Most of the protocol is written around the fast. The preparation, the fast itself, the water bridge, the refeed, T3, hGH: all of it is scheduled around a few intense weeks. Then the cycle ends and you are left with a long quiet gap, sometimes several months, before the next one. That gap is where this page lives.
The gap is not a break. It is the period when viral load quietly rebuilds, when microclots reform, and when the immune system is doing the slow work of consolidating what the fast cleared. Running nothing through it is how people arrive at cycle two no better than they arrived at cycle one. The standing stack below is what holds the ground the fast took.
Which Page You Actually Need
Four pages on this site cover four different phases, and people regularly land on the wrong one. Use this to check you are in the right place.
The refeed itself. How to come off a fast without triggering refeeding syndrome, and how to stage food back in.
This page
The long gap after a cycle has finished and before the next one starts. The standing daily maintenance stack.
The Direct Antiviral Core
This is the part of the stack that does the actual pathogen work. Everything else supports it.
Agent
Role
How to take it
Valacyclovir (standing backbone, prescription)
The lead antiviral. It holds continuous pressure on the herpesvirus family that drives reactivation in most chronic illness cases.
With or without food. A small snack or a full glass of water prevents nausea. Extra fluid every single day is mandatory, not optional. See the timing gate below.
Ivermectin (secondary, prescription)
A secondary supportive antiviral and the primary antiparasitic. It calms the nervous system and inflammation and may mildly inhibit viral entry. It is not the lead antiviral.
Prescription only. Read the quercetin interaction note further down before running the two together. The dose is raised temporarily during a PEM crash; see that section below.
L-Lysine
Competes with arginine for the transporter herpesviruses depend on, tilting the ratio away from replication.
Empty stomach where possible: 30 minutes before food, or 2 hours after, with water. Amino acids compete for the same gut transporters, so dietary protein blocks uptake. A little food is acceptable if it causes cramping.
Monolaurin
Disrupts the lipid envelope of enveloped viruses. A virus with a damaged envelope cannot enter new cells.
Must be taken with food. It is a concentrated fat-soluble lipid extract and causes gastric burning on an empty stomach. Food or a healthy fat also improves absorption.
The Valacyclovir Timing Gate
Valacyclovir is renally cleared. That single fact sets its entire schedule, and it is worth understanding rather than memorizing.
Off for the whole fast, dry and waterWithout renal water flow the drug cannot be cleared at the rate the dosing assumes: clearance kinetics go wrong and concentration builds. That is obvious for the dry fast. It is also true of the water fast, which is the part people get wrong. Water fasting still purges water through the kidneys, so the body stays systemically dehydrated even on the water days. Electrolytes help, they do not fix it. So valacyclovir never runs during the fast in either form. This is a pharmacology boundary, not a preference.
Earliest start: refeed day 3The standing course starts on refeed day 3 at the earliest, after at least two days of eating with heavy rehydration. Food and fluid together are what actually restore the water balance the drug needs in order to clear. Have it in hand before the fast ends so it is ready on that day.
Very low temperature: your call, and my advice is to waitIf your waking temperature was very low going in, kidney function may lag behind the rest of the refeed until T3 brings it back, and T3 does not start until after refeed day 7. There is no hard gate here. It is your own decision, at your own risk. My advice is to wait until refeed day 3 at minimum and stay on L-lysine and monolaurin until you feel ready to start.
L-lysine and monolaurin are the cover, not a placeholderL-lysine comes back on water day 1, the moment water does. Monolaurin and olive leaf come in with the first meal. Those three hold the antiviral line through the water days and the first days of eating, so the gap before valacyclovir starts is covered, not empty.
The real job is the months between fastsThe refeed start is the doorway, not the point. Valacyclovir’s main work is the daily course through the months of refeeding and regeneration, lowering the burden of reactivated EBV, HSV and shingles while the body rebuilds. Once started it does not stop at the refeed boundary or the T3 boundary. It carries straight into the standing between-fasts course this page describes, with the kefir and kombucha rider alongside it and a kidney panel every few months.
A prodrome is an escalation on top, not a switchTingling, burning or itching at an old outbreak site means replication has already started. The loading dose for a prodrome is layered on top of the standing course, not substituted for it, and only once that course is running. A prodrome on refeed day 1 or 2, before the course has started, is your decision: if you feel rehydrated you can start early, knowing why the drug is not advised during the water fast. See Viral Reactivation for the full prodrome decision tree.
A prodrome during the fast is a different call entirelyIf a prodrome arrives while you are still fasting, dry or water, there is no course to escalate and no rehydrated body to clear the drug with. That case ends the fast, in order: convert to water with electrolytes if you are dry, L-lysine at once, break the fast once you are rehydrated, monolaurin and olive leaf with the first calories, and valacyclovir on the standing rule above. A prodrome that repeats every cycle means the fast needs restructuring rather than a bigger rescue: a water-first lead-in, with one condition, at least 3 L of water a day with electrolytes (a pinch of normal salt plus potassium salt) while the drug is held. See Viral Reactivation for the reasoning, and ask me for the modified protocol before improvising your own.
The Gut Rebuild Rider (Mandatory, Not Optional)
In my clinical observation, a months-long valacyclovir course damages the bacterial biome and the virome alongside the pathogens it is aimed at. That collateral damage is predictable, so the repair runs alongside the course rather than after it.
What to do
Start raw kefir daily from the first day of the standing course. Once kefir is comfortably tolerated, layer in raw kombucha. This rider runs for the entire length of the standing course. Treat it as part of the antiviral protocol, not as a nice extra.
Nervous System, Sleep and Immune Reset
The second layer targets the part of chronic illness that is not pathogen load: the glial and mast-cell overreaction, the wired-and-tired nervous system, and the depleted immune baseline.
The Neuro-Immune Layer
Ultramicronized PEAPalmitoylethanolamide is in the stack to dampen hyper-reactive microglial and mast-cell flares. A systematic review of 47 human randomized controlled trials found consistent clinical benefit for pain and general wellbeing, with mast-cell and microglial damping given as the rationale (Bortoletto et al., 2025). Read that as researched for calming overactive immune and glial signaling, rather than as a settled human imaging finding. The ultramicronized form is the one used, because particle size drives absorption.
Liposomal apigenin (before bed)Taken 30 to 60 minutes before bed. Apigenin crosses the blood-brain barrier and binds the benzodiazepine site on the GABA-A receptor. That receptor affinity is well demonstrated, but only in preclinical work: rat brain tissue and cultured cells (Avallone et al., 2000). The same paper found no anxiolytic effect in living animals, so receptor binding is a mechanism, not evidence of a sleep or calming benefit. If your insomnia is histamine-driven, the MCAS page covers the tools that address it directly.
Thymus glandular (with food)Bovine thymus tissue, taken with food, to support T-cell maturation and the immune baseline between cycles. Note the category carefully: this is a glandular, not a peptide. Thymalin remains the only thymus peptide in the protocol. This is my own clinical framework rather than a tested protocol, and no published trial evidence is being claimed for it.
Blood Clearing and Biofilm
Microclots and viral biofilms are physical obstacles. They block oxygen delivery and they shelter pathogens from both the immune system and the antivirals. Nattokinase works this layer, daily.
Nattokinase (Daily, Empty Stomach)
An enzyme, not a supplement to skipNattokinase breaks down microclots and viral biofilms in the bloodstream. It must be taken on an empty stomach, first thing in the morning or right before bed. The reason matters: taken with food, the enzyme is spent digesting meal protein and never reaches the bloodstream at all. With food it is not a smaller effect. It is a wasted dose.
Artemisinin: An Optional Extra, Not a Core Item
Artemisinin is sweet wormwood extract. It earns its place in this protocol for one reason only: when viral reactivation is strongly suspected, it stacks with the standing antivirals to add extra pressure while that suspicion is being worked through.
What It Is Actually For
An extra antiviral for stacking, nothing moreArtemisinin is not a daily agent and it is not a PEM-crash tool. In my own assessment it is a marginal item in the protocol: useful specifically when stacking antivirals because reactivation is strongly suspected, and outside that situation it would not really have a place in the protocol at all.
Never dailyContinuous use lets the body upregulate its metabolic clearance of artemisinin, so the same amount does less and less over time. Reserving it for the situations that actually call for it, with real gaps between uses, is what keeps it useful on the occasions it is genuinely needed.
Screen for G6PD Deficiency Before Any Artemisinin
Artemisinin drives oxidative stress on purpose. Red blood cells in people with G6PD deficiency cannot buffer that stress, and the result can be hemolysis. G6PD deficiency is common, frequently undiagnosed, and simple to test for. Get the test before the first dose, not after a reaction.
Medical caveat: G6PD status is a screening decision that belongs with your physician, and artemisinin is not appropriate for everyone even with a normal result.
What To Do During a PEM Crash
Post-exertional malaise is the collapse that arrives hours or a day after you did something ordinary. Every other page on this site covers how to avoid crashing. This section covers what to do once you are already in one, because that is the question people are actually typing at 2am.
The first rule is the least satisfying one: the standing stack keeps running unchanged. A crash is not the moment to add three new supplements or to stop the antiviral backbone. The stack is what holds the baseline while the crash passes.
What does change is dosing on two items already in the picture: ivermectin, and, for some patients, T3. Artemisinin is not part of crash management. It is an optional extra antiviral for stacking against suspected reactivation, covered above.
Ivermectin: The First Lever
Why ivermectin works hereIvermectin is already in the standing stack as a supportive antiviral, where it calms the nervous system and inflammation and may mildly inhibit viral entry. In my clinical experience, that same calming and anti-inflammatory effect is powerful enough that raising the dose is often what pulls someone out of a crash. Some patients keep ivermectin as a crash-only medication rather than a daily one. Others run it daily and simply raise the dose when a crash hits.
The dose is raised, not the drug changedThe amount goes up during a crash and comes back down once the crash has passed. What that amount is, and how it is ramped, is set per case, in the members portal or with whoever prescribes it. The quercetin interaction covered further down still applies: flag the crash dose to your prescriber the same as you would the standing one.
Acute T3 Increase: For Patients Already On T3
The second tried strategyFor someone already established on T3 therapy, a temporary, acute increase in the T3 dose is the other strategy I have seen work to beat back a crash quickly. This applies only to patients already running T3. It is not a reason to start T3 early, or to begin it because a crash hit.
Not a self-directed changeA thyroid hormone dose is not something to adjust on your own, especially mid-crash. If you are already on T3, this is worth discussing in advance with whoever manages that prescription, so you know what an acute increase looks like for your case before you need one.
Medical caveat: both of these are dose changes to prescription medications. Raising ivermectin or T3 during a crash belongs with the physician managing that prescription, not as a self-directed decision made in the moment.
Systemic Support
The last daily layer is broad cover: antimicrobial breadth, mast-cell stability, and mitochondrial energy.
The Systemic Layer
Garlic (odorless)Broad antimicrobial defense. Allicin, the active compound, reacts with thiol groups on microbial enzymes, and that single mechanism underlies documented activity against a wide range of bacteria, against Candida, and against parasites such as Entamoeba and Giardia (Ankri and Mirelman, 1999). That evidence is laboratory pharmacology covering antibacterial, antifungal and antiparasitic breadth. It is not cited here as antiviral efficacy, and garlic is not doing the antiviral work in this stack. Valacyclovir is.
Olive leaf extractA plant-derived antimicrobial. It sits alongside garlic as background pressure, not as a primary agent. In my clinical experience it helps interrupt viral replication loops, which is why it is in the stack, and no trial evidence is being claimed for that.
QuercetinStabilizes mast cells and acts as a zinc ionophore, carrying zinc into the cell where it can interfere with viral replication. It is also the one item in this stack with a real drug interaction, covered immediately below.
Pyrucet (IdeaLabs)Topical or oral mitochondrial energy support, taken in the morning. Read the molecule warning below before adding it.
Two Interactions You Must Check
Quercetin raises ivermectin exposureQuercetin inhibits P-glycoprotein, the efflux pump that normally shuttles ivermectin back out of cells and out of the body. Inhibit the pump and circulating ivermectin exposure rises, even though nothing about the ivermectin itself has changed. Flag it to whoever prescribes your ivermectin whenever the two run together, so the interaction is accounted for rather than discovered.
Pyrucet is ethyl pyruvatePyrucet is not similar to the prescription refeed agent. It is the same molecule: ethyl pyruvate. Running the over-the-counter product and the prescription version at the same time is not stacking two supports, it is doubling one. Do not run both at once. Ethyl pyruvate belongs to the refeed phase, paired with methylene blue, and Pyrucet belongs to this between-fasts phase. Pick the one that matches where you are.
Psilocybin Microdosing: Optional, Not Baseline
Psilocybin microdosing appears in the protocol as an explicitly optional extra. It is deliberately excluded from the daily baseline. Nobody needs it to run this stack correctly, and leaving it out costs you nothing.
If You Choose To Use It
What it is there forThe rationale is neuroplasticity: giving a nervous system locked in a chronic-illness pattern a window in which it can form new ones. Run in cycles with scheduled off days rather than continuously.
Do not combine with methylene bluePsilocybin is serotonergic and methylene blue is a monoamine oxidase inhibitor. Combining them risks serotonin toxicity. Methylene blue runs during the early refeed, which is one more reason psilocybin and the refeed phase stay separate.
Stop signalsMonitor for transient rises in heart rate or blood pressure. Pause immediately on any CNS hyper-arousal or anxiety. Chronic illness nervous systems are already dysregulated, and hyper-arousal is a reason to stop rather than to push through.
Medical caveat: psilocybin is a controlled substance in most jurisdictions. Nothing here is a suggestion to obtain or use an illegal substance, and the legal position where you live is yours to establish.
Safety, Bleeding Risk and the Phase Boundary
Bleeding Risk: The Hard Stop On This Stack
Nattokinase and garlic are anti-platelet. Individually the effect is modest. Stacked daily it is real, and it compounds with anything else that thins the blood. Olive leaf is mildly anti-platelet as well, but it is the one item I run alongside low-dose aspirin without issue, so it is not part of this hard stop.
While the anti-platelet items are running, completely avoid
Aspirin
Ibuprofen and other NSAIDs
Prescription anticoagulants
Bromelain
Omega-3 at 2 to 4 g (ordinary culinary intake is not the concern here)
The phase boundary
The phase boundary applies to the anti-platelet items only: nattokinase and garlic. Those two do not overlap the T3 and refeed phases, where low-dose aspirin is a deliberate co-factor, and you never run them and low-dose aspirin at once. If you are moving into a refeed or starting T3 therapy, nattokinase and garlic are what comes down first. Olive leaf starts with the first meal and stays on through both phases.
Valacyclovir is the explicit carve-out and it does not come down here. It is the standing antiviral backbone, it is not anti-platelet, and it keeps running straight through the refeed and the T3 phase. The refeed is the vulnerability window for viral reactivation, which is exactly why the backbone joins on refeed day 3 and stays on through it.
Routine monitoring
Pull liver enzymes (ALT and AST) and kidney function (BUN and creatinine) every few months while the standing course is running. The point is to confirm the body is clearing the full stack cleanly, and to catch a trend early rather than a crisis late. Valacyclovir in particular is renally cleared, which makes kidney monitoring non-negotiable on a months-long course.
Where the Doses Live
The full dose sheet for this stack is individualized and lives in the members portal, where it sits next to your own labs and can be adjusted against them. Members get the complete between-fasts sheet with amounts, frequencies and personal overrides, plus the ability to ask about their own case. See what membership includes.
Medical caveat: valacyclovir, ivermectin and T3 are prescription medications. Every item on this page, prescription or not, is a decision to make with a physician who knows your history and your labs.
Frequently Asked Questions
What do you take between fasts?A standing daily stack, not a pre-fast shopping list. It has four working parts: a direct antiviral core (valacyclovir as the backbone, ivermectin as supportive cover plus the primary antiparasitic, lysine and monolaurin as the natural baseline), nervous-system and immune support (PEA, liposomal apigenin, thymus glandular), blood and biofilm clearing (nattokinase, daily), and systemic support (garlic, olive leaf, quercetin, Pyrucet). Artemisinin sits outside the daily stack entirely: it is an optional extra antiviral, added only when stacking against a strongly suspected viral reactivation. Artemisinin and psilocybin are the only two items that are not daily.
Do you stay on antivirals between fasts?Yes. Valacyclovir is a standing backbone, not a short course you stop once the refeed ends. It never runs during the fast, dry or water, because it is renally cleared and a water fast still leaves the body systemically dehydrated (the kidneys keep purging water, and electrolytes help but do not fix that). It starts on refeed day 3 at the earliest, after at least two days of eating with heavy rehydration, and from there it keeps running through the refeed, the T3 phase and the long gap before the next cycle. L-lysine from water day 1, and monolaurin and olive leaf from the first meal, are the cover until it starts. Ivermectin runs alongside it as a secondary supportive antiviral and the primary antiparasitic, and some patients keep it as a crash-only medication rather than a daily one, since the same calming effect that supports it as an antiviral is also the reason it is reached for during a PEM crash. If a prodrome starts, the loading dose is an escalation layered on top of the standing course, not a replacement for it.
What can you take during a PEM crash?The standing stack keeps running unchanged. What changes is dosing on two items already in the picture. Ivermectin is the first lever: its calming effect on the nervous system and on inflammation, already part of why it is in the stack, is often strong enough on its own to pull a crash back, so the dose is raised temporarily. Some patients keep ivermectin as a crash-only medication rather than a daily one. For patients already established on T3 therapy, an acute, temporary increase in the T3 dose is the second tried strategy, set with whoever manages that prescription, never a reason to start T3 early. Artemisinin plays no role here. It is an optional extra antiviral for stacking against suspected viral reactivation, not a crash tool.
Can you take aspirin or ibuprofen on this stack?No. Nattokinase and garlic are anti-platelet, so while they are running you avoid aspirin, ibuprofen and other NSAIDs, prescription anticoagulants, bromelain, and high-dose omega-3. This is also why the phase boundary matters, and that boundary applies to those two items only. Nattokinase and garlic do not overlap the T3 and refeed phases, where low-dose aspirin is a deliberate co-factor, so never run them and low-dose aspirin at once. Olive leaf is mildly anti-platelet too, but I run it alongside low-dose aspirin without issue: it starts with the first meal and stays on. Valacyclovir is the explicit carve-out: it is not anti-platelet, it is the standing antiviral backbone, and it keeps running through the refeed and the T3 phase instead of coming down at the boundary.
Why are there no doses on this page?Because a dose that is right for one patient is wrong for the next. Kidney function, liver function, body weight, how many cycles you have completed, and which pathogens are actually driving your case all change the numbers. The full dose sheet is individualized and lives in the members portal, where it can be adjusted against your own labs rather than published as a one-size number.
Get your own customized refeed plan
Members build a personalized, day-by-day refeed plan: food choices and a calorie ramp sized to their own fast, plus when to layer in T3 and the rest of the protocol.
Ask Yannick directly. Members send their labs, symptoms, and questions and get a personal, reviewed answer, plus help sourcing medication and the full synthesized protocol behind every reply.
See the full research & citations page for the complete evidence base and how each study is used.
The information on this site describes a personal health protocol and is provided for educational purposes only. It is not medical advice. Consult a qualified physician before modifying your diet, fasting practice, or any medication regimen.