Evidence-based decision support

Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through C-quality evidence.
weight management protocol table

Labs and supplements for gastrointestinal health

The gut’s influence extends beyond digestion, impacting immune function, mental health, and overall well-being through its diverse microbiome. This ecosystem communicates with the brain. Maintaining gut health through diet, lifestyle, and stress management is crucial. Functional gastrointestinal (GI) testing offers comprehensive insights into the microbiome and digestive function enabling practitioners to develop personalized plans, supporting optimal health outcomes.

Labs

Doctor’s Data GI360™

The GI360™ test by Doctor’s Data is a comprehensive stool analysis that provides detailed insights into GI health using multiple testing methodologies. It evaluates gut microbial conditions, digestion/absorption markers, and inflammation indicators, screening for over 80 microorganisms including bacteria, parasites, and fungi. The test offers a broad assessment of the gut microbiome, digestive function, and potential pathogens, enabling healthcare providers to develop personalized plans for various GI and systemic health issues.

Diagnostic Solutions Laboratory GI-MAP®

The GI-MAP® by Diagnostic Solutions Laboratory is a comprehensive stool analysis that uses quantitative PCR technology to assess the GI microbiome and detect pathogens. It evaluates bacterial, viral, and parasitic pathogens, normal flora, opportunistic bacteria, fungi, and markers of digestion, inflammation, and immune function. The test provides detailed quantitative results that allow healthcare providers to determine the clinical significance of findings and develop personalized protocols to address gut dysfunction and underlying imbalances.

Genova GI Effects® Comprehensive Stool Profile

The GI Effects® Comprehensive Stool Profile by Genova Diagnostics is an advanced stool test that provides a comprehensive assessment of GI health. It evaluates digestive function, intestinal inflammation, and the gut microbiome using multiple methodologies to analyze biomarkers related to digestion/absorption, inflammation/immunology, and microbial balance. The test offers detailed insights into potential root causes of GI symptoms, allowing healthcare providers to develop personalized plans that address underlying imbalances.

Herbal microbiome-support supplements

Herbal supplements can increase beneficial bacteria. Many herbs contain prebiotic polyphenols that nourish gut bacteria and promote the growth of probiotics like Lactobacillus and Bifidobacteria. Some herbs also show effects on healthy levels of yeasts and other organisms.

Black walnut (Juglans nigra)

1.5 ml of extract in a small amount of water, 3-4 times daily between meals.

  • Black walnut provides microbial support due to its phytochemicals, such as eriodictyol-7-O-glucoside, which contribute to its beneficial effects. (Vu 2020)

Caprylic acid

1,000–2,000 mg, 2–3 times per day 

  • Caprylic acid has the potential to support microbiome health through its bactericidal and fungicidal properties. (Murray N.D.)(Yoon 2018)

Olive leaf extract

500–1,000 mg, 1-2 times per day

  • Olive leaf extract supports the microbiome by promoting the growth and metabolism of beneficial flora while reducing non-beneficial flora. (Haddadin 2010)(Silvan 2021)

Oregano (Origanum vulgare)

200 mg, 2–3 times per day

  • Oregano’s essential oils, including carvacrol, terpinen-4-ol, linalool, sabinene, α-terpinene, and γ-terpinene, provide microbial support to help maintain a balanced microbiome. (Aligiannis 2001)

Goldenseal (Hydrastis canadensis)

300–500 mg, three times per day (berberine)

Colloidal silver

1 tsp, three times per day

Grapefruit seed extract

100–500 mg, 2–3 times per day


General digestive-support supplements

Digestive enzymes and prebiotics are crucial for optimal digestive health and nutrient absorption. Enzymes, produced by the pancreas, mouth, and small intestine, break down food into absorbable nutrients. Insufficient enzyme levels can cause bloating, gas, and nutrient deficiencies. Prebiotics are non-digestible fibers that nourish beneficial gut bacteria, promoting a healthy gut microbiome essential for digestion and immune function. Together, enzymes and prebiotics work synergistically to support efficient nutrient extraction, maintain a healthy gut environment, and enhance overall well-being by facilitating proper digestion and fostering a balanced gut microbiome.

Digestive enzymes

Dosing may vary depending on the specific product and should be tailored to the individual’s nutritional needs and goals, such as enzyme repletion or metabolic support. Healthcare providers should consult product-specific guidelines and adjust the dosage based on the patient’s unique requirements and response.

  • Digestive enzymes such as amylases, lipases, protease, and pepsin are crucial for metabolic health, facilitating food breakdown into digestible nutrients and maintaining a healthy gut microbiome. (Ianiro 2016)

Prebiotics

3–5 g per day 

  • Inulin and various oligosaccharides stimulate beneficial microflora and short-chain fatty acid production in the gut, creating a healthy intestinal environment that supports overall microbial well-being. (Davani-Davari 2019)


Inflammation-support supplements

Certain herbs can significantly enhance GI health by supporting healthy inflammation balance and soothing the digestive tract. Key herbs include turmeric, which contains curcumin; ginger, known for its properties and ability to promote digestive enzyme production; omega-3 fatty acids, which support gut microbiome diversity; and marshmallow root, which helps soothe the digestive tract and protect the gut lining. Incorporating these herbs into a gut health regimen can promote overall GI wellness.

Omega-3 fatty acids

500–1,000 mg per day (adjust dose based on testing)

  • Omega-3 fatty acids help maintain healthy inflammatory balance in the GI tract by supporting a healthy omega-6/omega-3 ratio. (Marton 2019)(Smyth 2024)

Curcumin (Curcuma longa)

500–2,000 mg per day (adjust dose based on testing)

Slippery elm (Ulmus rubra)

1–3 tsp in 240 mL of water, up to three times per day (adjust dose based on testing and form) 

Ginger (Zingiber officinale)

250 mg to 2 g per day given in 3–4 divided doses (adjust dose based on testing and form) 

  • Ginger’s terpene compound, zingiberene, and phenolic compound, gingerol, support a healthy inflammation balance. (Bodagh 2019)

Reviewed by

Natacha Montpellier, ND

Medical Science Liaison

Dr. Natacha Montpellier is a registered naturopathic doctor in Ontario, Canada. She currently maintains a private clinical practice focused on hormonal and reproductive health. Dr. Natacha, ND, also serves as a Medical Science Liaison on Fullscript’s Medical Advisory team.

References

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Disclaimer

This site is intended solely as an informational reference tool for practicing healthcare professionals. The content provided is not intended to be for medical diagnosis or treatment, is not a substitute for your professional judgment, and is not meant to provide you with medical or professional advice. You should evaluate and independently confirm the appropriateness of the content provided, and you should rely on your experience and judgment and other available resources when applying the provided content to an actual patient care situation. While content has been obtained from sources believed to be reliable, we cannot and do not guarantee the accuracy, validity, timeliness, or completeness of the content.