80% less symptoms on day 1 and 90% on day 4 is a very significant improvement over 7 days of severe symptoms. 

This will make it far more easier for your project to have a child

Keep us updated about your further progress in fine-tuning your husband's method of POIS relief. When it will be clearly established, I would like to add him as a reference in my POIS Types chart, in the pre-pack section.

Thanks for your good words about my involvement here on the forum !

[demografx]

Thanks for your good words [psy] about my involvement here on the forum !

You deserve more!!

Quantum, you are an underreported phenomenon here at POISCenter!

[psy]

Update on my husband's experience with the previously mentioned pre-pack:

Pre-pack includes: Quercetin 500 mg, turmeric curcumin 500 mg (black pepper 3 mg), green tea extract 315 mg, magnesium 167 mg (with Calcium 333 mg, vitamin D3 200 IU), flaxseed oil 1000 mg x2, lycopene 10 mg and sleep supplement 'Olly' x2 of melatonin 1.5 mg/L-theanine 50 mg/Chamomile/Passionflower/Lemon balm.

Other background: he also takes duloxetine 30 mg


We've now tried using the pre-pack for 3 of my cycles and each time it has made a significant difference for him. He even used it after a nocturnal emission and found it helpful after the fact. The most recent week of use he ejaculated 3x in about a week period. From the last ejaculation to feeling back to normal was about 72 hours (previously around 7 days from last ejaculation). For example the latest time, symptoms were anywhere from 40-80% reduced during the majority of his period of being unwell and gradually improved to 95% reduced on the last evening. He did not have tramacet available the last two times but still did relatively well.

What he found additionally helpful was taking taurine 500 mg before taking a nap for ~2h - prior to the nap he would be experiencing only 40% reduction in symptoms and then after the nap maybe 80% reduction, so he was taking taurine and naps regularly throughout this time (he works from home and has a flexible schedule so this was doable). He also took the sleep supplements (Olly) every night as well. His sleep was much more restorative than previously! Additionally he went for regular massage therapy and physiotherapy (thanks work benefits!) which helped with his POIS pain symptoms. He also took regular Tylenol (though not sure how much this actually helped).

Overall - this is a gamechanger!