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Kassem's Medical Student Stack

medicine medical student student medical ciltep mitochondrial enhancemen cognitive enhancement brain functioning peak performance

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#1 kassem23

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Posted 30 September 2013 - 07:55 PM


Hello all,

I think it is prudent for me to finally start a log. It has been a long time since I have ever documented my nootropic experiences, but since I started medical school, I see no reason not to.

First off, I do not subscribe to the idea that I am suffering from any disorder, but much like everyone else, I have to deal with the constant stream of instant-gratification so verily abundant in our society, and thus the cognitive debilitations that follow, namely a decrease in ability to sit down for extended periods of time with a high level of focus.

Anyhow, let's get right to it.

Studying medicine requires a high level of investment, cognitively speaking. The stack for my medical school focuses on a couple of things.

(1) The ability to focus for extended periods of time. As everyone who has ever heard anything about medical school will know, medschool requires a lot of dedication. The material may not be as difficult to comprehend conceptually as physics or mathematics, but there is a lot of information that needs to be understood, applied and committed to one's working base of knowledge. Thus, the ability to focus is crucial to one's performance in studying medicine.

(2) Divergent / holistic problem thinking. Not only building a linear path of knowledge, but also being able to make conceptual leaps. The body is an interrelated machine of various mechanisms, and a lot of things affect a lot of other things. Understanding that the body is a dynamic system with various pieces moving in different directions, causing direct or indirect changes is paramount to understanding the various physiological mechanisms. Thus, being able to creatively link disparate pieces of knowledge in a medicine context.

(3) Memory. For me, this should be a side-effect to studying with focus for extended periods of time. Spaced-repetition schemes should be applied to a certain extent for a large amount of fact-based knowledge building. That said, the more times you go over the various mechanisms, and apply the knowledge that one has learned, the more solidifed the memories of said knowlege will become. It matters a lot to me that the knowledge that I attain is not simply recall, but an understanding behind as it will allow for a more holistic view and understanding.

(4) General brain performance and health. I am aiming for a stack that will provide me not only with enhancement but with basic nourishment for the cognitive demand.

Anyhow, let us move on to the stack.

Basic Supportive / General Brain Health
  • Vitamin B complex
  • Vitamin D3, 10000IU
  • Zinc, 50mg
  • Vitamin A, 10000IU
  • Creatine monohydrate, 5g
  • PQQ, 10mg
  • Magnesium L-Threonate, 144mg
  • Fish oil from mackerel and salmon (~10g fish oil, daily)
Reasoning behind these are based on mitochondrial improvement, ATP synthesis and general vitamin basis. Creatine and PQQ in particular are of interest to me as they both increase subjective measures of energy. Energy, as many knows, is the main culprit behind intelligence. More directed energy will allow for more time for cognitive pursuits and thus also improve cognition, systemwide. Creatine is one of the only substances that have shown -- in healthy individuals -- to improve scores in Raven's Progressive Matrices, a g-dependent task (that is, it stresses working memory capacity very significantly.) I do not have any personal experience with PQQ yet, but I am looking forward to adding it to my stack, having read great things about it from the folks behind the TULIP protocol, and who does not want to grow new neurons? ;)

I have added a high dose of vitamin D3 because I usually experience system wide negative effects during the winter period, including a reduction in general well-being, energy, and a dip in mood. The zinc is self-explanatory, but has shown to improve dopamine synthesis (some positive effect observed in ADHD populations, or ADHD populations were found to be zinc deficient) and for testosterone. I have added vitamin A for my skin because I am vain. Vitamin B complex for my brain. Magnesium L-Threonate because of the MIT study that has also been spoken about here on longecity. Purportedly, brain magnesium levels improves cognition, short and long-term memory, and improves learning ability in rats. I will be taking this supplement at night as I have heard it is quite relaxing.

NGF boosters – general brain health
  • Noopept, 10mg B.I.D., sublingual
The reasoning for noopept is that it improves BDNF and purportedly short/long-term memory and general cognition.

I have been using noopept for 8 days now, and I have found it to be quite supportive of my general well-being. It feels calming and improves cognition in ways not immediately perceptible. Peak of BDNF should be around day 26-28. I will continue taking this for general brain health for the next three months. I have not noted any short-term memory loss, "tip of the tongue" syndrome, but rather improved short-term memory and brain energy.

I may later add stuff such as Lion's Mane and Hydergine but for now I remain very simplistic.

Specific Long-Term Potentiation Stack – Focus / Memory
  • Artichoke Extract (source of Luteolin, a PDE-4 inhibitor), 450mg
  • Forskolin 10mg Life Extension source (~considering taking half of the contents from the capsule)
  • L-phenylalanine, 500mg
I have not started CILTEP yet, so I cannot say what effects it will have on me, but as soon as it arrives I will be adding it to my stack and noting the subjective and objective improvements (more on that in a second..)

The overall price per day for nootropics is 3.26$/day, which I deem to be an okay price to pay for enhanced cognition and thus learning ability.

As for the subjective / objective improvements, I am tracking my improvements using Dual N Back (DNB) and Cambridgebrainsciences (CBS) I am currently on Dual 3 Back around 83-89%, sometimes better than others - having just started DNB around day #6 of noopept administration I cannot tell whether or not it has helped in DNB, but my immediate feeling is that it has. I have also been doing lumosity, although I find the principles behind lumosity more questionable than DNB and CBS. And of course, my subjective / "objective" ability in retention level from my studying.

Comments are very, very welcome.

And as always, stay safe everyone.

Edited by kassem23, 30 September 2013 - 08:01 PM.

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#2 MercuryAX

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Posted 01 October 2013 - 03:26 AM

I really like this, Kassem. It looks like a really "clean" stack. No super-dosing racetams or nonsense drugs that often appear in "study stacks". A few questions, though:

1) Why the vitamin A for skin? You could also look into supplementing collagen...type 1 and 3. That should help.
2) How are you taking only 144mg of Mg Threonate, is that number describing elemental Mg?
3) How is the PQQ working for you? Feel any differences?
4) I know Isochroma advocates taking large doses of fish oil. Do you know if there's a good medical explanation for this? I think this is mostly because the DHA forms neural tissue, and you might need more of it to support a rapidly changing brain.

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#3 kassem23

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Posted 01 October 2013 - 07:48 AM

I really like this, Kassem. It looks like a really "clean" stack. No super-dosing racetams or nonsense drugs that often appear in "study stacks".


Thank you for your kind comment. I appreciate the feedback.

A few questions, though:

1) Why the vitamin A for skin? You could also look into supplementing collagen...type 1 and 3. That should help.


I have heard good things about vitamin A for skin. There is a reason that tretinoin is used by dermatologists. Besides, vitamin A is great for vision and the immune system. I see no reason not to try it. Fish oil helps skin as well.

2) How are you taking only 144mg of Mg Threonate, is that number describing elemental Mg?


I am taking NeuroMag by Life Extension, and it states 144mg out of 2000mg L-threonate. I am not sure exactly what they mean as it is not directly specified. I am considering getting some magnesium sulfate and supplementing that as well. We'll see.

3) How is the PQQ working for you? Feel any differences?


I am waiting for my PQQ to arrive. I am currently only using noopept, creatine and the B-complex. Waiting for all the other supplements to arrive.

4) I know Isochroma advocates taking large doses of fish oil. Do you know if there's a good medical explanation for this? I think this is mostly because the DHA forms neural tissue, and you might need more of it to support a rapidly changing brain.


I believe that DHA and EPA both have beneficial effects, with a preference for DHA in terms of improving mood (especially in depressives). There is human evidence to support that there is an increase in working memory upon administering DHA, but it is not clear whether this is only for people with low dietary DHA. I remember reading articles that suggested that we usually got somewhere between 15-30 grams of fish-oil daily back in the day. I mean, we're a fish-eating species. If you look at human history, we've always lived near water, and I think it's a defining characteristic.

That said, you can also look at it from the fluidity perspective. Myelin, the sheaths along neurons, propagating the electrical signal, are 70% fatty acids. I think it makes sense that supplementing high levels of essential fatty acids is going to enhance signal propagation in one way or another. Maybe through myelin, maybe through membrane fluidity, maybe through a completely different mechanisms. I have heard great things about phosphadylserine as well, with some significant effects observed in ADHD cohorts (200mg per day, IIRC.)

Edited by kassem23, 01 October 2013 - 07:50 AM.


#4 penisbreath

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Posted 01 October 2013 - 08:00 AM

Hey Kassem, would you be willing to share your noopept source?

#5 kassem23

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Posted 01 October 2013 - 08:52 AM

Hey Kassem, would you be willing to share your noopept source?


Sure I would. I am getting my noopept from intellimeds.co.uk in tablet form. I take 10mg BID (bies in dies, twice daily, morning and evening), sublingually.

#6 xks201

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Posted 01 October 2013 - 11:15 AM

None of that would do much for me. Lol
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#7 MercuryAX

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Posted 03 October 2013 - 08:30 PM

Kassem, any update on the PQQ? Curious to see more anecdotes on it.

#8 kassem23

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Posted 04 October 2013 - 09:44 AM

Kassem, any update on the PQQ? Curious to see more anecdotes on it.


I have not received it yet, so I could not tell you.

I will let you all know when I receive all of my supplements and start the entire protocol. Currently only 10mg noopept BID (total of 20mg), B complex and creatine.

#9 Artificiality

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Posted 04 October 2013 - 09:56 AM

I think I recall reading some of your posts a while back where you had found success using large amounts of fish oil and Piracetam. I see you are still taking large amounts of fish oil but noticed the piracetam is not in your stack anymore. If you don't mind me asking, is there any reason for dropping the piracetam?

#10 chung_pao

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Posted 04 October 2013 - 12:13 PM

Cool thread. I remember seeing some newbie threads way back where you were raving about Piracetam and choline.
Your current approach and attitude seems much more mature and experienced.

I'm also getting into the medical field, starting school in a few months, so I'll be following this log.

As you probably know, you are what you eat, i.e. diet determines the composition and thus function of your body and physiology.
For example, a seemingly trivial thing such as "ratio of omega 3 to omega 6" can have radical effects and produce either fatigue or alertness.
Or falling victim of one of today's dietary epidemics: Choline deficiency, can make you a ADHD-symptomatic manic.
To say the least, dietary composition is important stuff.

What kind of diet are you following?
I've very good results lately when incorporating Natural sources of the known Nootropic "pseudovitamins" (Creatine, Phosphatidylserine, DHA, EPA, Choline, Q10), such as Eggs, Fish eggs (caviar / roe), Mackerell, Organ meats (such as heart). These foods have been very effective, far more so than the supplemental forms.

Btw, careful with vitamin A. I recently experienced Hypervitaminosis A from excessive Cod liver oil intake, and it wasn't pretty: hair loss, brittle skin, headaches due to cerebral edema...

Edited by chung_pao, 04 October 2013 - 12:15 PM.


#11 TVO

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Posted 04 October 2013 - 12:22 PM

Kassem you should give phenylpiracetam a shot, its my favorite racetam so far.

#12 kassem23

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Posted 05 October 2013 - 08:42 PM

I think I recall reading some of your posts a while back where you had found success using large amounts of fish oil and Piracetam. I see you are still taking large amounts of fish oil but noticed the piracetam is not in your stack anymore. If you don't mind me asking, is there any reason for dropping the piracetam?


I am currently employing noopept. I may re-add piracetam after I get a proper feel for this stack, but I do not know yet. As I have mentioned a couple of times, my products have not yet arrived. They should arrive during next week. I am still waiting for Forskolin, Artichoke Extract, Vitamin D3 and Magnesium L-Threonate.

#13 kassem23

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Posted 06 October 2013 - 11:04 AM

Cool thread. I remember seeing some newbie threads way back where you were raving about Piracetam and choline.
Your current approach and attitude seems much more mature and experienced.

I'm also getting into the medical field, starting school in a few months, so I'll be following this log.


Glad to hear it. Indeed I have grown up quite a bit.

As you probably know, you are what you eat, i.e. diet determines the composition and thus function of your body and physiology.
For example, a seemingly trivial thing such as "ratio of omega 3 to omega 6" can have radical effects and produce either fatigue or alertness. Or falling victim of one of today's dietary epidemics: Choline deficiency, can make you a ADHD-symptomatic manic.
To say the least, dietary composition is important stuff.

What kind of diet are you following?


Very clean diet. Eggs, mackerel, black bread, chicken and lots of greens.

I've very good results lately when incorporating Natural sources of the known Nootropic "pseudovitamins" (Creatine, Phosphatidylserine, DHA, EPA, Choline, Q10), such as Eggs, Fish eggs (caviar / roe), Mackerell, Organ meats (such as heart). These foods have been very effective, far more so than the supplemental forms.

Btw, careful with vitamin A. I recently experienced Hypervitaminosis A from excessive Cod liver oil intake, and it wasn't pretty: hair loss, brittle skin, headaches due to cerebral edema...


Vitamin A and vitamin D go in ratio 1:1. Vitamin A toxicity can be hindered by taking an equal or larger amount of vitamin D. See http://jdmoyer.com/2...luble-vitamins/
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#14 kassem23

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Posted 08 October 2013 - 02:51 PM

Finally received the components of CILTEP.

Today I took:

2 x 450mg NOW Artichoke Extract @ 1.00pm
5mg (half of 10mg Life Extension's) Forskolin @ 1.00pm
500mg (QUEST) L-phenylalanine @ 1.00pm
10mg (Life Extension) PQQ @ 1.00pm
Cup of coffee @ 2pm

The effects have been great thus far. Focus and motivation significant increase. Can only be described as a quite distinct dopaminergic feel that pushes you in a positive self-improvement direction. There has been zero anxiety to speak about despite the significant increase in mental energy. I feel very directed and emotionally stable. There has been no overwhelming euphoria, simply significant increase in mental energy and most importantly mental stamina which in itself is a wonderful mood boost.

EDIT: I just completed my Dual-N-Back for today. Hovering between 75-90% on visual/auditory on D3B. So, no significant reduction on DNB scores, actual slight increase, especially in visual. Will compile more tests, but mostly I will be focusing on my ability to study for extended periods of time. Even if we hypothesize that CILTEP reduces WM-capacity, the mere fact that I will be studying focused for extended periods of time would be a net benefit.

Edited by kassem23, 08 October 2013 - 03:22 PM.


#15 kassem23

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Posted 08 October 2013 - 11:20 PM

Update

I had an extremely productive day today, much more than I would have expected. I have learned about membrane dynamics (active transport, passive transport, membrane potentials, etc.) today and done a bunch of exercises, and felt really really motivated during the entire thing. It wasn't akin to amphetamine where you feel uncomfortably pushed towards completing your goals, it was simply the mere fact that I was not getting tired nor discouraged by not understanding things immediately. This is a direct improvement in intellectual habits, since more time spent learning whilst not being frustrated and bored will cumulatively lead to a net increase in abilities and knowledge formation. I completed some cognitive tests on Cambridge Brain Sciences today, and made two new records, one in spatial search (9.) and one in feature match (196.), my previous high scores in those two, respectively were 7 and 126. Hence, a significant increase.

That said, this is my first day, but if it continues this way, I will be very grateful.

Absolutely wonderful.

I am surprised Abelard could keep his mouth shut about his subjective effects, he has remained surprisingly level headed during the entire time. Also quite amazing that it has worked for him for several years now at the same doses, with minor alterations (added ALCAR, for instance.)

This will be very interesting to experiment with.

Beautiful that some mechanisms in the mind can be distilled into their mere components and utilized. A PDE-4 inhibitor alternative... in Artichoke Extract (luteolin), who would've guessed. And then a cAMP increaser, forskolin. Nature already provided us with all the tools and secrets, we just need to open our eyes and find them.

Edited by kassem23, 08 October 2013 - 11:23 PM.


#16 chung_pao

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Posted 09 October 2013 - 03:53 PM

All the effects from the above anecdote, do you ascribe them to CILTEP? Or the combination of PQQ + CILTEP?
To replicate the effects you've had, would PQQ be necessary?

#17 kassem23

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Posted 09 October 2013 - 11:37 PM

All the effects from the above anecdote, do you ascribe them to CILTEP? Or the combination of PQQ + CILTEP?
To replicate the effects you've had, would PQQ be necessary?


I took PQQ in the days before that and did not find it to have such a significant effect. This was definitely the CILTEP at work. I am still amazed by its effects today. Had a great day, mood boost and that dopaminergic push was there again - you set your mind on completing something, and instead of hearing a bunch of internalized complaints ("This is too boring. Why are you wasting your time with this? This is too difficult.", etc.) there is just this clearness in your mind, allowing you to accomplish the things that you set for yourself. Thus far, I have been thoroughly impressed. The best part about the focus is that it does not under any circumstances feel forced something that is very important for me, since the feeling of one being forced is usually one driven by anxiety, and it also usually inhibits proper socialization skills for me. Like there is a trade-off on focus / executive functioning (prefrontal activation) and ability to socialize and relax in the presence of others. I have found no such trade-off on CILTEP. Very, very happy about it thus far.
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#18 MercuryAX

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Posted 10 October 2013 - 12:01 AM

CILTEP is definitely one of the most promising stacks out there - it works incredibly consistently. The person who created it has been using it since 2011 with no degree of tolerance. However, some people have noted drowsiness as a side effect. This is likely due to cAMP's upregulation of acetylcholinesterase, which was somehow remedied using ALCAR.

#19 abelard lindsay

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Posted 10 October 2013 - 12:06 AM

I am surprised Abelard could keep his mouth shut about his subjective effects, he has remained surprisingly level headed during the entire time. Also quite amazing that it has worked for him for several years now at the same doses, with minor alterations (added ALCAR, for instance.)


I figure if people read the science and understand it and take it because of their understanding then they deserve the benefit. I don't want to have to rave to get people to try it. It's not for people who are only influenced that way. You see... some things you can't buy with money. One of those things is being able to distinguish truth from falsehood without having to rely solely on authority or how hyped something is. I'd like to reward people capable of that way of thinking.

Edited by abelard lindsay, 10 October 2013 - 12:12 AM.

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#20 kassem23

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Posted 10 October 2013 - 12:14 AM

I am surprised Abelard could keep his mouth shut about his subjective effects, he has remained surprisingly level headed during the entire time. Also quite amazing that it has worked for him for several years now at the same doses, with minor alterations (added ALCAR, for instance.)


I figure if people read the science and understand it and take it because of their understanding then they deserve the benefit. I don't want to have to rave to get people to try it. It's not for people who are only influenced that way. You see... some things you can't buy with money. One of those things is being able to distinguish truth from falsehood without having to rely solely on authority or how hyped something is. I'd like to reward people capable of that way of thinking.


Do not understand me wrongly, dear friend. I was simply impressed, and quite happy that you carried it out in the way you did. I did read between the lines in your posts and quite a lot of excitement and passion was channeled, and that's absolutely great. :) Thanks again.

#21 JChief

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Posted 10 October 2013 - 02:22 AM

Noopept worked great until about 3 weeks in and noticed symptoms of reduced testosterone, low libido, reduced semen volume, and I quit taking it. I like it except for the fact I do not like those effects.

#22 Isochroma

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Posted 10 October 2013 - 02:29 AM

Same Noopept sex problems here.

No more Noopept.

#23 chung_pao

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Posted 10 October 2013 - 09:52 AM

All the effects from the above anecdote, do you ascribe them to CILTEP? Or the combination of PQQ + CILTEP?
To replicate the effects you've had, would PQQ be necessary?


I took PQQ in the days before that and did not find it to have such a significant effect. This was definitely the CILTEP at work. I am still amazed by its effects today. Had a great day, mood boost and that dopaminergic push was there again - you set your mind on completing something, and instead of hearing a bunch of internalized complaints ("This is too boring. Why are you wasting your time with this? This is too difficult.", etc.) there is just this clearness in your mind, allowing you to accomplish the things that you set for yourself. Thus far, I have been thoroughly impressed. The best part about the focus is that it does not under any circumstances feel forced something that is very important for me, since the feeling of one being forced is usually one driven by anxiety, and it also usually inhibits proper socialization skills for me. Like there is a trade-off on focus / executive functioning (prefrontal activation) and ability to socialize and relax in the presence of others. I have found no such trade-off on CILTEP. Very, very happy about it thus far.


Dopamine is beautiful, and we're a simple animal.
This is why amphetamine-derivates are used to "treat" ADHD; their function is to Condition kids to study, by coupling the act of studying with the positive reinforcement of dopamine.
That effect is also their downside, the addictive potential.

What sets CILTEP apart is very much the mechanism. It mimics some of the downstream effects of Testosterone (upregulation of TH), providing a very natural effect, making you instantly more motivated and assertive.
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#24 lehm

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Posted 11 October 2013 - 06:59 PM

Finally received the components of CILTEP.


5mg (half of 10mg Life Extension's) Forskolin @ 1.00pm



This brand of Forskolin is only 10% potency, and 60 medium-large size capsules, which contain corn and rice fillers. Corn is a very alarming ingredient for any supplement to contain. (In the US reports estimate that about 90% of the corn is GMO, and one should never buy supplements containing corn. GMO corn has been found to cause massive inflammation and organ damage. It's banned in many countries.)

y/n ?

Edited by lehm, 11 October 2013 - 07:02 PM.


#25 kassem23

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Posted 11 October 2013 - 07:38 PM

I have no idea. Other people have good experience with that forskolin, and I seem to be having, too. I am not very concerned.

#26 Construct

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Posted 28 October 2013 - 01:29 AM

Congrats on starting med school.

Did you notice much effect from the Magnesium L-Threonate? I've been using Magnesium Citrate so far, but I haven't noticed anything in the way of substantial sedating effects like some of the other internet anecdotes claim.

I have added a high dose of vitamin D3 because I usually experience system wide negative effects during the winter period, including a reduction in general well-being, energy, and a dip in mood.


Have you considered adding early morning bright light therapy to your daily routine? Spending 30 minutes in front of a bright, cool-white light source after you wake up will go a long way toward keeping your circadian rhythm in check. Keeping the phase angle of your circadian rhythm within the sweet spot relative to your daily rhythm is correlated with greater improvement in SAD-related symptoms (PMID 15470966). The effects of bright light therapy are noticeable almost immediately (both from my experience and per PMID 22210362) so you will probably notice mild improvement right away with the full benefit appearing after your circadian rhythm is fully corrected. There is even some weak (not placebo controlled) evidence that bright light therapy is beneficial for ADHD: PMID 17107243

Any updates on the Artichoke Extract / Forskolin / L-Phenylalanine combo? I'm a bit leery of that combination with all of the reports of mid-day somnolence.

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#27 xsiv1

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Posted 11 November 2013 - 03:05 AM

Mid-day tolerance is remedied with ALCAR in my experience.

As for Noopept, I've been taking it for some time and now that you guys mention it, my libido has been somewhat low lately. Is this a common effect among others?

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