Addyi Treatment Protocol for Endometriosis Patients

• Discontinue Mirena and start Orilissa 150 mg daily with Norethndrone 10 mg daily for severe endometriosis. May consult Reproductive Endocrinology at the closest academic center.
• Drink 1,500 ml distilled water/Pedialyte from 4 pm to bedtime daily, minimize black box warning of hypotension.
• Check hormonal levels, maintain above 50^th percentile. Vaginal estrogen for vaginal dryness or low/borderline estrogen level. Topical liposomal progesterone brand source naturals, if low or borderline.
• Start psychotherapy/telecounseling with a licensed social worker for cognitive behavioral therapy weekly for anxiety-stress-depression and alcohol dependence management. Start Hypnotherapy. May start Cervella electrotherapy.
• Check thyroid/parathyroid levels if borderline consult endocrinology. Start liquid iodine daily, Lifeflo brand. Vitamin E softgel 400 IU with selenium, 3 softgels daily, Nature's Way brand. Start Selenium 100 mcg daily, NOW brand.
• Pharmacogenetic testing and exome panel testing.
• Consult Neurology for a spinal tap to evaluate CSF spinal fluid for neurometabolic disorders with a neurometabolic panel.
• Check Vitamin D/B12/B6/B9 level, started correcting.
• Maintain hemoglobin at 13-15 mg/dL, (Blackstrap molasses 2-3 TBSP daily in tea, Plantation brand) or Slow Fe or Ferrett’s elemental iron.
• Check hemoglobin A1C and albumin/creatinine ratio.
• Obesity Medicine consult.

Additional Endometriosis Therapy

• Buy Woodlock oil on eBay: Massage to pelvis and sacrum then place saran/cling to pelvis then hot water bottle/heating pad for 1 hour BID
• Low dose Naltrexone 3 mg daily
• Tylenol 1,500 mg BID prn and Celebrex 400 mg daily for breakthrough pain
• Pau D' Arco, Nature's Way brand 3 capsules BID and Astragalus Gaia herbs brand 3 capsules BID

Remaining HSDD and Endometriosis Regimen

• Start green tea with lemon/pomegranate/ginger daily
• Mediterranean diet: high protein low carbohydrate diet, 3 serving fruits/vegetables, should be organic produce
• 500 ml distilled or bottled water before meals, total 1500-2000 ml per day
• Juicing: carrot, beet, ginger, and kale, 8 ounces daily, cannot store in the refrigerator, organic produce
• Gluten-free diet
• No sugar, gluten-free honey
• Reduce carbohydrate content of diet
• Organic meat, no hormones or antibiotics, vegetarian fed
• Fresh/wild fish, no farm-raised fish
• Cage-free brown eggs
• Organic aloe vera juice 150 ml daily, Saluttie/Aloevine aloe vera juice 1,000 ml daily
• Kefir 250 ml twice a day, minimum, coconut or cashew-based if lactose intolerant. Lifeway brand
• Walking by water 3 times a week for 60-90 minutes for weight loss and cognitive behavioral therapy (CBT), run-walk-run method
• Vitafusion Prenatal MVI 4 gummies twice daily or Alive women's MVI 3 gummies BID
• Methylcobalamin 10,000 mcg (10 mg) sublingual daily, brand source naturals or NOW
• Methylfolate 2 mg daily, NOW brand
• Pyridoxine-6-phosphate 300 mg daily, source naturals brand
• Evening Primrose Oil 1,300 mg softgel, 2 softgels twice daily, brand nature's way or made
• Vitamin D3 softgel 50,000 IU weekly total brand NOW (5,000-10,000 IU softgels each)
• Vitamin C 2,000 mg daily, extended-release/ Emergen C(immunity boosting) in AM
• Zinc gluconate 150 mg daily, NOW brand
• Magnesium Citrate 400-800 mg softgel daily brand Carlson
• Tai Chi 1-2 times weekly at community center/public library
• Acupuncture with moxibustion for stress management/endometriosis-hormonal imbalance management weekly, Chinese/Japanese
• Meditation, sound therapy (Taos Winds Spirit Music on YouTube) several times a day, Weight Loss Hypnosis video on YouTube daily by David McGraw
• Refer to the American Association of Endocrinology obesity guidelines to interchange meds for ones that do not cause weight gain
• Reflexology daily, print foot map from online use Family Dollar chest rub for massage, mainly focus on heart lungs, and intestines
• Supplement purchasing from luckyvitamin.com or Vitacost or iHerb