Clinical Protocol Library
Metabolic Optimization &
Longevity Protocol Library
Dr. Kim Lockheimer, PhD, DFM
For educational purposes only. Not intended to diagnose, treat, or replace individualized medical care.
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Clinical Goals
- Improve cellular energy efficiency
- Reduce inflammation & oxidative stress
- Support glucose and lipid balance
- Enhance detoxification pathways
- Promote longevity signaling (AMPK, sirtuins, autophagy)
Lab Testing
- Organic Acids Test (OAT)
- DUTCH Complete
- Fasting Insulin, Glucose, HOMA-IR
- hs-CRP, Homocysteine
- HTMA or RBC Mineral Analysis
- Advanced Lipid Panel
Nutrition & Lifestyle
- Whole-food anti-inflammatory diet
- Time-restricted eating / fasting-mimicking cycles
- Resistance and aerobic exercise
- 7–9 hours quality sleep & circadian optimization
- Breathwork, mindfulness, grounding
Supplement Support
- CoQ10 (Ubiquinol): 100–200 mg daily
- Magnesium Glycinate: 300–400 mg at bedtime
- Alpha-Lipoic Acid: 100–300 mg daily
- Berberine: 500 mg twice daily
- NAC: 600–1200 mg daily
- Resveratrol, PQQ, or NMN
Monitoring & Follow-Up
- Recheck labs every 8–12 weeks
- Track energy, sleep, and focus metrics
- Adjust nutrients & adaptogens based on progress
- Document changes for longitudinal tracking
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Clinical Goals
- Restore insulin receptor sensitivity
- Stabilize postprandial glucose response
- Improve HOMA-IR & fasting glucose
- Enhance metabolic flexibility
- Reduce visceral adiposity
Lab Testing
- Fasting Insulin & Glucose
- HOMA-IR (target <1.5)
- HbA1c & fructosamine
- C-peptide if needed
- Advanced lipid particle sizing
Nutrition & Lifestyle
- Low-glycemic, fiber-rich whole foods
- Post-meal walks (10–15 min)
- Time-restricted feeding window (8–10 hrs)
- Resistance training 3–4x/week
- Reduce refined sugars and seed oils
Supplement Support
- Berberine: 500 mg twice daily
- Chromium Picolinate: 200–400 mcg
- Magnesium: 300–400 mg daily
- Alpha-Lipoic Acid: 300 mg daily
- Inositol (Myo + D-Chiro) for PCOS/insulin
Monitoring & Follow-Up
- Fasting glucose & insulin q8–12 weeks
- CGM monitoring if indicated
- Track weight, waist circumference
- Document dietary compliance
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Clinical Goals
- Reduce hs-CRP to <1.0 mg/L
- Normalize homocysteine (<7 µmol/L)
- Quench ROS / free radical load
- Upregulate Nrf2 pathway
- Support phase I & II detoxification
Lab Testing
- hs-CRP
- Homocysteine
- Oxidized LDL
- 8-OHdG (oxidative DNA damage)
- Glutathione (whole blood)
Nutrition & Lifestyle
- Mediterranean-style anti-inflammatory diet
- Omega-3 rich foods (wild salmon, sardines, walnuts)
- Cruciferous vegetables for sulforaphane
- Reduce ultra-processed foods
- Sauna therapy (if tolerated)
Supplement Support
- Omega-3 (EPA+DHA): 2–4 g daily
- NAC: 600–1200 mg daily
- Glutathione (liposomal): 250–500 mg
- Curcumin (with piperine): 500–1000 mg
- Quercetin: 500 mg daily
Monitoring & Follow-Up
- Recheck hs-CRP & homocysteine q8 weeks
- Track inflammatory symptoms & fatigue
- Assess gut health (microbiome link)
- Review environmental exposures
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Clinical Goals
- Optimize T3/T4 conversion
- Balance cortisol diurnal rhythm
- Support estrogen & androgen metabolism
- Reduce SHBG dysregulation
- Correct adrenal fatigue patterns
Lab Testing
- DUTCH Complete (hormonal-metabolic interplay)
- Full thyroid panel (TSH, fT3, fT4, rT3, TPO-Ab)
- Salivary or serum cortisol (AM/PM)
- Sex hormones (estradiol, progesterone, testosterone, DHEA-S)
- SHBG, prolactin
Nutrition & Lifestyle
- Adequate iodine & selenium for thyroid
- Reduce xenoestrogen exposure (plastics, pesticides)
- Circadian light entrainment
- Stress management for HPA axis
- Seed cycling for estrogen support
Supplement Support
- Ashwagandha: 300–600 mg (adrenal/thyroid)
- Selenium: 100–200 mcg (thyroid conversion)
- Zinc: 15–30 mg (sex hormone support)
- DIM or I3C (estrogen metabolism)
- Magnesium: 300–400 mg at bedtime
Monitoring & Follow-Up
- Repeat DUTCH & thyroid panel q12 weeks
- Track mood, libido, temperature, energy
- Assess menstrual cycle regularity
- Coordinate with prescribing physician if HRT involved
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Clinical Goals
- Activate AMPK & sirtuin pathways
- Promote autophagy & mitophagy
- Inhibit mTORC1 overactivation
- Reduce senescent cell burden
- Extend healthspan, not just lifespan
Lab Testing
- Telomere length testing
- GlycanAge or epigenetic clock
- IGF-1 levels
- p21/p16 senescence markers (research)
- Inflammatory SASP panel
Nutrition & Lifestyle
- Periodic fasting or fasting-mimicking diet
- Caloric restriction windows
- Zone 2 aerobic training (mitochondrial biogenesis)
- Cold & heat hormesis (sauna, cold plunge)
- Polyphenol-rich, low-AGE diet
Supplement Support
- NMN or NR: 250–500 mg daily (NAD+ precursors)
- Resveratrol: 250–500 mg with fat
- PQQ: 10–20 mg daily
- Fisetin (senolytic): 500–1000 mg cyclically
- Spermidine: dietary or supplemental
Monitoring & Follow-Up
- Annual or semi-annual epigenetic age testing
- Track grip strength, VO2 max, HRV
- Monitor IGF-1 to avoid excess
- Document quality of life & biomarker trends
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Clinical Goals
- Replete key mitochondrial cofactors
- Support hepatic phase I, II, & III detox
- Reduce heavy metal & toxin burden
- Restore gut mucosal barrier
- Enhance lymphatic clearance
Lab Testing
- RBC Mineral Analysis (magnesium, zinc, selenium)
- HTMA (Hair Tissue Mineral Analysis)
- Heavy metals panel (urine provoked)
- Organic Acids Test (OAT)
- Comprehensive stool analysis
Nutrition & Lifestyle
- Cruciferous vegetables (sulforaphane, glucosinolates)
- Clean filtered water (2–3 L/day)
- Reduce alcohol, processed foods
- Dry brushing & infrared sauna
- Binders with meals if high toxin load
Supplement Support
- NAC: 600–1200 mg (glutathione precursor)
- Milk Thistle (silymarin): 140 mg 3x/day
- B-complex (methylated): active B6, B12, folate
- Zinc + Selenium for metallothionein support
- Molybdenum if sulfite sensitivity
Monitoring & Follow-Up
- Repeat mineral & metals panel q12 weeks
- Track fatigue, brain fog, chemical sensitivities
- Liver enzymes (ALT, AST, GGT) baseline & q12 weeks
- Adjust binders & chelation cautiously
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Functional Target Ranges
- Fasting Glucose: 70–85 mg/dL
- Fasting Insulin: <5 µIU/mL
- HOMA-IR: <1.5
- hs-CRP: <0.5 mg/L
- Homocysteine: <7 µmol/L
Recommended Testing Cadence
- Metabolic panel: q8–12 weeks
- Hormonal panel: q12–16 weeks
- Heavy metals: annually or if symptomatic
- Epigenetic/telomere: annually
- OAT / DUTCH: q6 months
Tracking Metrics
- Subjective: energy, sleep quality, cognition
- Objective: HRV, resting HR, sleep stages
- Body composition: DEXA or impedance
- Physical performance: grip, VO2 max
- GI: bowel regularity, bloating, transit
Documentation Protocol
- Maintain longitudinal lab trend charts
- Record supplement adjustments with dates
- Note lifestyle interventions & outcomes
- Pre/post comparison after each protocol cycle
Clinical Follow-Up
- Review with prescribing clinician q quarter
- Coordinate OAT & DUTCH interpretation
- Adjust protocols to patient response
- Refer for advanced imaging if indicated
Key Functional Lab Markers Referenced Across All Protocols
Organic Acids (OAT)
DUTCH Complete
Fasting Insulin
HOMA-IR
hs-CRP
Homocysteine
HTMA
RBC Mineral Analysis
Advanced Lipid Panel
Full Thyroid Panel
DHEA-S
Oxidized LDL
8-OHdG
IGF-1
Salivary Cortisol
HbA1c
Glutathione (whole blood)
Heavy Metals Panel
Telomere Length
GlycanAge / Epigenetic Clock