POIS treatment: theory & supplement stack

[Nas]

Thank you for your valuable suggestions Nanna!
I will personally be trying a vasoconstrictor stack: Indomethacin, Propanolol, Paracetol and Aspirin before orgasm, if the Endothelial theory holds true, then perhaps increasing vascular walls' integrity can decrease the level of permiability in the Endothelium and the Epithelium.   

[Nas]

Ok so I did try the Vasoconstrictor stack and here is the result:
I took 10mg Propanolol, 25mg Indomethacin, 100mg Aspirin and 250mg Paracetamol.
I waited ~45min and then I orgasmed, during this 45min I felt a little bit of flush effect where my skin was tingling and got a little bit high body temperature, added to that slight dizziness.
After Orgasm many of the symptoms I experience usually after Orgasm were reduced, I didn't feel as much fatigue, brain fog, dissconnection, etc. I am writing this currently after about an hour from O and I do feel slight cognitive symptoms like brain fog, speech problems and social anxiety but they are noticably reduced. To be honest I was a bit skeptic on the effectiveness of this stack given that I tried many NSAID's like Aspirin but they didn't do much.
But now I think there is a definitely a positive effect from this stack, and I'm probably going to increase the dose slightly next in hope of increasing its effectiveness.
Thank you again for your valuable suggestion Nanna! And I hope other members try this very simple stack to prove its effect.

[nanna1]

Hi Nas,

  I'm glad you found some relief.

Ok so I did try the Vasoconstrictor stack and here is the result:
I took 10mg Propanolol, 25mg Indomethacin, 100mg Aspirin and 250mg Paracetamol.
I waited ~45min and then I orgasmed, during this 45min I felt a little bit of flush effect where my skin was tingling and got a little bit high body temperature, added to that slight dizziness.

I should say that I have never tried Propanolol (beta-blocker), so I don't know what it's effects are on the body. I did not experience these side-effects with the Excedrin-methylation-D3 test. So my first guess would be that Propanolol has something to do with that, but you would know before I would. The dizziness comes from reduced blood supply to the brain. I would think the dizziness is definitely a Propanolol side-effect. Both indomethacin and aspirin reduce platelets, which would increase blood circulation. So they would not cause dizziness.

After Orgasm many of the symptoms I experience usually after Orgasm were reduced, I didn't feel as much fatigue, brain fog, dissconnection, etc. I am writing this currently after about an hour from O and I do feel slight cognitive symptoms like brain fog, speech problems and social anxiety but they are noticably reduced.

  That's good! I'm glad for your progress. From my experience, the cognitive symptoms from POIS come from neurotransmitters being depleted. Dopamine depletion causes irritability. Serotonin depletion causes depression. Acetyl-choline and NAD+ depletion causes brain fog and speech problems. There is some overlap in the neurotransmitter neurons, so I always just try to make sure all my neurotransmitters are at sufficient levels to function.

  For cognitive issues, some people take neurotransmitter precursors (L-Phenylalanine for dopamine), (5-HTP for serotonin), (AlphaGPC for acetyl-choline) and (niacinamide for NAD+). This works, but for me a good methylation stack (SAM-e, TMG, B-Vit) takes care of the neurotranmitter/cognitive issues. From my experience, B vitamins alone are not good enough. I either need methyl-donors (alphaGPC, TMG, choline) with the B vitamins or I have to supplement neurotransmitter precursors.

To be honest I was a bit skeptic on the effectiveness of this stack given that I tried many NSAID's like Aspirin but they didn't do much.

  I understand why many people who have tried aspirin or caffeine and had no results might be skeptical. Excedrin is a synergistic combination. Each of the three drugs in Excedrin (aspirin 250mg, Paracetamol 250mg, caffeine 65mg) have a much greater effect together than their individual components. Caffeine (adenosine blocker) enhances aspirin (COX inhibitor) and Paracetamol/acetaminophen (pro-cannabinoid) enhances caffeine and COX inhibitors. If you separate them, the results will not be the same. However, you can substitute indomethacin 50mg for aspirin 250mg. Indomethacin was shown to be a stronger anti-inflammatory (smaller RF numbers are better) (RefSE). Click below image to see full size.

  Prostaglandin E2 (PGE₂) is one of the main vasodilators on the body (Ref). Norepinephrine and histamine cause vasodilation by increasing PGE₂ production. Indomethacin causes vasoconstriction by blocking COX and the production of PGE₂. Below are some articles that discuss properties of indomethacin.
Increase in reflex vasoconstriction with indomethacin in patients with orthostatic hypotension and central nervous system involvement.
Coronary Vasoconstriction Caused by Indomethacin
Cerebral vasoconstriction by indomethacin in intracranial hypertension. An experimental investigation in pigs.

By the way, Paracetamol (acetaminophen) is a pro-cannabinoid. So Paracetamol may be able to replace CBD oil for people who use it in their stacks. I'm back taking my regular stack and vegan diet. The Excedrin was just a test.

But now I think there is a definitely a positive effect from this stack, and I'm probably going to increase the dose slightly next in hope of increasing its effectiveness.
Thank you again for your valuable suggestion Nanna! And I hope other members try this very simple stack to prove its effect.

Thanks Nas, I wish you well on your success.

[SN]

Hi Nanna,

Thank you for all the detailed responses.  I started your POIS stack 3 weeks back.  I notice the fatigue part is completely gone. However, my skin gets so hot (particularly on my back when I lay down) like I have fever. When I feel very hot, that makes my muscles tired (gets worse every summer).  I dont know if anyone else have the same issue with body heat regulation

Questions: 

1. In your original POIS stack post, you mentioned taking B6 and 200mg of folate along with Sam-E and alpha gpc twice a day.  I saw in another post about cancer risk of using folate regularly.  So, what is a safe daily dosage for folate?
2. Do you take Sam-E/b6/folate 3 times - 2 regular daily dose plus one when you use Betaherpesvirinae prepack?
2. In your recent update, you took EPA/DHA off, even though you recommend taking it for general health reasons.  Do you see any problems taking CLA & EPA/DHA together?  Or Should it be either/or ?

Thank you

[nanna1]

Hi SN,

  Thanks for the questions,
1. The dosage posted on the original post (200 microgram) is a safe daily dose. For folate-cancer data, please see Table 1: cancer endpoints under the Outcomes heading.

2. I only take The POIS Cascade stack (so Sam-E/b6/folate/etc.. twice daily) and maintain a (high-vegetable low-arachidonic acid) vegan diet. The type of diet is as important as the stack. I do not take Betaherpesvirinae prepack. I have tested the Betaherpesvirinae prepack. Most people choose not to do the diet because of cost, food taste, time of food prep, etc... So the Betaherpesvirinae prepack is for anyone who does not feel that the vegan diet is for them. However, the vegan diet has many health benefits beyond POIS reduction, and I believe my test results show this.

3. I don't see any problems with taking omega-3. Omega-3 is an essential nutrient for human health and mental health. DHA, EPA and CLA are all naturally occuring in the body, and I do not see an issue with taking them together. I crossed out omega-3 only for people who want to save money. For reducing POIS symptoms, I only need CLA (POIS Cascade stack + diet). I can stop taking DHA/EPA and still get full relief. So my reason for taking DHA/EPA is that it has many health benefits, too many to name here.

  I'm not sure what's going on with the burning on your back. A doctor would have to run test to find out. But whenever I would have skin issues (burning, tingling, rash), I would put d-limonene essential oils like lemon oil or orange oil on the skin. d-limonene is bactericidal and virucidal, so it kills pathogens in the skin. Also it exfoliates dead and damaged skin cells. This should reduce future immune response in the skin. Vitamin C serums also work (bactericidal/virucidal/exfoliation). Just a thought. But I don't know why your back is burning. I hope something here was helpful.

  One final note: If you find the Betaherpesvirinae prepack effective, it may be worth talking to your doctor about getting virus tested. This could help you customize your treatment more effectively.

[nanna1]

Hi All,

  After recent post from Swell and POISse, I decided to do another trial of indomethacin Friday night. I went to two parties (Wednesday and Friday) where meat was served. So I was not on my diet Friday during the trial (this was a coincidence). From my usual daily stack (POIS Cascade stack) I only took vitamin D3 and CLA on Thursday and Friday morning. I took one dose of selenomethionine (100micrograms) Friday morning on an empty stomach (not part of prepack trial).

Here is my 2nd Indomethacin trial (Friday night):
Taken 2.5 hours prior to sexual activity
---indomethacin 50mg
---vitamin D3 (2000IU sublingual)
---Betaine-TMG (2g)
---N-acetylcysteine (1.2g)
---selenomethionine (60 micrograms)
---vitamin E (mixed gamma-E, 700mg)

Experience:
Waiting two and a half hours is a long time to wait to start an orgasm. With that said, I did not experience any POIS symptoms the night of the orgasm. This is an improvement over my Excedrin trial where I had to take a 2nd dose of Excedrin after the orgasm to prevent POIS. Note: the optimum timing for indomethacin is 2 hours pre-orgasm even though I took it at 2.5 hours pre-sexual activity. It has a half-life of 4.5 hours.

Symptoms:

• The next day (Saturday) I woke up and did not feel any symptoms of POIS for the first 3 waking hours. I had energy and mental clarity. Then after about the 3rd waking hour, I had some drainage in my nose. So, I took a dose of N-acetylcysteine (600mg) and selenomethione (30mg) and blew my nose once. The drainage went away.
• During the middle of the day Saturday for a period of about 30min I felt some burning in my forehead as if I had a fever and some drainage in my left ear. I was at work at the time staring at a computer screen. I took a break from work and these symptoms went away within 30 minutes. I attribute this to work-stress, but it could also be POIS related. But I did not experience this on the Excedrin trial.

  I went to work all day Saturday and ate lunch with a coworker. I was fully social and engaged as I usually am on my other stack+diet. I did not have any of the typical POIS symptoms (no neurological issues, fatigue, sneezing, etc...). Today (Sunday) I spent the entire day with friends playing games, and eating out. We had a lot of fun! Over all, the two (Saturday) symptoms listed above did not interfere with my productivity, moody or social life.
 
  In my opinion, adding N-acetylcysteine and selenomethionine to this trial helped reduce some of the side-effects of indomethacin that I experienced before in my first trial. But this is hard to say for sure. POISse mentioned that he takes a second dose of indomethacin the next day after an orgasm (post). I think this advice would probably help reduce symptoms (1) and (2) since that was also what I tried in my first trial (see COX-2 inhibitors section). Also, thanks to POISse for figuring out the right dose timing for indomethacin (2 hours pre-orgasm). Egordon has shared his experience with indomethacin here (Post1, Post2).

[Hopeoneday]

Wery good work, but for people with all redy broken guts I dont know how will it be on long run with indomethacin etc.
NAC  is capable of moving mercury to the brain from body tisues. (for thouse who hawe amalgams etc...)

[Nurse86]

Hey Guys,

First off I want to thank Nanna for the original well thought out posts. I haven't fully dissected all the information but I've found something that worked for me. I've been studying biology/physiology and psychology for over 10 years and now I'm currently in nursing school pursuing NP. I've tried everything to cure this but I found something in your post that worked for me, the missing link.

My supplemental stack post orgasm is:
Calcium 600mg/Vit D 800IU
Vitamin C 500mg
Magnesium 500mg
Vitamin B1 250 mg


Aside from that I also take or do:
Master amino acid pattern
Vegan nutritional shake
Fish Oil
Probiotics
Intermittent fasting



I believe it is the high dose of thiamine that seem to eliminate most of my cognitive/mental/energy problems. I feel like I could write a novel on this but I'm going to keep it short and write some tips. I wanted to share this because it has taken a huge toll on my daily life and to find something that works is blowing my mind. I just want to share a few tips or pieces of information.

*Don't overdo it with masturbation and sex
*Don't abuse the supplements, for B1 you need rest periods and it is possible to gain tolerance. I would not take it everyday. High dose fast acting niacin was messing with my liver enzymes. It may seem harmless, just a vitamin but the effects on the body are far reaching and very complicated.
*Make sure you exercise everyday (Either many hours before sex or the next day after sex, unless walking) I prefer powerwalking mixed in with a handful of 5-10second sprints and a couple of 1minute jogging for 1 hour on the track in the morning. Nature walks are also good. Light calethstenics/weight workouts to maintain strength and muscle tone. Cardio for the longest time has been my go to to alleviate my symptoms faster, possibly something with adrenaline and increased blood flow to the brain. This is my second week trying my new stack but this time i didn't exercise and I don't feel as good as I did the first week. I also binged on a lot of food these past days. The first week was euphoric. Also in the past when my face went beat red from flushing it relieved some of the pressure in my head.

*Try to keep your blood glucose, insulin, and blood pressure in check but keeping a clean diet. Try to eliminate refined carbohydrates and reduce sugar intake. It is a lot of experimentation and documentation.
*Personally for me I did not respond well to Sam-e with orgasms. Similar to when I tried ssri with orgasms. SSRI+orgasm made things very bad for me. That is a whole new topic  recently i did genetic testing and it might have to do with a mutation in my dopamine receptor and a gene encoding MAO.
*I have yet to try the other suggestions, I have to fully review the pro and cons and the remainder on the list to assess the effects it has on the rest of the body.
*Everyone is different so you may or may not need certain supplements or may have to adjust the dosage.
*I also believe there is a hormonal issue but which one I don't know, because they are all in someway intertwined.
*I'm also sensitive to cortisone, I develop pseudo-cushings syndrome from a few days of cortisone based products.
*This was a messy post, my apologies. Hopefully you can find 1 thing useful.


Thanks again Nanna, you are a wealth of knowledge!

[Quantum]

Welcome to poiscenter, Nurse 86 ! 

Thanks for sharing what works for you.

Am I mistaken to think that you are a girl?  We do not have a lot posting here.

[Limejuice]

Hi Nurse,

You mention that “I believe it is the high dose of thiamine that seem to eliminate most of my cognitive/mental/energy problems.” but do not have that specific amino acid in your stack - only an amino acid ‘complex’. Could you elaborate as well as provide the high dosage amount please?

Thank you

[FernandoPOIS]

Unfortunately, so far everything I've tried only has a good result if taken along with antihistamine or prostaglandin inhibitor (anti-inflammatory or analgesic). The way is to find something that works pre orgasm to avoid the exacerbated reaction of the immune system.

[Limejuice]

My bad thiamine sounded like an amino acid but is vit b1.

[Nurse86]

I'm a guy . What exactly do you take Fernando? I've taken various antihistamines and nsaids but they were ok. I've tried blood pressure medication. People kept on saying niacin but it was sometimes a hit or miss and it was starting to mess with my body. I've tried various herbal supplements like ginger root, fenugreek, tumeric, ect but really nothing substantial. My test from the doctor came back all fine. I literally was contemplating just getting chemically castrated because of the impact it has had on my life. I found something that works for me; it lets me function at a good level and I'm more than ok with that.
Anyway, I've tried thiamine through a complex of 25mg but that wasn't enough. The therapeutic value for me was 100mg-250mg. My original stack was just for relieving anxiety and social anxiety, which was made a lot worse with POIS. Right now, if I take my new stack I feel goooooodddddd. But that is also supplemented with a good diet, exercise, and proper sleep cycle. Can't feel good if you don't put in the work to give your body a fighting chance. Some people are genetically gifted so this doesn't apply to them.

Aside from that, finding a solution through a magic pill isn't going to cure everything because i believe it isn't just the immune system. Everything is connected in someway and right now I've been more heavily invested in hormones because of my subset of symptoms still present. I also do agree with you that an unnecessary immune response is occurring but that is just part of it. I also believe in some sort of neurotransmission imbalance (possibly enzymatic), brain-gut axis disregulation, wonky endocrine system due to maybe an over release of a hormone and neuroplasticity in the brain play a apart in this too. Some postsynaptic cells might have more receptors then others causing an increased response or the effect is prolonged because certain channels aren't resetting at appropriate times. Honestly I do not know. I also don't like taking medication because it seems to me it is a double edge sword.

Some bodies are different from others, like some can't have gluten or some have a sun allergy. There is no way around some of these things. Everything though we've made a lot of progress in the health care industry we still really don't know what the heck is going on. People with diabetes, high cholesterol, and blood pressure looking toward a pill to be healthier but instead it promotes the same poor lifestyle and they get unpleasant side effects. Our lifestyles have changed dramatically from our parents, and so has our diet. Our brain is overloaded with synthetic stimuli, poor nutrition, sedentary lifestyles, decreased social interactions and so forth.

I just read some of nannas posts he concluded that after taking Sam-e and B1 he was functional again. We also have very similar problem, including the generic diagnosis of ibs. For me I didn't take Sam-e because of a mutation in a gene regulating my catecholamines so i think it is the B1 vitamin responsible then. I suggest you read his posts because he knows his stuff lol. He is a very smart guy. You changed my life

Isn't NE=norepinephrine?
Also who is the dutch doctor?

[dizzy]

Hi Nurse,

I've also taken B1 a lot, in different forms, and I found it highly useful. But ... indeed, you can build a tolerance. And I have found that after a while of taking 300 mg a day, 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.

[Nurse86]

I'm glad you shared that with us dizzy and I agree with you that the side effects can be quite scary. Especially the synthetic forms, you can gain tolerance and have withdrawal symptoms. All the most common prescriptions coming out of pharmacies will mess you up one way or another down the line and then they will prescribe more to treat your symptoms lol. You have to keep in mind that certain treatments put your health on the line just so you can get instant gratification. Also if you supplement too heavily the body might think oh I don't have to produce as much anymore of xyz. Try to keep things as natural as possible because honestly until we have some real powerful diagnostic tools in the medical industry, we really do know what is going on. Going to the doctors they all run the same generic tests hoping for a hit but, yea that is another topic.. Is it really worth it for an fleeting orgasm?


I'm just happy because now I can have a happy and responsible sex life and also function in society without having to heavily plan around it. I'm not using my stack so i can blow my load constantly. I'm grateful for it and I'm not going to take advantage of it. 1-2 a week max. For the supplements i do take regularly I make sure they are within range of obtaining them through dietary means. So low dose for daily life and then high dose, day of O.   Pills can only do so much for us and the rest is based on our lifestyle. Do you have good friends, have good/healthy coping mechanism, exercise, eat well, and ect. For the past  couple years I really zoned in on nutrition because that exacerbated my pois. Frozen foods, fast food, deceptive serving sizes (who eats 5 chips, I kill the whole bag lol), sodium, high fructose corn syrup, and ect. All this stuff causes inflammation through various reasons and mechanisms. Anyway, i'm rambling. Oh and dizzy I have 90percent of your symptoms.

[FernandoPOIS]

Nurse

I try to take only antihistamines. I avoid the anti inflammatory and analgesic and only take these in last case.
After orgasm I take Allegra D in the morning and Fenergan near bedtime because it is sedative.
When I need taking anti-inflammatory or analgesic take Tandrilax (Acetaminophen, Caffeine, Carisoprodol, Diclofenac Sodium) 1 tablet every 8 h, but this is the case I am in pain and tension in the spine.
I also drink coffee in the morning and afternoon and it helps keep my brain working well.
I took Arcalion 3 times daily (Sulbutiamine 200 mg) the last few times but it seems that the effect was not very significant. Maybe I have to increase the dose. Sulbutiamine is a potent form of vitamin B1 used to increase mental and physical energy.
I take 200 mg of taurine every time I have symptoms (3 x daily).
As I mentioned, the times I tried to take all this without the anti histamines, the effect seemed too small, which leads me to believe that the target is the release of histamine. What needs to be done is to lower this starting point. For me what works as prevention is the health of my spine and health of the vagus nerve. Postural exercises, Aerobic exercises and no stressed events near the time of the orgasm.

[Quantum]

I'm glad you shared that with us dizzy and I agree with you that the side effects can be quite scary. Especially the synthetic forms, you can gain tolerance and have withdrawal symptoms. All the most common prescriptions coming out of pharmacies will mess you up one way or another down the line and then they will prescribe more to treat your symptoms lol. You have to keep in mind that certain treatments put your health on the line just so you can get instant gratification. Also if you supplement too heavily the body might think oh I don't have to produce as much anymore of xyz. Try to keep things as natural as possible because honestly until we have some real powerful diagnostic tools in the medical industry, we really do know what is going on. Going to the doctors they all run the same generic tests hoping for a hit but, yea that is another topic.. Is it really worth it for an fleeting orgasm?


I'm just happy because now I can have a happy and responsible sex life and also function in society without having to heavily plan around it. I'm not using my stack so i can blow my load constantly. I'm grateful for it and I'm not going to take advantage of it. 1-2 a week max. For the supplements i do take regularly I make sure they are within range of obtaining them through dietary means. So low dose for daily life and then high dose, day of O.   Pills can only do so much for us and the rest is based on our lifestyle. Do you have good friends, have good/healthy coping mechanism, exercise, eat well, and ect. For the past  couple years I really zoned in on nutrition because that exacerbated my pois. Frozen foods, fast food, deceptive serving sizes (who eats 5 chips, I kill the whole bag lol), sodium, high fructose corn syrup, and ect. All this stuff causes inflammation through various reasons and mechanisms. Anyway, i'm rambling. Oh and dizzy I have 90percent of your symptoms.

Hi Nurse,

I totally agree that a healthy diet is important to lower POIS symptoms, and I also agree that once or twice a week is probably the most often we can have releases, even if we have a good stack/pre-pack to control our symptoms.  More than that, the cumulative effect of POIS seems too much to handle.

[Nurse86]

How come allegra-d? Have you tried antihistamines without pseudoephendrine? Personally I prefer benadryl for allergic reactions but it makes you drowsy. I would definitely not increase that dosage for sulbutiamine; 600mg is ALOT. If you take it more than you don't then you will gain tolerance and have withdrawal symptoms. The first week i tried my stack i did 2 os for 4 days straight and was good, along with my lifestyle regimen. The 5th day however was a different story. 2nd week I'm doing good again. 1st week was just a test and I literally sat on the floor saying to myself holyshoot, this is actually working for me.

Personally I think you are gaining benefits from the stimulants in your stack by activating your adrenergic receptors, pseudoephedrine is a strong stimulant from Allegra-D, Caffeine from your Tandrilax, Caffeine from your coffee and sulbutiamine but then you also have depressants. This is not a good long term solution though. You also say you don't get symptoms during sex which also leads me to believe your adrenergic system plays a role in it. I have to do more research if i'm not lazy lol. When someone has a severe allergic reaction, epinephrine is administered first hand and then possibly antihistamine 2nd. Masturbation is very low physical activity vs sex. Brain activation is also different such as talking to people through texting vs talking in person.

I've tried psuedoephedrine also in the past. It made me ejaculate when not having sex. In social situation i would be excited and stimulated (not sexually and then when i pee, i ejaculated.)

I'm interested in your vagus nerve suggestion as I do have pain but nothing substantial. My bowel movement have been weird and POIS has effected it. Personally for me I think it is because the muscles become overactivated either smooth and  skeletal. These hormones have short half-lives but these effected cells seem to have more receptors or prolong its effects well after it is gone. It has been a longggg time since i studied neurotransmission. If we had better diagnostic tools, this would be easier to pinpoint. I think the muscle relaxer is providing you that relief. Instead of all these stimulants, i suggest replacing it with exercise. Walking/jogging/sprints and light weight training but the whole body.

Yeah quantum, everything in moderation.

[Rinat]

Dizzy,i had the same simptoms after taking b1.

[Nurse86]

What strength did you take of b1? High dose and low B1 gets processed differently in the body.

How long were you taking 150mg before going to 300mg? Do you take it once a day? Do you take any other supplements or medication?