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Clinical Reference // Treatment Guidelines

7.1 Using Daily Essential Nutrients
Unless contraindications (see 6.2 Contraindications) or precautions (see 5.2 Precautions) direct otherwise, Daily Essential Nutrients can generally be administered to patients as outlined in this section. Individual patient characteristics may require adaptations according to clinical judgment.

7.1.1 Initial dosing
Generally, Daily Essential Nutrients can be titrated up to an appropriate therapeutic dose (see 3 Indications & Dosage) within 4 days (see Figure 1).

7.1.2 Instructions for Daily Essential Nutrients use
Patients should take Daily Essential Nutrients as directed on the label to avoid potential gastrointestinal side effects (see 4.1 Side effects):
“Suggested Use: Take with food. Start with 1 capsule 3 times daily. For optimal results, increase to 4 capsules 3 times daily or as recommended by a physician.”
Children should take Daily Essential Nutrients under adult supervision (see 5.2 Precautions).

If a patient has difficulty falling asleep, he/she should take Daily Essential Nutrients prior to 6 pm (see 8.7.2 Inadequate sleep).

7.2 Psychiatric medications
Psychiatric medication doses, including lithium, should be monitored carefully during Daily Essential Nutrients therapy (see 5.1 Warnings).

If psychiatric medication side effects emerge, gradually reduce medication dosages (see 4.2 Drug interactions). Ideal psychiatric medication tapering minimizes patient symptoms by avoiding both adverse interaction and withdrawal effects (see 8.1 Psychiatric medication management). Figure 2 illustrates the importance of minimizing drug-related symptoms during the psychiatric medication reduction process.

Hardy Nutritionals™ Free-Form Aminos or protein powders can help ameliorate drug-related symptoms until medication reductions are optimized, perhaps by binding to pharmacologically active drug metabolites and diminishing their pharmacologic effects. Absorption of protein products will be expedited if taken between meals.

7.2.1 Polypharmacy
Multiple psychiatric medications are often prescribed together to manage symptoms for which one medication alone may not be effective. These medications should be reduced at the same rate in order to maintain the balance that they exert together on the central nervous system.

7.3 Other medications
All medication doses should be monitored by a physician during Daily Essential Nutrients therapy (see 5 Warnings & Precautions).

Medications for health conditions such as thyroid irregularities, insulin irregularities, heart issues, high blood pressure, high cholesterol, and cancer need to be monitored closely. Medication dosages may require adjustment.

Non-psychiatric medications that may limit a patient’s response to Daily Essential Nutrients are listed in 8.2 Non-psychiatric medications.

7.4 Gastrointestinal issues
Healthy gastrointestinal function is critical for optimal digestion and absorption of nutrients from foods and supplements. Various gastrointestinal issues, such as bowel disorders, constipation, diarrhea, and gut microflora imbalance can limit response to Daily Essential Nutrients therapy. For detailed recommendations, see 8.5 Gastrointestinal problems.

7.5 Other considerations
Additional patient characteristics that can influence the use of Daily Essential Nutrients and/or adjunct treatments include the following:
7.6 Addressing residual symptoms

Daily Essential Nutrients doses may need to be adjusted over time according to patient response and factors that limit the effectiveness of Daily Essential Nutrients therapy (see 8 Possible Limiting Factors). Adjunct treatments may also be useful.

7.6.1 Physical Symptoms of anxiety and stress
Physical symptoms of anxiety may include light-headedness, muscle tension, and ‘butterflies’ in the stomach, which may be accompanied by excessive worrying, poor concentration, and distractibility. Patients who continue to experience symptoms of physical anxiety or stress while taking a therapeutic dose of Daily Essential Nutrients may benefit from added inositol (such as Hardy Nutritionals™ Inositol Powder). 

7.6.2 Racing or obsessive thoughts

Patients who continue to exhibit rage, aggression, racing thoughts or obsessive thoughts while taking a therapeutic dose of Daily Essential Nutrients may benefit from added choline (such as choline bitartrate or phosphatidylcholine).