Protocol Decision Logic Tree

What you need to know

Use Part 0 to find your starting level: Beginner, Intermediate, or Advanced, based on how long you have been sick and how much your daily life is affected. Everyone fasts first. Whether you run T3 is decided by how the fast leaves you.
Fast first, always. T3 first is the exception, and it is for the person who has struggled with fasting, pushed through, kept getting worse with signs of metabolic trouble, and needs a jump start. Log your waking temperature from day one because it is the dial T3 is dosed to later.
T3 is for the post-fast metabolic slowdown, not for everyone. Run hot, hold your weight and feel great after the fast, and you skip it. The long-term sufferer who has tried everything runs fast then T3 at least once to test the water, and weans off if it does little. hGH enters around the third cycle, only when two cycles of fasting plus T3 were not enough.
Stop the fast immediately if your heart rate goes above 120 bpm, you stop urinating for more than 24 hours, you develop a fever above 100.4F, or you feel confused or delirious. Short of that, feeling worse is a reason to walk, massage and move the system, and to break the fast if it feels really bad or the pain is excruciating.
Your diet history (carnivore vs. high-carb) and your thyroid panel each have their own decision branch: follow the chart that matches your situation.

Table of Contents

Part 0: Protocol Category Selection
Fast First or T3 First? (And What Your Temperature Is For)
Critical Thresholds: Stop Signals
Part 1: Diet History & Carb Approach
Part 2: T3 Thyroid Assessment
Part 3: Long COVID, Insulin Resistance (IR) & Ivermectin

Part 0: Protocol Category Selection

Determine which Scorch Protocol category is path-appropriate for your current health status.

Fast First or T3 First? (And What Your Temperature Is For)

The order is fast first. Always. T3 first is the exception, and the trigger is not a number on the thermometer, it is history: you have struggled with fasting, pushed through it, kept getting worse, fasting is plainly not working for you, there are signs of metabolic trouble, and you need a jump start before the fast can do its job. That is the person I put on a T3 course before the fast. Everyone else fasts first.

What the evidence says: that trigger, and the judgement of who needs T3 after the fast, are my clinical rules. The literature has no published criterion for who needs T3 after a fast; the nearest objective candidate is the low free T3 and high reverse T3 pattern measured in chronic fatigue patients (Ruiz-Nunez 2018), which is a blood test, not the history-and-temperature screen I use.

Your waking temperature still matters, for a different reason. Long Covid and ME/CFS patients commonly run cold (96 to 97°F) because viral persistence has suppressed the thyroid axis, and that reading is the dial the T3 course is dosed to after the fast. A low reading is also the main sign you will come out of the fast needing that course. Measure it every morning (on waking, before getting out of bed) and 30 minutes after breakfast, starting now, so the trend is in hand when the decision arrives.

≥98.6°F (37.0°C)

Running warm. Fast first, standard protocol. If you also hold your weight and feel great coming out of the fast, you are the person who does not need the T3 cycle at all.

97.8-98.5°F (36.6-36.9°C)

Mildly low. Fast first, and track temperature daily through the fast and refeed. If the slowdown shows up after the fast (cold, weight stuck, old symptoms back), the 30-day T3 course follows refeed day 7.

<97.8°F (<36.6°C)

Low. The main sign of a slow metabolism, and the picture that most often needs the T3 course after the fast. The order is still fast first unless the failed-fasting history above applies to you. Expect to dose T3 against this number once the refeed is done.

95-96°F (35.0-35.6°C)

Severe metabolic suppression. A cortisol-inversion pattern (temperature drops after eating) means cortisol is the only thing holding metabolism up, a major red flag. Run this picture past me with your numbers before you plan anything. Whether a reading this low on its own changes the order is a call I make case by case, not a rule I publish.

Critical Thresholds (“Stop Signals”)

Strict criteria for potentially dangerous complications requiring fast termination. Short of these, feeling worse mid-fast is the normal texture of the work: go on walks, do massages, move the whole system. If it starts to feel really bad, or the pain is excruciating, break the fast. While heart rate, temperature, blood pressure and urination look fine, you can continue.

1. Hemodynamic Instability

Systolic BP: < 80 or > 180 mmHg
Heart Rate: > 120 or < 40 bpm
Orthostasis: Syncope or >30 mmHg systolic drop

2. Fluid & Renal Status

Weight Loss: > 5-7% in 24 hours
Urine: 0 ml for > 24h
Note: 200-300ml is normal low output.

3. Thermoregulation

Sustained Fever: > 38.0°C (100.4°F)
Note: 37.5°C is normal “acidotic fire.”

4. Neurological

Severe confusion
Delirium
Inability to obey commands

Part 1: Diet History & Carb Approach

Determine your starting point based on previous diet history (Carnivore vs. High Carb).

Part 2: T3 Thyroid Assessment

How to evaluate T3 thyroid status.

Part 3: Long COVID, Insulin Resistance (IR) & Ivermectin

Model for Long covid therapeutics like Ivermectin, Ketotifen, etc.

There are a few supplements around calming the immune system and reducing inflammation that can be used to treat long covid symptoms. One of the more powerful and consistent helpers is Ivermectin

Key Takeaways

The Bridge: Ivermectin acts as a metabolic bridge, offering quick wins via liver/IR optimization.
Durability: Long-term success often hinges on eradicating viral reservoirs through autophagy (fasting).
Maintenance: Pulsing holds most of the gains long-term while avoiding tolerance.

Have a question about your own case?

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References

Ruiz-Nunez B, Tarasse R, Vogelaar EF, Janneke Dijck-Brouwer DA, Muskiet FAJ. Higher Prevalence of "Low T3 Syndrome" in Patients With Chronic Fatigue Syndrome: A Case-Control Study. Front Endocrinol (Lausanne), 2018;9:97. PMID 29615976. DOI 10.3389/fendo.2018.00097.the nearest thing to a published criterion for who might need T3 after a fast: chronic fatigue patients carried lower free T3 and total T3 and more reverse T3 than matched controls at a similar TSH; a blood pattern, not the history-and-temperature screen used here

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.