Disclosure of interest: None Poster Session II - ACUTE ISCHEMIC STROKE MANAGEMENT 01.00 - ACUTE ISCHEMIC STROKE MANAGEMENT - 01.02 - ACUTE MANAGEMENT - Thrombolysis or thrombectomy P621 - ESOC25-1482 STRATEGY FOR IMPROVING STROKE TREATMENT RESPONSE (SISTER): A PHASE-2 CLINICAL TRIAL OF TS23, A NOVEL MECHANISM FOR IMPROVING OUTCOMES IN ACUTE ISCHEMIC STROKE Eva Mistry 1 , Jordan Elm 2 , Pamela Plummer 1 , Rebeca Aragon Garcia 1 , Paul Kussie 3 , Ryan Sullivan 3 , Iris Davis 1 , Yasmin Aziz 1 , Vivek Khandwala 1 , Achala Vagal 1 , Noor Sabagha 1 , Joseph Broderick 1 , Guy Reed 3 , Pooja Khatri 1 , Scott Janis 4 1 University of Cincinnati, Cincinnati, United States, 2 Medical University of South Carolina, Charleston, United States, 3 Translational Sciences, Inc., Phoenix, United States, 4 National Institute of Neurological Disorder and Stroke, Bethesda, United States Background and Aims: Plasminogen activators for acute ischemic stroke (AIS) suffer from limitations of a narrow therapeutic window, suboptimal thrombolysis of larger clots, paradoxical microthrombosis, neurotoxic effects and hemorrhage
It has a genuine FDA-approval history rather than being a novel "research chemical," but no FDA-approved finished product remains on the market, so it is supplied only through compounding pharmacies and prescribed off-label in adults for growth-hormone-axis support, general wellness, or anti-aging purposes rather than its original pediatric indication
Things Worth Discussing with Your Doctor: Baseline kidney function testing (eGFR and cystatin C) before starting B12 MTHFR genetic testing if you have a family history of kidney disease Comprehensive nutrient testing (magnesium, zinc, B6, folate) Homocysteine and methylmalonic acid baseline levels Regular urinalysis every 3-6 months if youre on high doses Advanced urine tests if youre high-risk Pulse dosing schedules based on your kidney function Optimal timing for taking supplements Creating Your Personal Approach Rather than following generic guidelines, its worth developing an individualized B12 strategy based on your kidney function, genetic factors, and how your body responds to supplementation
Weeks 48: The This Is Working Phase If youve stayed consistent, this is where many clients feel like theyve hit a groove
Timing Considerations Administration timing matters with DSIP
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