In this article:
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.
As a result, the Fullscript Integrative Medical Advisory team advises using an evidence-informed approach to protocol development. To simplify this process for practitioners, we have assembled a sampling of evidence-based standardized protocols that practitioners can use as a foundation when developing individualized protocols.
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. These are categorized as follows:
A Systematic review or meta-analysis
B Randomized Double Blind Placebo Controlled (RDBPC) 2+ studies and/or 1 study with 50 + subjects
C Randomized Double Blind Placebo Controlled (RDBPC) 1 study
Please refer to the complete Rating Scale for further information.
The ingredients included in these protocols are based on a review of existing clinical research, with a priority placed on systematic reviews and meta-analyses, classified as A in the Rating Scale.
These protocols are intended to form a foundation for developing individualized treatment plans. Clinician discretion is highly advised, as ingredients can vary in safety and effectiveness, depending on the needs of the individual patient.
Ingredient-Based Protocol: Nonalcoholic Steatohepatitis (NASH)
Milk Thistle (Silybum marianum)
70-140mg, two to three times per day, minimum 12 weeks1
- Compared to a controlled regimens, significant reduction of AST and ALT levels were observed1,2,3
- Demonstrated decrease in transaminases of NASH patients, which led to a revival of liver function in NASH patients, hence improving prognosis and progression of liver cirrhosis1,2,3
Search for Milk Thistle in the Fullscript catalog.
800 IU, once per day, minimum 2 years4
- Compared to control, vitamin E was shown to be effective in reducing fibrosis, AST, ALT, ALP, steatosis and inflammation5
- It has been shown that vitamin E is the therapeutic choice for NASH as it has properties as an anti-inflammatory, anti-apoptotic and antioxidant6
Search for Vitamin E in the Fullscript catalog.
Artichoke (Cynara scolymus)
600mg, once per day, minimum 2 months7
- Artichoke leaf extract has been shown to have beneficial effects on liver enzymes ALT and AST7
- Symptoms associated with NASH have been shown to be alleviated by artichoke leaf extract in addition to improving lipid levels and liver enzymes8
Search for Artichoke in the Fullscript catalog.
Adding Protocols to your Fullscript Catalog
Create a Template
- Click the “Prescriptions” button
- Click “Manage your prescription templates”
- Click “Create a new template”
- Add a title, products, dosing, message, and attachments
- Click “Save Template”
Templates can be accessed and applied when creating a new prescription for your patients.
Write a Prescription
- Click the “New Prescription” button
- Click the “Templates” button in the right-hand menu column
- Click the “Apply” button beside the template you wish to apply
- Modify as needed
- Click the “Send to Patient” button!
Create a Category
- Click the Catalog button
- Click the “Your Favorites” tab
- Click “Add Category” and add name
- Add products
Categories can be used for quick reference or for patient use when accessing the catalog (depending on catalog settings).
Visit the Fullscript Integrative Clinical Education Hub for a full review of the literature used to develop this protocol.
We’d be happy to help you create a protocol containing these ingredients in your Fullscript catalog! Contact our Customer Success team for assistance.
1 (A) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728929/
2 (B) - https://www.ncbi.nlm.nih.gov/pubmed/22343419/
3 (B) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612568/
4 (B) - https://www.ncbi.nlm.nih.gov/pubmed/20427778
5 (A) - https://www.ncbi.nlm.nih.gov/pubmed/26059365
6 (A) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313719/
7 (B) - https://www.ncbi.nlm.nih.gov/pubmed/29520889
8 (B) - https://www.ncbi.nlm.nih.gov/pubmed/27735918