Therapeutic Intervention Framework | Runar Health
Runar Health Therapeutic Intervention Framework
Medical Disclaimer: For educational purposes only — not medical advice. Consult a licensed healthcare professional before beginning any therapy, especially plasma-based or high-intensity metabolic protocols.

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Tier 1 — Foundational Lifestyle Pillars
Sleep & Recovery
4
Sleep Optimization

7–9 hours nightly; consistent sleep/wake schedule; cool, dark room (65–68°F); limit caffeine after 2 PM; avoid bright screens 1h before bed. Consider blue-light blocking glasses.

Hormonal
Strong Evidence
Sleep Hygiene & Circadian Entrainment

Morning sunlight within 30–60 min of waking (10–30 min). Anchor sleep times ±30 min daily. Reduce artificial light after sunset. Melatonin 0.5–1mg 1h before bed if needed.

Nervous System
Strong Evidence
Magnesium for Sleep

Magnesium glycinate 200–400mg 1h before bed. Supports GABA receptors and muscle relaxation. Particularly beneficial for those with high stress or poor recovery.

Cellular
Moderate Evidence
Yoga Nidra / NSDR

20–30 min non-sleep deep rest protocol (guided body scan). Use after poor nights or pre-nap. Restores dopamine and reduces cortisol. Practice 3–5x/week.

Nervous System
Moderate Evidence
Nutrition & Hydration
6
Mediterranean Diet

Olive oil as primary fat; fatty fish 2–3x/week; abundant vegetables and legumes; moderate whole grains; limit processed foods and added sugars. Reduce red meat to <2x/week.

Metabolic
Strong Evidence
Protein Optimization

0.7–1.0g/lb body weight daily (higher for athletes/elderly). Prioritize leucine-rich sources: eggs, meat, fish, whey, legumes. Distribute across 3–4 meals for maximal MPS.

Metabolic
Strong Evidence
Hydration Optimization

2–3 L/day baseline; add 500–750ml per hour of exercise. Include electrolytes (sodium, potassium, magnesium) for endurance activities. Monitor urine color (pale yellow target).

Metabolic
Strong Evidence
Fiber & Gut Microbiome Support

30–40g dietary fiber/day from diverse plant sources. Include prebiotic foods (garlic, onion, leeks, oats) and fermented foods (kefir, sauerkraut, kimchi) daily. Aim for 30+ plant varieties/week.

Metabolic
Strong Evidence
Foundational Micronutrients

Vitamin D3: 2,000–5,000 IU/day with K2. Omega-3: 2–4g EPA+DHA/day. Zinc: 15–25mg/day. Magnesium: 300–400mg/day. Test levels before megadosing.

Immune
Strong Evidence
Blood Sugar Regulation

Eat protein/fat before carbs; walk 10–20 min post-meal; limit refined carbs; consider CGM for personalization. Berberine 500mg 2–3x/day with meals as adjunct if indicated.

Metabolic
Moderate Evidence
Movement & Exercise
6
Zone 2 Aerobic Training

30–90 min, 3–5x/week at conversational pace (60–70% max HR). Cycling, rowing, brisk walking, or swimming. Builds mitochondrial density and metabolic flexibility. Foundation of longevity protocol.

Cardiovascular
Strong Evidence
Resistance Training

2–4x/week; 3–5 sets, 4–12 reps. Compound movements: squat, deadlift, press, row. Progressive overload principle. Critical for bone density, insulin sensitivity, and GH/testosterone.

Cardiovascular
Strong Evidence
VO₂ Max Training

4×4 intervals (4 min at 90–95% max HR, 4 min recovery) 1–2x/week. VO₂ max is the strongest predictor of all-cause mortality. Add after Zone 2 base is established.

Cardiovascular
Strong Evidence
Mobility & Flexibility Work

10–20 min daily; focus on hip flexors, thoracic spine, hamstrings, shoulders. Dynamic warm-up pre-workout; static holds (30–60s) post-workout. Yoga or dedicated mobility class 1–2x/week.

Skeletal
Moderate Evidence
Daily Non-Exercise Activity (NEAT)

Target 8,000–10,000+ steps/day. Take standing breaks every 45–60 min. NEAT can account for 300–500+ kcal/day differential. Use a standing desk, walk during calls.

Cardiovascular
Strong Evidence
Balance & Proprioception Training

Single-leg exercises, balance boards, or unstable surfaces 10–15 min, 3x/week. Single-leg balance ≥10 sec is an independent longevity marker. Reduces fall risk dramatically with age.

Skeletal
Moderate Evidence
Tier 2 — High-Impact Metabolic
Fasting & Metabolic Protocols
5
Intermittent Fasting (16:8)

16h fast, 8h eating window. Stop eating 3h before bed. Break fast with protein-rich meal. Hydrate with water, black coffee, or plain tea during fast. Avoid if pregnant, underweight, or history of eating disorders.

Metabolic
Strong Evidence
Prolonged Fasting (24–72h)

24–72h water fast 1–4x/year under medical supervision. Triggers deep autophagy, immune system reset (especially 72h). Replenish electrolytes. Refeed with light, easy-to-digest foods. Not for routine use.

Cellular
Moderate Evidence
Fasting Mimicking Diet (FMD)

5-day low-calorie protocol (700–1100 kcal/day, specific macro ratios). 1 cycle every 1–3 months. Prolon is a validated commercial option. Reduces IGF-1 and activates autophagy while preserving lean mass.

Metabolic
Moderate Evidence
Ketogenic Diet (Therapeutic)

<30g net carbs/day; 70–80% calories from fat; adequate protein. Therapeutic applications in epilepsy, metabolic syndrome, and cognitive decline. Cycle in/out; monitor lipids and electrolytes closely.

Metabolic
Strong EvidenceContext-Dependent
HIIT — High Intensity Interval Training

20–30 min, 2–3x/week. Work:rest ratio 1:2 or 1:3. Warm up 10 min. Options: sprint intervals, bike, rower, assault bike. Potent for VO₂ max gains and insulin sensitivity. Do not exceed 2x/week if combined with strength training.

Cardiovascular
Strong Evidence
Tier 3 — Nervous System & Cognitive
Stress Resilience & Nervous System
5
HRV Biofeedback

10–20 min, 3–5x/week. Breathe at resonance frequency (~5.5 breaths/min). Apps: Elite HRV, Morpheus. Enhances vagal tone and stress regulation. Wearables: Garmin, WHOOP, Polar H10 for daily HRV tracking.

Nervous System
Strong Evidence
Breathwork — Diaphragmatic & Box Breathing

4-7-8 method: inhale 4s, hold 7s, exhale 8s. Box breathing: 4s inhale, hold, exhale, hold. 5–10 min 2x/day or before stressful situations. Activates parasympathetic nervous system acutely.

Nervous System
Strong Evidence
Mindfulness Meditation (MBSR)

8-week structured MBSR program or 10–20 min daily practice. Body scan, focused attention, open monitoring techniques. Reduces cortisol, amygdala reactivity; increases gray matter density with 8+ weeks.

Cognitive
Strong Evidence
Cold Exposure (Progressive)

Cold shower 2–5 min daily; cold plunge 39–59°F for 2–4 min, 3–4x/week. Protocols by Susanna Søberg: 11 min total/week minimum. Activates brown adipose tissue, norepinephrine release, vagal tone.

Nervous System
Moderate Evidence
Adaptogens

Ashwagandha: 300–600mg KSM-66 extract/day for cortisol. Rhodiola rosea: 200–400mg/day for HPA axis. Eleuthero: fatigue and stress resilience. Cycle 8 weeks on, 4 weeks off.

Hormonal
Moderate Evidence
Cognitive Enhancement
4
Nootropic Supplements

Lion’s Mane: 500–1000mg/day for NGF. Alpha-GPC: 300–600mg for acetylcholine. Bacopa monnieri: 300mg/day (12+ weeks for effect). L-theanine + caffeine: 200mg:100mg stack for focus.

Cognitive
Moderate Evidence
tDCS / Transcranial Direct Current Stimulation

1–2 mA, 20 min sessions targeting DLPFC. 5 sessions/week for 2–4 weeks per protocol. Modest but real effects on working memory and learning. Consumer devices available (Flow, Soterix).

Cognitive
Moderate Evidence
Photobiomodulation — Transcranial

810nm near-infrared light applied to scalp, 10–20 min per session, 3–5x/week. Increases cerebral blood flow, ATP production, and BDNF. Early evidence in TBI, depression, and cognitive aging.

Cognitive
Emerging
Deliberate Learning & Neuroplasticity

45–90 min focused learning daily followed by sleep or NSDR for consolidation. Use spaced repetition (Anki). Interleave topics. Learning a new motor skill (music, sport) has outsized neuroplastic effects.

Cognitive
Strong Evidence
Tier 4 — Recovery & Cellular Optimization
Thermal & Light Therapies
5
Sauna Therapy (Dry / Finnish)

176–212°F; 15–30 min, 2–4x/week. Post-exercise or evening. Avoid alcohol beforehand; hydrate well after. 4+ sessions/week linked to 40% reduction in cardiovascular events (Laukkanen et al.). Induces heat shock proteins.

Cellular
Strong Evidence
Contrast Therapy (Hot/Cold Cycling)

Alternate sauna (15–20 min) → cold plunge (2–4 min). Repeat 2–3 cycles. End cold for alertness; end hot for relaxation. Amplifies cardiovascular and lymphatic benefits vs. either alone. Do not use post-strength session (blunts hypertrophy).

Cellular
Moderate Evidence
Red Light Therapy (PBM)

630–660nm (red) + 810–850nm (NIR); 5–20 min, 3–5x/week. 4–6 inches from panel. Targets muscle recovery, skin collagen, mitochondrial function. Morning use preferred (may be activating).

Cellular
Moderate Evidence
Hyperbaric Oxygen Therapy (HBOT)

1.5–3.0 ATA; 60–90 min sessions. 20–40 sessions for longevity protocols (Shai Efrati research). FDA-approved for 13+ indications. Off-label use for anti-aging, TBI, long COVID. Requires qualified facility.

Cellular
Moderate EvidenceFDA-Approved Indications
Ozone Therapy (Systemic)

Major autohemotherapy (MAH): 100–200ml blood + O3 gas reinfused IV. 6–10 sessions typical course. Hormetic oxidative effect upregulates Nrf2 and antioxidant pathways. Must be administered by trained practitioner.

Cellular
Emerging
Longevity Supplementation
5
NAD+ Precursors (NMN / NR)

NMN: 500–1000mg/day sublingual or oral. NR: 300–500mg/day. Take in the morning. Replenishes declining NAD+ for sirtuin activity, DNA repair, and mitochondrial function. Stack with resveratrol or TMG.

Cellular
Moderate EvidenceOngoing Trials
Rapamycin (mTOR Inhibition)

Intermittent low-dose: 5–6mg once weekly (off-label). Inhibits mTORC1 to activate autophagy. Most replicated longevity intervention in animal models. Requires physician oversight; monitor immune function and lipids.

Cellular
EmergingRx Required
Metformin / AMPK Pathway

500–1500mg/day (Rx). AMPK activator; mimics caloric restriction signaling. TAME trial ongoing. May blunt some exercise adaptations — timing relative to workouts matters. Alternative: Berberine 1500mg/day (OTC AMPK activator).

Metabolic
Moderate EvidenceUnder Investigation
Senolytic Protocols

Dasatinib + Quercetin: D(100mg) + Q(1000mg) orally for 3 consecutive days, repeated every 3–6 months. Clears senescent cells. Fisetin: 20mg/kg for 2 days/month. Early human trials ongoing.

Cellular
Emerging
CoQ10 / Ubiquinol

Ubiquinol 200–400mg/day with fat-containing meal. Essential for mitochondrial electron transport chain. Especially indicated with statin use (statins deplete CoQ10). Supports cardiac function, energy production, and antioxidant defense.

Cellular
Strong Evidence (statin-depleted)
Advanced Clinical — Plasma-Based Modalities
Precision Factor Removal & Signaling
4
Clinical TPE — Therapeutic Plasma Exchange

Broad removal of pathogenic circulating factors (autoantibodies, cytokines, prions). Replaces plasma with albumin or FFP. 3–7 sessions per course. Used in GBS, myasthenia gravis, and experimental longevity protocols.

FDA-Approved IndicationsRisk: Mod-High
Clinical DFPP — Double Filtration Plasmapheresis

Secondary filtration membrane selectively removes large MW proteins (IgG, LDL) while preserving albumin. Reduces need for replacement fluids vs. TPE. Used for hyperlipidemia, autoimmune, and anti-aging protocols.

Moderate EvidenceRisk: Moderate
Clinical Immunoadsorption

Highly selective antibody removal via Protein A or antigen-specific adsorption columns. Plasma returned to patient after depletion. Used in refractory autoimmune diseases, dilated cardiomyopathy, and experimental protocols.

Moderate EvidenceRisk: Mod-High
Clinical Plasma Ozonation

Blood drawn, plasma separated and exposed to precise O3 concentration ex vivo, then reinfused. Hormetic oxidative signaling stimulates Nrf2-mediated antioxidant response without systemic ozone exposure. Requires specialized equipment.

EmergingRisk: Low-Mod
Therapeutic Apheresis & Blood Purification
5
Clinical Apheresis (Blood Component Removal)

Withdraws blood, separates components, and returns needed parts while discarding harmful ones. Includes: Plasmapheresis (PEX) for toxins/antibodies; Therapeutic Cytapheresis for harmful blood cells; Lipoprotein Apheresis for LDL; INUSpheresis® for heavy metals and inflammatory proteins.

Established Clinical Use
Clinical Hemoadsorption (CytoSorb™ / Seraph®)

Sorbent polymer bead column removes cytokines, endotoxins, and inflammatory mediators via adsorption. Used in septic shock, cardiac surgery, and cytokine storm. CytoSorb approved in 70+ countries. Seraph® 100 targets pathogens via heparin mimicry.

Moderate Evidence
Clinical EBOO / EBO₂ — Extracorporeal Blood Oxygenation

Blood processed through dialysis-like membrane; ozonated and re-oxygenated before return. 500–2000ml blood per session. 6–10 sessions per course. Removes lipids, heavy metals, inflammatory proteins. Not FDA-cleared; widespread in integrative medicine.

Emerging
Clinical Hemodiafiltration (HDF)

Combines hemodialysis (diffusion) and hemofiltration (convection) for superior middle-molecule removal vs. HD alone. Online HDF reduces cardiovascular mortality by 35–40% vs. conventional HD. Gold standard for end-stage renal disease.

Strong Evidence
Clinical MARS — Molecular Adsorbent Recirculating System

“Artificial liver” for albumin-bound toxins (bilirubin, bile acids, ammonia). Used in acute-on-chronic liver failure as bridge to transplant or recovery. 6–8h sessions. Significantly reduces systemic inflammatory burden.

Moderate Evidence
Specialized — Hormonal Optimization
Hormone Optimization Protocols
5
Hormonal TRT — Testosterone Replacement Therapy

For confirmed low T (<400 ng/dL with symptoms). Injectable: Testosterone cypionate 100–200mg/week IM or SubQ. Topical: 1% gel 5–10g/day. Monitor hematocrit, PSA, estradiol (E2). Anastrozole 0.25–0.5mg/week if E2 elevated.

Strong EvidenceRx Required
Hormonal Growth Hormone Peptides

Sermorelin / CJC-1295 + Ipamorelin: 100–300mcg SubQ injection before bed 5 nights/week. Stimulates pituitary GH pulse. Ipamorelin is selective (minimal cortisol/prolactin spike). Monitor IGF-1 levels. 3–6 month cycles.

Moderate EvidenceRx Required
Hormonal Thyroid Optimization

Test: TSH, Free T4, Free T3, Reverse T3, thyroid antibodies. Optimize TSH to 1–2 mIU/L range with Free T3 in upper third of range. Consider T3/T4 combination therapy if symptoms persist on T4 monotherapy. Rule out Hashimoto’s.

Strong Evidence
Hormonal DHEA Supplementation

25–50mg/day for men; 10–25mg/day for women (levels decline with age). Precursor to testosterone and estrogen. Supports immune function, mood, bone density. Test DHEA-S before supplementing. Monitored use in older adults.

Moderate Evidence
Hormonal Low-Dose Naltrexone (LDN)

1.5–4.5mg nightly (off-label). Transiently blocks opioid receptors, triggering endorphin rebound. Anti-inflammatory via TLR4 blockade. Used in autoimmune, fibromyalgia, long COVID, and mood disorders. Well-tolerated; requires Rx.

EmergingRx Required