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July 23, 2018 Patrick Nemechek, D.O.

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  1. Gayathri Parangipettai 1 week ago

    My ASD kid (4yr) is been in protocol for 8months and recently we increased his fish oils intake from 3/4 to 1tsp and he has become so hyper, completely lost his focus and his concentration , lots of meltdown and tantrums. He is behaving completely different . Do i have to decrease the dosage?

    • Author
      Patrick Nemechek, D.O. 1 week ago

      I would for now but consider increasing the inulin some. This might stop this unusual reaction to the fish oil.

  2. Anonymous 1 week ago

    Hi Dr. Nemechck, I belive my son is sensitive to salicylates. This is a new reallization. I know EVOO and inulin are high in salicylates. (Just learned evoo was high in it). I only have given evoo as I had plan to add the FO soon and later the inulin. He is 4 yr old and started with only cooking in evoo then increased to cooking with evoo plus 1 teaspoon in peanut butter. He started to be extra in behavior more spinning, stimming, more irritable and not listening. Although he seemed more aware and saying more things that were funny. Not sure if the it was just the evoo or what. Can this still work with salicylate sensitivity, and if so whats the best way to continue the evoo and introduce the FO and inulin without major reactions? Not sure if I will be able to tell difference between a reaction or awakening. Currently only cooking in EVOO. Thank you for your time.

    • Author
      Patrick Nemechek, D.O. 1 week ago

      I wouldn’t interpret this as being related to salicylates. I believe its an interaction between EVOO and an overgrowth of gut bacteria.

      I would start with the inulin first then add the FO, and finally the EVOO after your inulin dose has gotten up to a 1/4 or 1/2 tsp per day

  3. Becky 1 week ago

    Dr. Nemechek,
    My son age 11 years and 6 months has slow motility bowel issues along with GERD. He is believed to be on the spectrum (highly functioning) he has anxiety disorder also. A little background his father (my son) was killed before he was born and his mother is an addict so he was removed at the age of 7 from her. It is believed he was born addicted and he also had a collapsed lung at birth. He lived in deplorable situations. Malnourished and exposed to drugs and just a bad environment physically and mentally. He is on zantac 175mg and Omeprazole 40mg each 1 time a day. He has been on multivitamins for 4 years and also takes singulair and zyrtec for allergies. My question is does he need to stop the GERD meds before starting the protocol. I know I read to stop the suppliments but I wasn’s sure about the GERD meds. Also I had read that the Fiber choice fruity bites gummies are ok, he would take these instead of inulan right?
    Thank you

    • Author
      Patrick Nemechek, D.O. 1 week ago

      Never stop a child’s prescription medications in order to start the protocol and only do so in consultation with the prescribing physician. The Fruity Bites work well as a source of inulin in most kids.

  4. Nish 2 weeks ago

    Dr. Nemechek, I am curious to know if your protocol is helping children with Cerebral Palsy, and if the same protocol as given in your book would be applicable for them. Any insights would be greatly appreciated. Thanks, Nish

    • Author
      Patrick Nemechek, D.O. 1 week ago

      Yes we have had several reports of significant improvements of CP using the same protocol. I inclination is that some of the kids will improve even more with VNS because of the severity of CP.

    • Nish 1 week ago

      Thank you so much. We live in Dubai, hopefully will come see you for VNS some day. I have another question, do you have any Vegetarian DHA/ Omega 3 supplements that we can choose? I haven’t found an answer to this anywhere Dr. Nemechek. This step is stopping me from following the protocol since we are strict vegetarians. Pls guide us. Thank you.

    • Author
      Patrick Nemechek, D.O. 1 week ago

      Nordic Naturals make an algae-derived DHA product you can try.

    • Nish 7 days ago

      Great, I really appreciate this, Thank you.

  5. Elizabeth Harwood 2 weeks ago

    Hi Dr Nemchek
    My son has high levels of heavy metals in his system. I’ve never really dealt with detoxing him because I fear stirring up the metals and for them to be redistributed to worse places than they are now. He has been on the Nemchek protocol for three months to help with his slow processing speed and add and I always have at the back of my mind that I should detox him of heavy metals. Does doing Nemchek help with the detoxing process so that I don’t need a specific detoxing protocol? If not is there a detox protocol that can be done in conjunction with Nemchek? Also you do not mention diet in your book. He is on a healthy, wholefood organic diet but would it help him to be gf and cf as well?
    Thanks for your help doctor, your book was amazing.

    • Author
      Patrick Nemechek, D.O. 1 week ago

      No specific detoxifying treatment is required nor is a specific diet.

  6. Vasu 2 weeks ago

    Hello Dr. N

    I Am very interested in taking up this protocol of yours as I m seeing amazing feedbacks and success stories. I have my 5 year old son who is mildly autistic and high functioning. Capable of speaking sentences though not fluently. His eye contact and auditory are not upto the mark hence mingling with peers doesnt happen. Can I just use the EVOO and nordic gummies with the prescribed dosage and substitute inulin with natural foods? Will this work. Awaiting your response. Thank you.

    • Author
      Patrick Nemechek, D.O. 1 week ago

      I do not recommend changing from the basic elements I have prescribed.

      It may seem simple and logical to do so but many who try do not get similar results.

  7. Annie Cheah 3 weeks ago

    Hi Dr Nemechek, I am wondering whether you have trained any doctors in Malaysia or Singapore on your protocol? I need to see a doctor myself for Rifaximin. I also need to take my autistic son who has arthritis to consult a doctor on the protocol. He is 15 years old and after 2 months on the protocol, his verbal stimming still doesn’t reduce. He is on Inulin (1 tsp) twice a day, DHA(1500mg) +EPA(2100mg) and Extra Virgin Olive oil (1.5 tbsp). Do you think he needs Rifaximin? Thanks.

    • Author
      Patrick Nemechek, D.O. 2 weeks ago

      I generally treat most older teenagers with rifaximin but I would keep him on inulin if there are substantial improvements

  8. Mario 3 weeks ago

    Hi Dr Nemecheck, i am a 64 years old male who was healthy with no problems whatsoever up until 20 months ago, i only had mild anxiety and a little arrhythmia . So 20 months ago on a trip abroad in a Latin country the pharmacist gave me diazepam and trifluoperazine (stelazine) wich i took for about one month. I started to have arrhythmia, heart palpitations, heavy sweating and then some involuntary eye, hands and feet movements . I thought it would all go away by itself but it stuck and some things became milder and some new symptoms appeared: occasionnal sleep problems after a year, it comes and goes, and now I just started to have what seems to be neuropathy in hands a feet but also a little bit all over the body. I just started to take the required fish oil quantity and today started on inulin. You opinion please

    • Author
      Patrick Nemechek, D.O. 3 weeks ago

      I think you have suffered another injury that triggered the need for these medications.

      Follow the protocol and you should have noticeable benefit in a few months.

      As a note, remember adults do much better with rifaximin than the inulin fiber.

  9. Sofía Gómez 4 weeks ago

    Estimado Dr. Mi hijo de 4 años con autismo sin definir, deberá ser operado por sus testículos retráctiles, he aplazado la cirugía varias veces, tengo miedo de que esto le perjudique y aumente SIBO, es aconsejable esta cirugía? debería hacer la cirugía y luego el protocolo? O empiezo su tratamiento antes, el tiene casi siempre diarrea. Muchas gracias

    • Author
      Patrick Nemechek, D.O. 3 weeks ago

      La cirugía es importante para su salud. Comience el protocolo, controlará su SIBO incluso si se realiza la cirugía; no debe preocuparse por una recaída.

  10. Heidi Schnoor 4 weeks ago

    Do you recommend same protocol for a child with apraxia diagnosis, but does not have autism. My son is 4 years old and non verbal, although has a lot of sounds and a few words.

    • Author
      Patrick Nemechek, D.O. 3 weeks ago

      Yes, same protocol works for both apraxia and autism as well as sensory issues, devel delay and ADD/ADHD

  11. Simon 4 weeks ago

    Hi Dr.,
    I know you recommend California EVOO.
    I’m in London, UK. Is there any oil at all that has your approval in Europe?


    • Author
      Patrick Nemechek, D.O. 4 weeks ago

      None that I know of.

  12. Bridget Dolan 2 months ago

    Hi Dr. Nemechek,

    I’ve read your book, watched a ton of your videos, and started my xifaxan treatment this morning. I’m a Navy veteran and have been through the ringer with the VA system. Anyhow, a doctor a neurologist at Northwell in New York City was the first one to say the words autonomic dysfunction to me. I had a tbi when I was a teenager followed by multiple concussions in the military. About 2 years ago I started experiencing neurological symptoms and was diagnosed with fibromyalgia and basically treated like I was crazy. After that ringer at the va I bought myself insurance and started seeing civilian doctors. The stomach problems started a little over a year ago and after being diagnosed with h pylori I did the quadruple therapy and my problems started to get worse. Once I became familiar with dysautonomia because the took note of my drastically low blood pressure, I found your protocol. I had a gastric emptying study done which showed abnormal results. Not slowed, but actually rapid that then slowed. I had a positive SIBO test which I’m glad because I was able to get the prescription for xifaxan which I was already aware of due to your book. Anyhow, after that long winded background, I wanted to understand how I’m suppose to be taking fish oil? I’ve aalready been taking about 1200 mg a day for 8 months or so. But sounds like with a history of tbi that wouldn’t suffice. Your recommendation for adults is 3000 mg a day? Is that just for the dha? How much epa? Is it safe to consume this much a day? How should I spread out the dosing? I want to do the protocol right. I’ve been suffering for far too long and ready to feel like the 36 year old that I am. Best, Bridget

    • Author
      Patrick Nemechek, D.O. 1 month ago

      Adults need a minimum of 3,000 mg of the omega-3 DHA, the amount of EPA that comes along with this can vary and seems less important for brain recovery.

  13. Fleur 2 months ago

    Dr Nemechek,

    Is NN fish oil ok for children with histamine intolerance?

    • Author
      Patrick Nemechek, D.O. 2 months ago


  14. Kat 2 months ago

    Dr. Patrick, do you combine Neomycin (or Flagyl) and Rifaximin for SIBO? I can see that for methane dominant there is often a combination of two recommended.

    • Author
      Patrick Nemechek, D.O. 2 months ago

      Only for severe constipation.

      I don’t use breath testing for SIBO diagnosis because it really seems to be just a marker for carbohydrate malabsorption from dysbiosis with or without overgrowth than from overgrowth alone.

  15. Mounya khnaba 2 months ago

    Hi dr nemechek,
    I read your book and i want start your protocole. But my 14 years old autistic child is anxious with insomnia and i will give them Ashwagandha for that.

    They have any interference with the nemchek protocole.

    We will start the protocole this monday.

    Thank you so much

    • Author
      Patrick Nemechek, D.O. 2 months ago

      Please read what I say about supplements in the protocol. A copy can be purchased at

  16. Anon UK 2 months ago

    I’m pretty sure my daughter has PANDAS (not tested as it’s impossible to test for it in the UK, but illness always coincides with severe aggression and psychiatric-like symptoms which disappear about a week after the illness. I know for sure she had strep at age 2 and definitely had a big behaviour regression right after that, i think that’s when the PANDAS took hold. SHe is now 8. I tried giving inulin and after just 3 days, she had the worst outbreak of aggression and self-injury. I suddenly worry that the inulin is feeding the strep. Do you ever treat PANDAS children with this protocol and have good results??

    • Author
      Patrick Nemechek, D.O. 2 months ago

      You’ve got it all backwards, the inulin re-organizes her gut bacteria to a more favorable balance and because of this the sedating effects of propionic acid are lessened (please read about this in my book).

      All children in the early stages have worsening of symptoms with any secondary infection. This is an inflammatory relapse (read about this in the book)

  17. Annie 2 months ago

    Hi Dr Nemechek,
    I stumbled across your protocol in your Youtube channel and I was convinced ever since that it will cure my autistic son. I have read your book and absolutely love it. My 15 year old boy is hyperactive, verbal stim a lot and has developmental delay. He was put on GF/CF diet since 5 and along the way he was on DAN protocol, SCD/GAPS diet for 1.5 years. He had his first arthritis attack at the age of 10. After 1 year of treatment using Voltaren, Prednisolone( for 2 months only) and Methotrexate, he recovered and was taken off the prescribed medicine. However, end of June this year, he has a relapse after 3 days of high fever and this time around it came back fiercer than before. His CRP was 141 when we first took him to see a Paediatric Rheumatologist. After 1 month of Voltaren, Prednisolone and Methotrexate, his CRP dropped to 21. He is still on the prescribed medicine now, I have started the Nemechek Protocol on my son since 5 weeks ago because I believe he has way too much inflammation in his guts and brain. I am wondering whether the prescribed medicine would deter his brain from recovering? Thanks.

    • Author
      Patrick Nemechek, D.O. 2 months ago

      The meds for RA should not interfere with the protocol.

  18. Lila 2 months ago

    Hi Doctor, we are in protocol for 3 and half weeks. First 5 days of protocol I gave my kid only oils , that time we had more awareness and good eye contact, then I introduced 1/8 tsp inulin. After that we dont see much gains, only she is trying to say Happy Birthday to you. other than that we dont have any communication, no pointing. Also we see more stemming. Do you think I need up inulin and see what happens. Because when I was giving oils only we had more awareness an more eye contact, and responding to her name, but I dont see it now, I dont think we are in awakening too. We are in GFCF diet, no omega 6 oil. My kid is 28 months, non verbal. She is only repeating some words she learns from cartoon, 3,4 words but not showing or pointing anything.
    Our current dose:
    Now inulin powder 1/8 tsp
    Now DHA 2/3 capsule
    EVOO for cooking and on her food extra 2 tsp

    • Author
      Patrick Nemechek, D.O. 2 months ago

      Your expecting too much too soon.

      Give things time to work before changing anything

  19. Claudia 2 months ago

    My my son is 11 and has confirmed SIBO with positive breath test- hydrogen and methane 3 years ago. Have done several courses of Rifaximin/neomycin over years but did not know of your protocol until recently and starting ASAP. He has diagnosis of PANDAS/autism/ LYME/CIRS but believe like you that all his symptoms stem from SIBO. I have a script for Rifaximin (2x550mg this time) but think we will try protocol first without? Add if needed? I have no access to a VNS device and have recently purchased a Vielight Neuro Gamma – I know it’s not the same but is it safe to use? Waiting for a consult with you to discuss further but would like to know if the vielight is safe in your opinion? Thank you- very gratefully yours.

    • Author
      Patrick Nemechek, D.O. 2 months ago

      I’d like to correct you. The SIBO may only cause on increase in propionic acid but is not responsible for all the symptoms.

      Many of the symptoms (including intestinal symptoms) are due to developmental delay and cumulative brain which remain after SIBO is reversed.

      I have no experience with the Vielight Neuro Gamma

    • Claudia 2 months ago

      Thank you – yes that makes complete sense. I’m loving the simplicity of the protocol and wishing we had discovered it much earlier but Here’s to lots of progress, hoping his tics and other severe symptoms will decrease soon and discussing further with you.

  20. Lila 2 months ago

    Hi Doctor, we recently started protocol. like 3 and half weeks ago. Before protocol i was giving my kid Nordic Naturals Cod Liver oil. First five days of protocol , I gave her recommended Now fish oil and EVOO. We had good eye contact and good responding to her name with oils, after five days i added NOW inulin powder – 1/8 tsp dose . Now 3 and half weeks in we lost eye contact and no responding to her name, no communication (we didnt have it before too) stemming a lot, like lining up toys, no aggression though . She started copying words from cartoons and now she is kind of trying to say “Happy Birthday to you” all the time. We have insomnia at night, waking up and having hard time to go back to sleep (we have this before too but not everyday, we have waking up at night everyday now in protocol). Currently I dont see any gains except saying Happy Birthday to You and trying to play ball. What is your recommendation? Do we need up something or decrease? Thank you very much for your response in advance.
    Kids age: 28 months (Non verbal, no pointing, no communication)
    Current dose:
    Now DHA Fish oil 2/3 capsule
    Now Inulin powder 1/8 tsp
    Californian EVOO cooking plus adding to her food everyday.

    Thank you very much,

    • Author
      Patrick Nemechek, D.O. 2 months ago

      These are good signs that indicate she is experiencing the awakening.

      Yu need to read the protocol all the way through to understand. A copy can be purchased at

  21. Heather 2 months ago

    Dr. Nemechek, what do you think of the new calamus oil that is beginning to be discussed for helping speech in nonverbal children? Would it interfere with the protocol? It is an intranasal oil.

    • Author
      Patrick Nemechek, D.O. 2 months ago

      Doesn’t make any sense to me.

      Why not just stick with something that is so cheap and effective?

    • Heather 2 months ago

      Fair enough!

  22. Linda Kraus 2 months ago

    Dr. Nemechek,

    First, I thank you for all you do!

    My 38 month hyperlexic possible ASD son and I started the protocol on 9/19/2018.

    Sons current dose:
    1/8 tsp of Now inulin
    1 ml of NN ProOmega FO
    Cooking with evoo, trying to eliminate bad oils from diet but some of his foods still have it.

    My current dose (29 weeks pregnant):
    1tsp Now inulin
    5ml of NN ProOmega
    2 tbsp California Ranch Evoo and cooking with Evoo.

    * Taking Baby and me 2 Prenatal vitamins now as I realized one a day prenatals are terrible and have regular folic acid. Not sure if i have mthfr gene.

    Trying to figure out if our doses are correct, my husband believes we shouldn’t increase inulin for son. My son has seen the following success is the last 2 1/2 weeks since we starting np.

    First day, he tugged at pull-ups, I asked if he wanted to go potty and he went…he also said potty time today and asked him if he needed to go and he went. Has been potty training but no real awareness when needing to go before this. Two days later he is at Nana’s house in the tub and stands up, goes pee and says I went pee pee, I get a sticker. Again more awareness. Rewards didn’t really resonate before this. For the weeks prior to starting NP we would watch potty videos with sign language. He would not try to imitatate the signs, now he is signing potty time, help, accident, celebrate. Not using the signs functionally but when we sing the song or mention a word. He did however sign ‘help’ when asking for help with a game today. I was able to cut toenails and fingernails today with no fussing, pulling away or having to count! We decided to see if he would be more open to trying new things as well. He hated gummy anything, today he tried a gummy vitamin and at first didn’t like it but tried it again and ate it( we won’t be adding to diet but this is a huge win). We also had him try dipping food today as he is a picky eater and does not like any sauces. He tried BBQ sauce on fries multiple times didn’t care for it and then marinara on garlic bread. He was also willing to go in the shower today. This is a kid who hated getting his hair wet. He wasn’t under the shower most of the time but just getting in there and not being fearful is huge! He laughed and had fun the whole time when spraying him with shower hose. He let the water run over his head for 10 seconds never getting upset. He has definitely made a point to want to walk rather than be pushed in a stroller the last 2 weeks. He had a day of no crying at preschool dropoff last week after 1 month of straight crying at dropoff. He is sleeping through the night and waking at normal kid hours. He seems to be having a more enjoyable time over all, sometimes laughing so much it’s a deep belly laugh.

    Some noted behaviors we are watching for: He had an upset stomach two days in to NP that caused lots of crying that seemed to be gas from the inulin. Putting fingers and hands in mouth quite often. He didn’t really having any sensory seeking behaviors besides burrowing before this. More emotional.
    Still lots of echolia and scripting. Receptive language and following directions getting better. We would love to see functional communication and more eye contact.

    Are we going through an awakening yet, not sure if these gains are awareness? Should we increase the inulin? My husband worries that it hurt his belly the first time around that increasing will do the same.

    Also any info you can give regarding my pregnancy and preventing issues with my newborn would be greatly appreciated. Also, I have a sinus infection(last 2 weeks) and doc wants me to take Zyrtec and if I don’t get better in a few days wants me to take antibiotics. I am scared to death to take either as I had antibiotics while pregnant with my son for a uti and then he and I both received antibiotics during my labor and delivery due to a fever I had during delivery.

    Linda from Chicago.

    • Author
      Patrick Nemechek, D.O. 2 months ago

      Too much to evaluate in a blog. Yu may want to consider a Skype discussion.

      Also, re-read the prevention chapter in the book and run everything you do past you obstetrician.

  23. Thalia 2 months ago

    Hi Dr. Nemechek, I am almost done reading your book and have some questions about my 3.5 year old son.

    Inulin – The label on the Now Inulin prebiotic says “for adults only” is this the right one or is there one specifically for children?

    Olive oil – Your protocol says to just cook with it at this age but he has been taking 1tsp daily. Is that OK?

    Fish oil – he has been taking the Nordic Naturals for a year now but higher amounts than you recommend in your book. We lowered the dose now to match your protocol. Is it harmful that he was taking a higher amount?

    • Author
      Patrick Nemechek, D.O. 2 months ago

      Inulin is safe in children
      Yes EVOO can be given orally
      No one knows the upper tolerance of child but the doses I used are considered safe.

  24. Amanda 2 months ago

    My son had his colon removed at 2 weeks old due to NEC. He’s 15 months now.

    Due to short gut, he has chronic diarrhea and when he was on safflower oil previously I discontinued because the diarrhea got uncontrollable. We used it in his bottles for extra calories when he was failure to thrive. Is this protocol contraindicated for him?

    He also has CP (unable to hold up his head independently, sit, roll, etc), epilepsy and a visual impairment so I am definitely curious about this protocol.

    Thank you!!

    • Author
      Patrick Nemechek, D.O. 2 months ago

      He most certainly has bacterial overgrowth after a bowel resection surgery.

      Usually the inulin is enough to control the overgrowth such that in 2-3 weeks the malabsorption from SIBO resolves and the gut is more able to tolerate oils and other foods more readily.

    • AMANDA GOSS 2 months ago

      Dr. Nemchek,

      Thank you! Is this protocol recommended in place of current gut meds? My son is on metronidazole the 1-7, neomycin 8-15 and nyastatin the 16-21 of every month to contain his bacteria. Otherwise we have found ourselves back in the ER numerous times.

      His overgrowth seems quite determined.



    • Author
      Patrick Nemechek, D.O. 2 months ago

      Too complicated to answer in a simple blog post. You probably need a full evaluation in AZ if this is what it takes to control SIBO

  25. Cathriona Barrett 2 months ago

    Hi Dr Nemechek, my son who is 4yrs 9 months has been on your protocol since June. He takes 2.5mls Nordic Naturals childrens DHA (which he was taking for a year prior to the protocol without issue), 1/8th tsp Inulin, and Evoo (high quality Greek) 2.5mls plus used in cooking. We saw a definite awakening at 1/8th tsp of Inulin so although the dose was minimal I stopped because the awakening obvious. We saw increase stimming and sensory seeking but gains in awareness and eye contact and began playing with a football which he had never done before. He started using a few words he had previously lost which was great as he is mostly nonverbal. In the last month and half sleep issues have become more frequent and speech has regressed again although he still has improved eye contact and loves playing ball. I suppose I’m second guessing myself, although I’ve had lots of positive comments about how his awareness has improved but it’s the regression in speech and the fact this is now leading to self injurous behavior which is so difficult to watch. It’s like he is more aware of his severe speech delay which didn’t seem to bother him as much before. Is awakening possible at this dose or should I increase? Your advice would be greatly appreciated. If I didn’t live in Ireland we would take a trip to see you any advice would be greatly appreciated.
    Kind regards,

    • Author
      Patrick Nemechek, D.O. 2 months ago

      The inulin is a bit on the low side although some awakening can occur at this dose, higher doses might help more.

      As its a positive sign that he is enjoying playing football (soccer), he might of also sustained a minor injury which is causing some of the new symptoms. This worsening should recover with due time.

    • Cathriona Barrett 2 months ago

      Thanks for the advice Dr Nemechek, it’s much appreciated.

  26. Debbie 2 months ago

    How do you get 4-7 year olds to take the olive oil?

    • Author
      Patrick Nemechek, D.O. 2 months ago

      All I can say is that when my grandmother gave me castor oil which I hated, I took it because I knew there was absolutely no other option.

  27. Anita hosie 2 months ago

    Hi Dr Nemecheck,
    Love your work!…im a 49 year old female, have autonomic dysfunction, Gut issues, brain inflammation….post chickenpox infection with secondary staph and encephylitis….20 years on I am only able to eat 6 foods due to salicylats and amine i tollerance and SIBO….keen to begin Rifaxamin and the oil therapies…however fish oil and olive are both extremely high in amines and salicylates….any suggestions…would cannola oil work to some degree?? I eat lots of flax seeds, pumkin seeds and organic eggs…and 2 or 3 vegies…thats about it…perhaps after Rifaxamin that may change???
    Kindest regards,

    • Author
      Patrick Nemechek, D.O. 2 months ago

      Canola won’t provide you the DHA your brain requires.

      Once you take the rifaximin, your leaky gut heals in about 2 weeks and you’ll be much more able to tolerate the supplements.

  28. Saranya 2 months ago

    Hello Dr. Nemechek,
    Thanks for helping lot of kids. My son is 4 years old and he is on the protocol for the past 4 months. He is on 1/2 tsp inulin and 1 Tbsp olive oil. I tried lot of fish oil brands for my son and it didn’t work. He refused to eat the food. Recently, I purchased Omega 3 innovations pure fish oil unflavored one. Some of them say it is not on the brand that the protocol suggested. What is your suggestions on that?

    • Author
      Patrick Nemechek, D.O. 2 months ago

      There is a reason why I am very specific about certain brands – it has to do with they are genuine, high quality and work.

  29. Iris 2 months ago

    Hi Dr. Nemechek, My 4 yo son is starting rifaximin. Does he take fish oil while on the rifaximin?

    • Author
      Patrick Nemechek, D.O. 2 months ago

      Yes he can but it is ok to hold off until he is done.

    • Iris Rubin 2 months ago

      thank you.
      He also takes grapefruit seed extract for PANDAS. Is that ok to continue with the rifaximin?
      With gratitude,

    • Author
      Patrick Nemechek, D.O. 2 months ago

      No it is not.

  30. Darcy 2 months ago

    Hi Dr. Nemechek, I’m very excited & hopeful to use your protocol on my 2 year old son, he’s about 28 lbs. I purchased Microingredients organic inulin powder made from Jerusalem artichoke & Barlean’s kids liquid fish oil containing 360 EPA/DHA per teaspoon. Today is day 2 of giving him 1 teaspoon inulin & about 9 mL of the fish oil spread into 2 of his 3 meals per day. I’m just wondering if you approve of these brand of supplements &/or if that is too much for his size? I haven’t seen any differences yet, will he possibly get worse before getting better or should I just expect improvement over the next few weeks? Thank you so much!

    • Author
      Patrick Nemechek, D.O. 2 months ago

      Those are not approved brands.

      Please read the protocol.

  31. Anonymous 3 months ago

    Dr N, I sincerely appreciate the opportunity you have given parents and children by sharing your protocol. At the age of 3.3 years, my son was diagnosed with ASD as mild.He is 4.9 years old now and has made lot of gains in terms of communication.He is verbal and communicates well with us . The major concern we are working now is Emotions.He is able to understand his emotions, but not others.For example, he is unable to understand tat if he pushes a kid, the kid will feel sad.We tell lot of social stories in which he identifies the emotions, but doesn’t feel them actually. We have not followed any medication/protocal till date.Appreciate if you can help me to understand if following Nemcheck protocal will help my kiddo. Thanks in advance.

    • Author
      Patrick Nemechek, D.O. 3 months ago

      Much of this inappropriate aggressive behavior is due to autonomic dysregulation because of cumulative brain injury.

      This often resolves itself with due time without changes in the protocol.

  32. Anonymous 3 months ago

    I am interested in starting the protocol for my son who is 7 years old and does not have autism but I am fairly sure he has ADHD and possible bipolar. I hate to diagnose but a mom knows her son. He always has struggled with lots of behavioral/aggressive issues and we struggle every day. Does this protocol also benefit ADHD and/or biploar? What I am scared of is this “awakening” period that is spoken of because my son has no problems with Autism and is fully awake! He can be very aggressive and very emotional most every day but has some better days the older he gets. Our family has a huge history on both sides of mental illnesses. My son was born with colic/acid reflux from the beginning and cried constantly the first 7 months of life. He was on prescription antacids as an infant which only helped a little. He was on antibiotics over 6 times for ear infections by the age of 18 months he got the ear tubes and better. He has always complained about stomach aches and I only give him lactaid milk for 3 years now. But he still complains and even gets out of school. When these stomach aches pass he seems better. He generally has loose stools, never constipated. Does you think he would benefit from this protocol or would the “awakening” from inulin make him worse/more aggression? Thanks!

    • Author
      Patrick Nemechek, D.O. 3 months ago

      Yes it can help both ADHD and Bipolar Disorder.

      Watch the Youtube video on aggression and anxiety. If you are worried about these issues, the key is to start with a very low dose of inulin and slowly work-up.

      In very severe cases, I’ll have the kids just start fish oil and olive alone and wait 2-3 months before starting the inulin. After a few months, the child often improves enough that the addition of inulin doesn’t cause too intense of an awakening.

  33. Brian Dey 3 months ago

    I have a problem with strep, I might be a strep carrier. I am on antibiotics now. How long after the antibiotics should I wait to start your protocol ? Should I start taking inulin in the short time?

    • Author
      Patrick Nemechek, D.O. 3 months ago

      Just a caution. The standard approach to strept carriers (+swab, + culture with out symptoms) is to not treat. Strept carriers over have a harmless strain of strept that does not rheumatic fever and other problems and does not make other sick. About 10% of the U.S. population are strept carriers.

    • Brian Dey 3 months ago

      Can taking DHA at night cause you not to sleep?

    • Author
      Patrick Nemechek, D.O. 3 months ago

      Potentially if it causes a little heartburn or nausea.

  34. Anonymous 3 months ago

    Dr Nemecheck , I have read your book and heard a lot of good things about your protocol. It is very fasciating and I like the simplicity of this protocol.
    I have a 5 year old on spectrum. We recently took him to Panama ( almost a month ago). I have spoken to few people who have also done the protocol along with stem cells. Their suggestions are quite diverse. Some have suggested to hold off starting protocol for 4 months after the stem cell treatment . The idea is that the awakening period might harm the stem cell . I am not sure if that is the right course of action. Would you have any suggestions about when we should start ?

    • Author
      Patrick Nemechek, D.O. 3 months ago

      Human stem cells do not function well if there are increased levels of pro-inflammatory cytokines. All aspects of my protocol are directed at reducing the abnormal production of pro-inflammatory cytokines.

      Its hard to image this benefit along with the fact we are only taking about olive oil, fish oil and a fiber found in onions and garlic could somehow worsen any treatment.

  35. Tasha McKinney 3 months ago

    Hello, I have just found your protocol and I am very happy. I have two sons, ages 4 and 6. I already give them Nordic Naturals Fish Oil (5ml) daily. Can you please tell me the amounts for the inulin and the DHA? They also can not yet swallow pills. What is your recommended alternative for your other suggested products?

    • Author
      Patrick Nemechek, D.O. 3 months ago

      The doses I use for my patients are discussed in detail in our protocol guide. I highly recommend using it because it will help you more fully understand the changes your child is going to go though, what they mean, the potential ways a child can relapse and more.

      A copy can be purchased at our website at

  36. Amino Amir 3 months ago

    Hi . I am a mother of 6 year old son on protocol since one month .i can’t get now inulin using inulin pure but 10 percent FOS in it inulin by healtharena uk brand
    Can I use it in this protocol
    What is FOS ?

    • Author
      Patrick Nemechek, D.O. 3 months ago

      I guess you can try it if you can’t find inulin.

  37. Imran Haider 3 months ago

    Dear Dr. Nemechek, thank you for sharing your findings with the distressed parents the world over. I am in Pakistan, and my 13 years old son is diagnosed with mild autism (PDD-NOS). We are going to try NP for him. But I cannot find California’s EVOO. Importers are giving time ranges in months for that. Can you please suggest if there are alternates to the California’s EVOO? Thank you and God bless.

    • Author
      Patrick Nemechek, D.O. 3 months ago

      I can only imagine the difficulties you have in looking for the proper supplements.

      We recommend Shipito as a service for delivering the supplies but if they delay is too long, I recommend using locally sourced olive oil and trying to cook only in canola oil since this is not inflammatory.

  38. Ana 4 months ago

    Dear Dr. Nemechek, I have been diagnosed with celiac disease. Is there a brand of inulin that you recommend that is certified gluten free? Unfortunately, the NOW brand is “Produced in a GMP facility that processes other ingredients containing these allergens.” (wheat). Thanks for your help in advance, Ana.

    • Author
      Patrick Nemechek, D.O. 4 months ago

      Sorry, I don’t know of any that I trust.

  39. Lori Gier 4 months ago

    Are you coming to Texas anytime soon? Like Houston? We are doing great with the protocol so far but would love to purchase your VNS without the traveling. Will you ever sell and ship?

    • Author
      Patrick Nemechek, D.O. 4 months ago

      Unfortunately, I am only licensed to practice medicine in Arizona and the VNS is a class 2 device and only be distributed after a face-to-face visit with a physician.

  40. Mrs Samina Noor 4 months ago

    Hi Dr Nemechek. Are we allowed to eat chicken, meat and eggs while on the suppliers of these foods say that they use products to feed their chicken which has got corns too. And animals are grass fed.please advice 2 children are on Protocol since 6 wks but no gains yet.using recommended brand and dosages.thanx

    • Author
      Patrick Nemechek, D.O. 4 months ago

      The olive oil will protect against the omega-6 content in grain-ed animals.

  41. Tammy Mouser 4 months ago

    I am sorry, I thought it was too much as well but the admin in the FB group encouraged me to do so.

    I am a single mom and already pay all of her expenses out of pocket and just bought hearing aids for her. We honestly live at poverty level bc of all her health issues. Thankfully she is on scholarship for her ballet. I keep telling people in the group that I can’t afford to see you.

    I apologize for sharing too much, I just didn’t know how else to do so.

    • Author
      Patrick Nemechek, D.O. 4 months ago

      Don’t apologize. It’s just we have to be very careful with regulations as I believe there are many who might like to interfere with the progress this protocol is having on children.

  42. Anonymous 4 months ago

    Dear Dr.Nemecheck: I’ve read your book twice and love the simplicity of your protocol. My son (Aspergers, 21) was diagnosed of severe Pyroluria 2 years ago. He had been on the nutrients and thatmanaged his anxiety somewhat. About 5 weeks ago, I started Nemecheck protocol and gradually increased doses to 6 caps FO, 2 Tbp EVOO and 2 tsp inulin. In the meantime, I stopped all his other supplements. However, he had extreme fatigue and became more sensitive to light and sound. He stayed up really late and slept more than 12 hours but still tired. I had to add back his old nutrients (Zinc, B6, GLA .) and I stopped FO but kept 1 tsp inulin. Now he has more energy. I really would like NP to work for him but can’t figure out why NP caused so much fatigue. Should I keep his old nutrients and do inulin or maybe Rifaxamin for a while before going on full NP? Or do the old nutrients and low dose of inulin and FO for now? I would really appreciate your advice.

    • Author
      Patrick Nemechek, D.O. 4 months ago

      I would generally use the rifaximin preferentially in patients his age.

  43. Tammy Mouser 4 months ago

    Hello!! We have attempted to be at this protocol a year after Kelsey Emuss shared a similar journeys between our daughters. We started last June 2017, but my then 13 year old was still on medication and prescribed iron and vit. C. She had been ill since 10 years old. Children’s doctors just filled her with medications and I eventually took her to a holistic doctor to look at the big picture. We made headway but were left with tons of side effects from the illnness like hair loss, eczema out of control, fatigue, and acne everywhere which is devastating to a 10 year old. For the past 3 years a dermatologist has attempted to help her. 3 years of every pill and cream and not any spot left. Her body has resisted medication her whole life which is so scary.

    From 10months old to 9 years old she had non stop ear infections. Nothing stopped them and even with tubes she kept a infection. She still gets them a few times a year but not as constant. This past Winter and Spring they happened more often and she struggled with her balance once again. All these ear infections have resulted in APD, partial hearing loss, balance issues and she also has SPD but it has lessened. She has also always had a gut that expands after she eats that is very noticeable. You see in the midst of all of the challenges, Addison is an accomplished dancer and is on scholarship This past year as an 8th grader as a trainee with Joffrey Ballet. Despite balance and hearing issues she pushes through in dance and is even on pointe. She also is an amazing advocate speaking publicly on instagram about her health and hearing struggles.

    In January 2018, we had finished all the meds and we restarted the protocol but started with inulin only bc she had some histamine reactions with FO. By March her face was clearer and by April her acne was totally gone. I have dramatic pictures to show the changes. After over 3 years of not one spot leaving, She was free of acne and had no scars. It was emotional in a good way! Inulin alone appeared to heal it.

    We always felt that to treat years of antibiotic overuse and infections that we needed the Rifaximin to help her further with inflammation, gut, APD, SPD, etc…. We have since done 2 rounds and feel we have seen nothing positive yet, as well we restarted the oils. Sadly, something has reignited the acne. A couple of weeks ago she begged to go back on inulin. She now feels fearful of the Rifaximin and oils feeling they are the cause of acne returning.

    I feel lost and I hurt for her. I am sure she needs a 3rd round of Rifaximin to help the gut and other issues but honestly I am scared to, I don’t want to cause the acne to get worse. Her self esteem has increased with having her acne gone.

    Was stopping inulin the cause of the acne returning? Is it the oils? The Rifaximin? Is it temporary? Why have we seen no other benefits to the protocol?

    I shared all of this with the FB group and admins felt we should bring the concern here. Addison is 14, has done 2 rounds of Rifaximin, does 5 fiber Choice gummies a day, 2tbs of EVOO, and 3,000mg of NOW DHA.

    • Author
      Patrick Nemechek, D.O. 4 months ago

      Please contact my office about setting up an appointment.

      This is too detailed to respond to on a blog

  44. Jolene Samuel 4 months ago

    Dr N, I sincerely appreciate the opportunity you have given parents and children by sharing your protocol. My 6 y.o. ASD, non verbal son, seems to have a negative reaction to the NN fish oil. Whenever I use it, he presents with heightened emotions and wets the bed. On inulin only and EVOO in cooking, he is dry at night (actually became dry at night once inulin started). Any suggestions re another omega 3 source? Should I try a different type of FO cod? Tuna? There seems to be a pattern related to fish oil use

    • Author
      Patrick Nemechek, D.O. 4 months ago

      Yes, I would try another brand. Maybe the contents of the DHA-500 capsules (2 ?) if he can’t swallow capsules.

      Another option is to increase the dose of inulin and see if the tolerance of FO improves.

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