QUESTION: Researching IV nutrient protocols for addiction and not finding much except a paper on NAAT but they are not sharing formulation because they have a patent….Any suggestions where I can find a protocol?
ANSWER: In my experience over the past few decades, there are a few primary targets in addiction therapies. **Here I will not reiterate the non-nutrient care required (behavioral, general diet, life skills, accountability etc) but of course no nutritional therapy can succeed without these.
There are in my experience a few things to consider as high value targets in the addict. They all generally need to be addressed in order to have any success and efficacy. One target to consider is ReDox balance, another is overall substrate availability (including cofactors) and the most well-known is dopamine augmentation (especially D2 activity). Some limited considerations:
- Ascorbate and dopamine metabolism: both intra- and extravesicular ascorbate participate in the regulation of dopamine beta-hydroxylase. Intravesicular ascorbate is the cofactor for the enzyme. Cytosolic ascorbate is most likely the electron donor for the vesicle-membrane electron transport system which maintains the intravesicular cofactor concentration. [PMID: 3097015]
- Ascorbate at high dose has anecdotally been reported in addiction medicine to decrease recidivism and physical side effects of drug detox.
- D2 receptors are allosterically inhibited by homocysteine [PMID 17081059].
- Iron Zinc and Magnesium are implicit co-factor ions for the dopamine pathway, and copper for NE formation.
- Methyl cycle defects as well as deficient upstream substrate (Phenylalanine and Tyrosine) will also aggravate dopamine deficiencies.
- In addition to all of this neuroinflammatory triggers such as glutamate and histamine are able to greatly exacerbate the underlying condition.
Targets of therapy to consider are:
- ReDox balance including membrane protein stability
- Addressing methylation for SAM / DA formation
- Address co-factors for all pathways
- Ascorbate therapy
- Address histamine/glutamate inflammatory triggers and metabolism
- Follow and specifically treat homocysteine elevations
PATHWAY REMINDERS:
Oral:
- Trace minerals mix + Magnesium to bowel tolerance daily
- High potency B Complex in addition to a multi vitamin
- Tyrosine and or phenylalanine – dose AM and Lunch as tolerated
- Niacinamide 1000 mg BID-TID
- Pantothenic Acid 1-2 grams a day
- Oral ascorbate with each meal to bowel tolerance
- If required and tolerated Methyl B12/Folate
- NAC 500-600 mg BID (both as a GSH substrate and as a Glutamate transport aid for CNS
- If anemic – replete iron
IV and oral:
- IV Vitamin C 25-50 grams (separate day from IV nutrients)
- IV Nutrients (to include those above) Plus Mixed Amino Acids (50-100 mL per 500 mL bag)
- Follow IV Nutrients with 1-4 grams GSH as tolerated