POIS treatment: theory & supplement stack

[Rinat]

At the begining 150 mg ,then 300

[Muon]

I got problems breathing. As in: I had to think about breathing, otherwise it felt like my body/brain just didn't do it automatically. Quite scary. At one point I was afraid to go to sleep. Fortunately, all turned out well, but I'm more careful with B1 now.

I've got this symptom as well and don't take B1. It only happens during hot weather conditions. Are you sure the B1 is responsible for this?

[dizzy]

@Muon

Yes, I'm pretty sure it was the B1. The reason I know is that B1 was having such good effect on me, that I really tried a number of times to start using it again, and every time I got the same effect on breathing (although I tried lower doses later, so the effect was milder).

[CuriousCharacter]

Really fantastic work here. Thanks so much for all your contributions, nanna1!

I'm interested in trying this out. I have Thorne's Stress B-Complex sitting in my cupboard, which seems to include many of the ingredients in nanna1's POIS Cascade stack:

* 25mg Pyridoxine HCI
* 200mcg folate (L-5-Methyltetrahydrofolate)
* 100mcg B12 (in the form of methylcobalamin)

And it includes some additional ingredients:

* Thiamin HCI (50mg)
* Riboflavin (28.6mg)
* Niacin (80mg)
* Biotin (70mcg)
* Pantothenic acid (250mg)
* Choline (14mg)

Would this be an acceptable substitute for the B vitamins in the POIS cascade stack?

[nanna1]

Hi CuriousCharacter,

  Thanks for the question! The B vitamins in your Stress B seem fine. I take low dose B vitamins daily, but I know there are many who take high dose B vitamins as a prepack. My B6 dose is low (2mg), which helps prevent tolerance. However, my original stack contained higher thiamine (vitamin B1) and higher choline than what is in your Stress B. I assume you will be using other sources of choline to increase your methyl-donors. If you choose to take this Stress-B as a prepack (taken before orgasm), then you may have to increase B1. But everybody's body is different, so I'm sure with a little experimentation you can find the right balance for you. Nurse86 wrote about a modified stack using vitamin B1 (https://poiscenter.com/forums/index.php?topic=2502.msg24761#msg24761).

  I don't know what effect Riboflavin, Niacin, Biotin, Pantothenic acid will have, but there is a niacin thread here (http://poiscenter.com/forums/index.php?topic=235.msg2958#msg2958) and here (http://poiscenter.com/forums/index.php?topic=2525.msg21809#msg21809).

Thanks again and keep us updated. 

[Rinat]

Have anybody felt hight temperature after taking CLA?

[Bombardier]

Hi CuriousCharacter,

  Thanks for the question! The B vitamins in your Stress B seem fine. I take low dose B vitamins daily, but I know there are many who take high dose B vitamins as a prepack. My B6 dose is low (2mg), which helps prevent tolerance. However, my original stack contained higher thiamine (vitamin B1) and higher choline than what is in your Stress B. I assume you will be using other sources of choline to increase your methyl-donors. If you choose to take this Stress-B as a prepack (taken before orgasm), then you may have to increase B1. But everybody's body is different, so I'm sure with a little experimentation you can find the right balance for you. Nurse86 wrote about a modified stack using vitamin B1 (https://poiscenter.com/forums/index.php?topic=2502.msg24761#msg24761).

  I don't know what effect Riboflavin, Niacin, Biotin, Pantothenic acid will have, but there is a niacin thread here (http://poiscenter.com/forums/index.php?topic=235.msg2958#msg2958) and here (http://poiscenter.com/forums/index.php?topic=2525.msg21809#msg21809).

Thanks again and keep us updated. 

Funny you should mention tolerance, Nanna. I'm currently taking your POIS Cascade Stack (though I haven't had time to test it out), and my biggest fear is developing a tolerance over time. How long have you been able to take it without upping the dose?

[nanna1]

Hi Bombardier,

  For B vitamins, as long as you stay below the daily recommended dose, there is no tolerance. My folate (200mcg) and B6 (2mg) doses are below the daily recommended doses. My B1 and B12 doses are above the daily recommended dose (1mg, 2.5mcg respectively). So there are times when I throttle/cycle them. Usually, when I start taking B12 I will have dreams which is probably from increased neurotransmitter production. After a two or three days the dreams go away. If you have dreams or increased energy from taking B12 then you probably have less than optimum levels (or deficiency). At optimum levels there should not be any increase benefit to increasing the dose. Most people who eat meat 3 times a day will get the daily recommended B12 (2.5mcg). Since my diet on this stack is vegan, I don't get any B12 or D3 from food. So I have to supplement those vitamins.

  There is no tolerance to taking omega-3. Your brain and heart are the main consumers of DHA and EPA and will always consume any excess omega-3. There is no tolerance to excess CLA, but there can be side effects related to too much fat breakdown. I personally have not experienced these side effect.

[helpwithpois]

Hey nanna1,

I am a heavy undermethylater. I have bad undermethylation and took the tests suggested in walsh's protocal. I have extremely high histamine and low in zinc and the protocol I am on now which is zinc 50 mg, p5p 100mg, Sam-e 600mg , vitamin e (400mg), and a couple other supplements. I tried your protocol but I didn't seem to have too much effect (I don't know if i had enough fish oil or alpha gpc). Whenever I have an 0 i get extreme racing heart beat, my throat gets really itchy, flu like symptoms, nausea, etc. I am on a low dose antidepressant and take 15mg of valium and want to get off it but I can't seem to figure out how to stop this.

I can stop 0 for a couple weeks and have a couple without symptoms but then it just keeps coming back. I am always tired and can sleep 12-14 hours a day if I could. There has to be someway to get rid of this. I have tried so many supplements and have wasted thousands on doctors.

Supplements I have tried:
L tryptophan - helps only at extremely high doses
l tryrosine
5 htp
almost all of your protocol
adrenal extracts like adrenal fatigue fighter
Ashwaganda
Vitamin c(helps)
niacin (sometimes can help)
and so much more.

your are really smart and I read some of your posts can we talk and have a chat?

[nanna1]

Have anybody felt hight temperature after taking CLA?

Hi Rinat,

  I personally don't experience a high body temperature from taking CLA alone. When I exercise or do some physical activity like running up stares I do seem to experience a longer increase in body temperature than when I do not take it. I know exercise is suppose to increase body temperature, but usually I cool down pretty fast once I come to rest. My subjective opinion is that CLA can either prolong the increase in body temperature that I would normally experience from exercise, or it causes me to feel less tired so that I exercise longer/harder and burn more calories. This has happen to me sometimes when I drink caffeine beverages. Caffeine makes me feel less tired so I end up doing more work and exercising longer, but CLA does not have the stimulant effect that caffeine has. Either way, I have not measured my body temp while on CLA and compared to not being on CLA. So this is just a subjective opinion. But I can say that apart from activities that consume calories, I have not noticed any CLA effect on my body temperature (increase or decrease). I hope this useful in some way.

[Rinat]

Nanna,thank you for your answer)

[nanna1]

Hi HelpWithPois,

  Thanks for your question. The racing heartbeat is probably due histamine or noradrenaline (norepinephrine). Both of these produce a fight-or-flight response. It may be that your elevated histamine is due to an allergy. Have you tried getting a skin prick allergy test from doctor/allergist? If you have a skin prick test then you can identify allergens that may be causing your elevated histamine levels, like pet fur or mold.

Image from https://www.naughtylittlemastcells.com/infographics/

  Intermittent Fasting (caloric restriction) has been proven to reduce the number of histamine releasing immune (mast, basophil, macrophage,...) cells in the body, increase natural T killer cells, and reduce allergen senstivity (Ref, Ref2). Fasting has even been shown to eliminate some autoimmune diseases. If you don't like fasting you can try a commercial fast-mimicking-diet (FMD) like Prolon. Prolon is a commercial product developed at the University of Southern California and funded by the Nation Institute of Health (NIH). So it is based on real science and clinical trials(Refs). I think that FMD are the best diets for POIS.

Figure 2 from "Nutrition and fasting mimicking diets in the prevention and treatment of autoimmune diseases and immunosenescence". This figure shows one case where a caloric-restriction or fast-mimicking-diet (FMD) resets the immune system and heals damage done by immune inflammation. Here is more information on how to do a FMD (Five day FMD).

  Sublingual vitamin D3, thiamine B1 and insulin are all negative regulators of histamine levels and the H1-hitamine receptor (diabetics have high histamine levels). In my opinion, sublingual vitamin D3 is a must for any stack because D3 is one of the bodies natural hormone regulators of the immune system. A vitamin D deficiency leads to chronic inflammation and allergies in everyone. Sublingual D3 is more bio-available than the pills. The pill form of D3 was not as effective for me.

  Even if elevated histamine levels are caused by something other than POIS, this histamine can still make your POIS problems worse by stimulating the H1-histamine receptor. (1)Diet, (2)adequate sleep, (3)drinking water and (4)vitamin D levels are more important than stacking supplements. But once those 4 things are taken care of, then supplements can offer benefit.
  TMG (betaine) is a good methyl donor if you want to save money from buying alpha-GPC. Herbal based supplements like (ashwaganda, tumeric, quercetin) can be helpful, but they do not work as prepacks because their bioavailability is too low (see Cost effective alternatives for omega-3). The only effect that herbs (and flavonoids) have in the short-term is hormonal (they stimulate progesterone, estrogen and testosterone receptors). To get the full benefit from herbal supplements, you have to take them daily to allow them to build up to therapeutic levels. Also, Curcumin is a MAO inhibitor which may interact with your antidepressant medications. I get my curcumin and quercetin from my diet (food only), which has been shown to have higher bioavailability and lower toxicity than the commercial pills. Adequate sleep is needed to strengthen the immune system so that it can fight whatever is causing POIS. Vitamin C (2g taken twice daily) can also strengthen the immune system and lower histamine levels (Ref).

  From what I can tell COX inhibitors are the most successful drugs to prevent POIS symptoms, but they each have their side-effect. Indomethacin (50mg) or aspirin (500mg) should be taken about 90 minutes before the start of sexual activity (see Betaherpesvirinae stack and vasoconstrictor notes in the original post). Celebrex (celecoxib) does not have the pharmakinetics to be taken as a prepack. Celecoxib has to be taken at 200mg twice a day with food for at least 5 days before you will see any noticable anti-inflammatory effect from it. So celecoxib is a long-term medication with no short-term benefits. With that said, celecoxib is the safest COX inhibitor that you can buy. I don't take pharmaceutical drugs. But for those that don't want to stick to a diet, several POISers find that COX inhibitors are an effective alternative for reducing POIS symptoms.

  I know I crammed a lot of information in this post, but I hope some of this is helpful.

[demografx]

nanna1, cool graphics!!

[Nas]

  From what I can tell COX inhibitors are the most successful drugs to prevent POIS symptoms, but they each have their side-effect. Indomethacin (50mg) or aspirin (500mg) should be taken about 90 minutes before the start of sexual activity (see Betaherpesvirinae stack and vasoconstrictor notes in the original post). Celebrex (celecoxib) does not have the pharmakinetics to be taken as a prepack. Celecoxib has to be taken at 200mg twice a day with food for at least 5 days before you will see any noticable anti-inflammatory effect from it. So celecoxib is a long-term medication with no short-term benefits. With that said, celecoxib is the safest COX inhibitor that you can buy. I don't take pharmaceutical drugs. But for those that don't want to stick to a diet, several POISers find that COX inhibitors are an effective alternative for reducing POIS symptoms.

I also think Piroxicam is an underappreciated COX inhibitor that mildly helps with brain symptoms but could be great if combined with other COX inhibitors.
Also from my experience it is important to take COX inhibitors before sexual activities, because taking them after ejaculation does almost nothing. Any possible explanation for that Nanna?
Also COX inhibitors and NSAID in general seem to be tested by many people but no one confirms their effect, especially Ibuprofen, I wonder why? Maybe it's a case where one COX inhibitor is not enough, especially for brain symptoms? 

[nanna1]

Hi Nas,
 Thank you for your question.

  From what I can tell COX inhibitors are the most successful drugs to prevent POIS symptoms, but they each have their side-effect. Indomethacin (50mg) or aspirin (500mg) should be taken about 90 minutes before the start of sexual activity (see Betaherpesvirinae stack and vasoconstrictor notes in the original post). Celebrex (celecoxib) does not have the pharmakinetics to be taken as a prepack. Celecoxib has to be taken at 200mg twice a day with food for at least 5 days before you will see any noticable anti-inflammatory effect from it. So celecoxib is a long-term medication with no short-term benefits. With that said, celecoxib is the safest COX inhibitor that you can buy. I don't take pharmaceutical drugs. But for those that don't want to stick to a diet, several POISers find that COX inhibitors are an effective alternative for reducing POIS symptoms.

I also think Piroxicam is an underappreciated COX inhibitor that mildly helps with brain symptoms but could be great if combined with other COX inhibitors....Also COX inhibitors and NSAID in general seem to be tested by many people but no one confirms their effect, especially Ibuprofen, I wonder why? Maybe it's a case where one COX inhibitor is not enough, especially for brain symptoms?

  Many POISers have confirmed the effectiveness of COX inhibitors. We have to remember that not all COX inhibitors are the same. The pharmacokinetics and potency (IC₅₀) are different for each COX inhibitor. Some inhibit COX-1 or COX-2 or both. An explaination of what the potency measure IC₅₀ means can be found here. Smaller IC₅₀ values result in a stronger effect (stronger COX inhibition). For example, indomethacin is a stronger COX-1 and COX-2 inhibitor than aspirin.

----------------

Ibuprofen is not an anti-inflammatory drug because it has extremely low potency. According to the above chart, Ibuprofen is the least effective COX inhibitor there is, because it does not inhibit COX-1 or COX-2 efficiently. I explain this in more details here.
   One more thing to consider is the pharmacokinetics. Taking indomethacin 30 minutes before orgasm will likely not be as effective since it requires more than an 2 hours to reach peak blood levels (post). A person that takes indomethacin 30 minutes before orgasm may not experience any relief. Whereas a person that takes indomethacin 120 minutes (2 hours) before orgasm will likely experience significant relief. Also since indomethacin has a half-life of about 4 hours, taking this drug more than 6 hours before an orgasm may not produce the expected relief either. So there is a window of time to start dosing between 2 hours and 4 hours pre-orgasm where you can expect relief.
  For celebrex (celecoxib), you have to take it for at least 5 days consistent at the proper dose to see any effect. And it mainly inhibits COX-2. So not all COX inhibitors can be grouped together as being the same. They are very different in their dose timing and effects.

Also from my experience it is important to take COX inhibitors before sexual activities, because taking them after ejaculation does almost nothing. Any possible explanation for that Nanna?

   The reason that COX inhibitors have to be taken before orgasm is explained by the below diagram (a testable hypothesis):

Certain prostaglandins (i.e. PGE₂) trigger events leading to POIS. COX inhibitors prevent prostaglandin production. But if you wait until after prostaglandins are produced, then COX inhibitors will have no effect. More details about the diagram can be found in the original post. Other supplements/drugs work synergistically with COX-2 inhibitors by downregulating or blocking NF-kB (see Betaherpesvirinae stack). Let me know if this was clear or if there is anything I need to correct.

[Nas]

Hi Nas,
 Thank you for your question.

  From what I can tell COX inhibitors are the most successful drugs to prevent POIS symptoms, but they each have their side-effect. Indomethacin (50mg) or aspirin (500mg) should be taken about 90 minutes before the start of sexual activity (see Betaherpesvirinae stack and vasoconstrictor notes in the original post). Celebrex (celecoxib) does not have the pharmakinetics to be taken as a prepack. Celecoxib has to be taken at 200mg twice a day with food for at least 5 days before you will see any noticable anti-inflammatory effect from it. So celecoxib is a long-term medication with no short-term benefits. With that said, celecoxib is the safest COX inhibitor that you can buy. I don't take pharmaceutical drugs. But for those that don't want to stick to a diet, several POISers find that COX inhibitors are an effective alternative for reducing POIS symptoms.

I also think Piroxicam is an underappreciated COX inhibitor that mildly helps with brain symptoms but could be great if combined with other COX inhibitors....Also COX inhibitors and NSAID in general seem to be tested by many people but no one confirms their effect, especially Ibuprofen, I wonder why? Maybe it's a case where one COX inhibitor is not enough, especially for brain symptoms?

  Many POISers have confirmed the effectiveness of COX inhibitors. We have to remember that not all COX inhibitors are the same. The pharmacokinetics and potency (IC₅₀) are different for each COX inhibitor. Some inhibit COX-1 or COX-2 or both. An explaination of what the potency measure IC₅₀ means can be found here. Smaller IC₅₀ values result in a stronger effect (stronger COX inhibition). For example, indomethacin is a stronger COX-1 and COX-2 inhibitor than aspirin.

Ibuprofen is not an anti-inflammatory drug because it has extremely low potency. According to the above chart, Ibuprofen is the least effective COX inhibitor there is, because it does not inhibit COX-1 or COX-2 efficiently. I explain this in more details here.
   One more thing to consider is the pharmacokinetics. Taking indomethacin 30 minutes before orgasm will likely not be as effective since it requires more than an 2 hours to reach peak blood levels. A person that takes indomethacin 30 minutes before orgasm may not experience any relief. Whereas a person that takes indomethacin 120 minutes (2 hours) before orgasm will likely experience significant relief. Also since indomethacin has a half-life of about 4 hours, taking this drug more than 6 hours before an orgasm may not produce the expected relief either. So there is a window of time to start dosing between 2 hours and 4 hours pre-orgasm where you can expect relief.
  For celebrex (celecoxib), you have to take it for at least 5 days consistent at the proper dose to see any effect. And it mainly inhibits COX-2. So not all COX inhibitors can be grouped together as being the same. They are very different in their dose timing and effects.

Also from my experience it is important to take COX inhibitors before sexual activities, because taking them after ejaculation does almost nothing. Any possible explanation for that Nanna?

   The reason that COX inhibitors have to be taken before orgasm is explained by the below diagram (a testable hypothesis):

Certain prostaglandins (i.e. PGE₂) trigger events leading to POIS. COX inhibitors prevent prostaglandin production. But if you wait until after prostaglandins are produced, then COX inhibitors will have no effect. More details about the diagram can be found in the original post. Other supplements/drugs work synergistically with COX-2 inhibitors by downregulating or blocking NF-kB (see Betaherpesvirinae stack). Let me know if this was clear or if there is anything I need to correct.

Thank you very much Nanna!, that was incredibly helpful!

[helpwithpois]

Hey nanna1,

It comes back to the fact that I don't know what is causing the pois. My doctor who specializes in methlyation says i am a very bad undermethylater due to high histamine, low b-6, and other factors.. right now I take a low dose antidepressant, valium, sam-e (800mg), p5p (100 mg), zinc (50mg), and some l tryptophan. I have tried everything in the game including your stack (without the alpha gpc and still have pois).I can o max 2 times a week anything after that I can flu symptoms, runny nose, sore throat, anxiety, brain fog, fatigue, and I sleep 16 hours a day I am pretty much done at that point. How can I figure out to 0 without getting these symptoms I don't know what to do. I have spent probably over 15k on doctors and supplements and they can't fully help. Can I contact you or reach you at a specific email or number?

[b_jim]

I like your Pois schema very much, nanna1.
It must be keeped in a sticky thread.

[FernandoPOIS]

Hi Everyone

Since I have been very careful about the issue of my posture, I have had no pain in my spine for several weeks. But the other day I had a headache and had to take a painkiller called Neosaldine (dipyrone, isometepteno mucate, caffeine). One tablet was enough and I did not have to take another. One day after taking this painkiller I did masturbation 2 times the same day (1 pm and 7 pm). I had no POIS symptom. This had not happened to me for a long time. As I have always mentioned if I have my spine healthy and pain free, I have practically no symptoms but this time I had no symptoms. I felt as if I had not had an orgasm. I had no muscle tension, no fatigue, nothing! It may have been the effect of the painkiller the day before that was still working on my body. Possibly by blocking the action of prostaglandins.

It is not the cure, but have no symptons is very interesting. Maybe if we balance the things (colateral effects, happiness, etc..), may be interesting to have a tablet the day before orgasm if we can have nothing happening with our body after the orgasm. We can try to do things in a moderate way so that you can have orgasms at one time or another.

[Bombardier]

Unfortunately, after about three weeks of diligent supplementation, I must report that the POIS Cascade Stack was ineffective for my type of POIS. I took all recommended supplements at their recommended doses, hoping it'd give me a sort of "safety net" against nocturnal emissions. When I had one however, I found myself in the midst of a very normal POIS Episode. The stack might have helped a bit with my emotional state that day, though one could also attribute that to an extra cup of coffee and interacting with friends.

I'll continue taking supplements till I've exhausted my current supply. Furthermore I am encouraged by the efficacy of caffeine in mitigating some of my symptoms, and have also gained some minor relief from a healthier diet and Vitamin C supplementation. As such, I may try the targeted herpes virus stack you detailed sometime down the line.