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

Ingredients for spring health

Between the holiday festivities, shorter days, and cold weather, for many, winter often brings with it a number of health challenges. Restore whole-body fortitude and prepare for spring with the evidence-based ingredients found in this protocol.



While many ingredients may be considered part of a wellness protocol, the Fullscript Medical Advisory Team has selected these based on general safety, effectiveness, broad applicability, and availability to the adult population.


Probiotics

~10 billion CFU per day, for 8 weeks, depending on the patient’s individual needs (Zhang 2016)

  • Digestive health: Probiotics may reduce the risk and severity of unwanted digestive symptoms, including pain, bloating, and gas, by 21%. (Ford 2014)(Didari 2015) The positive effects may be seen with doses lower than 10 billion CFU within 8 weeks, but higher doses and duration are also beneficial. (Zhang 2016)
  • Allergies: Probiotics may be moderately helpful for reducing allergy symptoms and may help improve quality of life, possibly by supporting a healthy helper T cell immune response. (Luo 2022)

L-theanine and GABA

200–400 mg of L-theanine (Hidese 2019)(Williams 2020) & 100–300 mg of GABA per day, minimum 4 weeks (Hepsomali 2020)

  • L-theanine may provide support for stress and nervous tension in people exposed to stressful conditions, (Williams 2020) and may help improve mood and sleep quality. (Hidese 2019)
  • GABA may help provide support for stress and promote sleep, (Hepsomali 2020) with some evidence suggesting it may have positive effects within one hour of taking. (Abdou 2006)

Prepare for spring with the evidence-based ingredients found in this protocol.

Quercetin

200–500 mg per day minimum, for at least 8 weeks (Mohammadi-Sargang 2017)(Serban 2016)(Yamada 2022)

  • Allergies: Quercetin may be helpful for relieving the symptoms of pollen allergies, including itchy eyes, sneezing, runny nose, and sleep issues. (Yamada 2022)
  • Anti-inflammatory: Quercetin can support optimal C-reactive protein levels and may help support a healthy inflammatory response. (Mohammadi-Sargang 2017)
  • Cardiovascular protection: Quercetin may help produce small improvements in blood pressure. (Popiolek-Kalisz 2022)(Huang 2020)(Serban 2016)

Collagen

2.5–10g of collagen hydrolysate per day, 3 months minimum (Choi 2019)(de Miranda 2021)

  • When used for at least 90 days, collagen supplementation may help support healthy skin aging by improving skin elasticity and hydration, which may help prevent or slow the development of wrinkles. (Choi 2019)(de Miranda 2021)

Authors

Christopher Knee, ND, MSc

Medical Education Manager

Dr. Christopher Knee is a naturopathic doctor, clinical researcher, and natural health and wellness expert from Ottawa, Canada. As the research and education manager for Fullscript’s Integrative Medical Advisory team, he oversees research projects and the development of medical education content for practitioners and patients across North America. He completed Bachelor's and Master's degrees from the University of Guelph in human kinetics and human biology and nutritional sciences, respectively, and naturopathic training at the Canadian College of Naturopathic Medicine. He's passionate about evidence-informed practice, patient education, health services research, and natural medicines. He has almost 15 years of academic, industry, and advisory experience, having worked with various organizations, including The Ottawa Hospital, the Ottawa Police Service, the University of Ottawa Heart Institute, the Ontario Association of Naturopathic Doctors, the Canadian College of Naturopathic Medicine, Valeant Pharmaceuticals, Nordion, and Pfizer.

Ross Bailey, MKin, BScKin

Lead Analyst, Medical Innovation

Ross graduated from Queen’s University with a Bachelor of Science specializing in kinesiology, then completed a Master’s in Kinesiology at Western University. At Western, he worked as a teaching assistant in the cadaver labs for undergraduate anatomy courses. Ross enjoys conducting in-depth research reviews on a variety of medical topics and is an advocate for evidence-based decision support. He actively engages in continuing education on subjects like research methods in systematic reviews and meta-analyses, supplement quality standards, and the regulation of sports nutrition.

References

  1. Abdou, A. M., Higashiguchi, S., Horie, K., Kim, M., Hatta, H., & Yokogoshi, H. (2006). Relaxation and immunity enhancement effects of gamma-aminobutyric acid (GABA) administration in humans. BioFactors, 26(3), 201–208. https://doi.org/10.1002/biof.5520260305
  2. Choi, F. D., Sung, C. T., Juhasz, M. L. W., & Mesinkovsk, N. A. (2019). Oral collagen supplementation: A systematic review of dermatological applications. Journal of Drugs in Dermatology: JDD, 18(1), 9–16. https://www.ncbi.nlm.nih.gov/pubmed/30681787
  3. de Miranda, R. B., Weimer, P., & Rossi, R. C. (2021). Effects of hydrolyzed collagen supplementation on skin aging: A systematic review and meta-analysis. International Journal of Dermatology, 60(12), 1449–1461. https://doi.org/10.1111/ijd.15518
  4. Didari, T., Mozaffari, S., Nikfar, S., & Abdollahi, M. (2015). Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World Journal of Gastroenterology, 21(10), 3072–3084. https://doi.org/10.3748/wjg.v21.i10.3072
  5. Ford, A. C., Quigley, E. M. M., Lacy, B. E., Lembo, A. J., Saito, Y. A., Schiller, L. R., Soffer, E. E., Spiegel, B. M. R., & Moayyedi, P. (2014). Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: Systematic review and meta-analysis. The American Journal of Gastroenterology, 109(10), 1547–1561. https://doi.org/10.1038/ajg.2014.202
  6. Hepsomali, P., Groeger, J. A., Nishihira, J., & Scholey, A. (2020). Effects of oral gamma-aminobutyric acid (GABA) administration on stress and sleep in humans: A systematic review. Frontiers in Neuroscience, 14, 923. https://doi.org/10.3389/fnins.2020.00923
  7. Hidese, S., Ogawa, S., Ota, M., Ishida, I., Yasukawa, Z., Ozeki, M., & Kunugi, H. (2019). Effects of L-theanine administration on stress-related symptoms and cognitive functions in healthy adults: A randomized controlled trial. Nutrients, 11(10). https://doi.org/10.3390/nu11102362
  8. Huang, H., Liao, D., Dong, Y., & Pu, R. (2020). Effect of quercetin supplementation on plasma lipid profiles, blood pressure, and glucose levels: A systematic review and meta-analysis. Nutrition Reviews, 78(8), 615–626. https://doi.org/10.1093/nutrit/nuz071
  9. Luo, C., Peng, S., Li, M., Ao, X., & Liu, Z. (2022). The efficacy and safety of probiotics for allergic rhinitis: A systematic review and meta-analysis. Frontiers in Immunology, 13, 848279. https://doi.org/10.3389/fimmu.2022.848279
  10. Mohammadi-Sartang, M., Mazloom, Z., Sherafatmanesh, S., Ghorbani, M., & Firoozi, D. (2017). Effects of supplementation with quercetin on plasma C-reactive protein concentrations: A systematic review and meta-analysis of randomized controlled trials. European Journal of Clinical Nutrition, 71(9), 1033–1039. https://doi.org/10.1038/ejcn.2017.55
  11. Popiolek-Kalisz, J., & Fornal, E. (2022). The effects of quercetin supplementation on blood pressure – Meta-analysis. Current Problems in Cardiology, 47(11), 101350. https://doi.org/10.1016/j.cpcardiol.2022.101350
  12. Serban, M.-C., Sahebkar, A., Zanchetti, A., Mikhailidis, D. P., Howard, G., Antal, D., Andrica, F., Ahmed, A., Aronow, W. S., Muntner, P., Lip, G. Y. H., Graham, I., Wong, N., Rysz, J., Banach, M., & Lipid and Blood Pressure Meta‐analysis Collaboration (LBPMC) Group. (2016). Effects of quercetin on blood pressure: A systematic review and meta-analysis of randomized controlled trials. Journal of the American Heart Association, 5(7). https://doi.org/10.1161/JAHA.115.002713
  13. Williams, J. L., Everett, J. M., D’Cunha, N. M., Sergi, D., Georgousopoulou, E. N., Keegan, R. J., McKune, A. J., Mellor, D. D., Anstice, N., & Naumovski, N. (2020). The effects of green tea amino acid L-theanine consumption on the ability to manage stress and anxiety levels: A systematic review. Plant Foods for Human Nutrition, 75(1), 12–23. https://doi.org/10.1007/s11130-019-00771-5
  14. Yamada, S., Shirai, M., Inaba, Y., & Takara, T. (2022). Effects of repeated oral intake of a quercetin-containing supplement on allergic reaction: A randomized, placebo-controlled, double-blind parallel-group study. European Review for Medical and Pharmacological Sciences, 26(12), 4331–4345. https://doi.org/10.26355/eurrev_202206_29072
  15. Zhang, Y., Li, L., Guo, C., Mu, D., Feng, B., Zuo, X., & Li, Y. (2016). Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: A meta-analysis. BMC Gastroenterology, 16(1), 62. https://doi.org/10.1186/s12876-016-0470-z

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