Regenerative Medicine Procedure Preparations: Instructions to help maximize the outcome of your procedure
Because this treatment is greatly affected by the ability of your cells to repair damaged tissue, we have found that certain medications may enhance or interfere with your results.
*Do not stop any prescribed drug without speaking with your prescribing physician*
The following medications have been shown to interfere with the effectiveness of your stem cell function and therefore we recommend holding them or replacing them with another class that is safe to use with your regenerative medicine treatment:
Steroid drugs like prednisone, inhaled steroids taken for asthma, or steroid injections are given for joint arthritis, neck pain, or sciatic leg pain should be stopped for 2-4 weeks prior to your procedure and 6 weeks after.
NSAIDs can also be as harmful to your stem cell treatment as steroids or statins (see below). Ideally, you should temporarily stop your NSAID use for 2-4 weeks prior to your treatment and for 6 weeks after your stem cell procedure. Baby aspirin (81 mg) is okay to continue. It is imperative to stop NSAIDs such as Motrin, Ibuprofen, Aleve, Naproxen, Celebrex, Diclofenac, etc. 7 days prior to your procedure to help prevent the excessive risk of bleeding.
AVOID bisphosphonates such as Fosamax, Actonel, or Reclast for osteoporosis management. Ideally, you should temporarily stop the use of these meds for 2-4 weeks prior to your treatment and for 6 weeks after your stem cell procedure.
“Statin” cholesterol-lowering drugs or HMG-CoA reductase inhibitors such as Atorvastatin or Lipitor, Simvastatin or Zocor, Rosuvastatin, or Crestor, and Ezetimibe or Zetia should be stopped for 4 weeks prior and 6 weeks after your procedure. You must clear stopping these drugs temporarily with your prescribing primary physician or cardiologist.
Blood pressure drugs like angiotensin-converting enzyme (ACE) inhibitors such as lisinopril or enalapril, and angiotensin II receptor blockers (ARB) including Diovan, Benicar, or losartan should be stopped 2-4 weeks prior and 6 weeks after your procedure. You must consult your prescribing physician about switching to a different blood pressure medication for the time being such as a calcium channel blocker like Amlodipine or Cardizem.
5-alpha reductase inhibitors like Finasteride or Propecia should be stopped 2-4 weeks prior and 6 weeks after your stem cell procedure to protect your stem cells.
Male or female hormone replacement including estrogen, progesterone, testosterone, and growth hormone may be continued during your stem cell process.
Antibiotic use should be evaluated on a case-by-case basis. Under no circumstance should fluoroquinolones be used, but especially within 4-6 weeks of a platelet-rich plasma or stem cell procedure due to increased risk of tendon rupture, damage to platelets and stem cells, and decreased likelihood of healing. Examples of fluoroquinolones include Ciprofloxacin and Levaquin. Taking other antibiotics during this time is okay, as long as there is no ongoing, active infection in your body, which would be indicated by an oral temperature of > 100.4°F without NSAIDs or Tylenol (acetaminophen).
Proton Pump Inhibitors – Nexium or For GI Reflux and Ulcer treatment. Substitute with an H2 Blocker like Pepcid or Zantac for 4 -6 weeks before and 6 weeks after your treatment.
Alcohol can have a profound negative effect on stem cell function, so this should be avoided for 2-4 weeks prior to and 6-12 weeks after your stem cell treatment. A glass of wine with dinner is okay, but more than this should be avoided. Cannabis such as marijuana can promote bone formation instead of cartilage, so these should be avoided, as well, for 2-4 weeks prior and 6-12 weeks after your procedure. CBD is OK up until your treatment. Avoid CBD for one week after your procedure.
You may stay on all supplements except the following, due to an increased risk of bleeding during the procedure:
- Reduce the dose of fish oil to 2 grams daily or stop completely for 5-7 days before and after your procedure.
- Reduce the dose of curcumin and/or turmeric to 500 mg daily or stop completely for 5-7 days before and after your procedure
Blood thinners should be stopped prior to your stem cell procedure with prior approval from your prescribing physician in order to avoid the risk of excessive bleeding and/or bruising. Plavix should be stopped 7 days prior to your treatment. Coumadin or Warfarin may be stopped 5 days prior. Heparin and Lovenox should be discontinued 24 hours prior. All of the above medications may be resumed 24 hours after your stem cell procedure.
Getting off of all prescription medications that you can possibly stop 1-2 weeks prior to your stem cell harvest is a good idea. However, this should be cleared by your prescribing doctor.
Cut the Sugar
This includes sweets, bread, pasta, juice, extremely sweet fruits like bananas, etc. Sugary foods cause the body to create too much insulin and combined with inactivity leads to a condition called metabolic syndrome (a combination of risk factors including high blood pressure, high blood sugar, high cholesterol, and increased fat around the waist), which leads to heart disease and stroke. We recommend going on a strict Paleo, Keto, Intermittent Fasting, Atkins, Zone, or South Beach Diet for 1-3 months prior to your stem cell procedure to help control blood sugar and excessive insulin. Resveratrol has also been shown to help control blood sugar. See below for dosage.
Try reducing your food intake by 20% for two weeks prior to your stem cell procedure to improve stem cell function.
Triglycerides are the storage system in the blood for carbohydrates that go unused and have a direct relation to excess weight. Research done on cultured stem cells has shown that stem cells grow poorly in patients with high triglycerides and/or who are obese. You can lower these by cutting your sugar intake, reducing your calorie intake, and starting a fish oil supplement. The recommended dose is at least 4 grams (4,000 mg) of EPA/DHEA combined. We recommend and sell a lemon-flavored, liquid, fish oil supplement called Vital Nutrients. It is an easy alternative to taking numerous fish oil capsules. Take 2 teaspoons daily to get 5 grams of EPA/DHEA.
Lift Weights and Stay Aerobically Active
Research shows that more active older animals have better stem cells that create more bone, exercise increases muscle stem cells, and weight lifters have better stem cells than the average population. The goal here is to push yourself to do more than you are currently doing. If you suffer from a significant injury and are unable to do much, try the stationary bike or walking in the pool. If you are a couch potato, start walking and lifting light weights. If you attend the gym regularly but are able to carry a conversation while you complete your workout increase your resistance while doing cardio or increase your weight while lifting weights. Hire a trainer to push you, if necessary. Most importantly, listen to your body and don’t push yourself so hard that you end up injuring yourself even more prior to your stem cell procedure.
Rehabilitation and Return to Activity
See our handout on rehabilitation phases and how to progress. The most important guideline is to LISTEN TO YOUR BODY! If you try a stretch or exercise one day and you are sore the next day this is your body telling you that you did too much. Back off from there and start a slower progression. If you have any questions regarding your specific case, please contact the office.
Physical therapy is typically started eight weeks after your procedure for stabilization exercises and they will progress to full exercise as tolerated.
Return to Work Protocol
Sedentary to light-duty job requirements – You can typically return to work within 1-2 weeks after your procedure.
Medium to heavy job duty requirements – You can typically return to work within 6-8 weeks after your procedure.
Take your supplements: All of the following supplements have been studied in stem cell culture and have been found to improve the quality and quantity of your stem cells. These should be taken for 4-6 weeks before and after your treatment. You can purchase them separately or from Amazon, GNC, Vitamin Shoppe, etc.
However, if you would prefer to take everything at once in liquid form you can purchase a one-month supply of Liquid Regenexx advanced stem cell support from Amazon. If you take this you do not have to take the supplements separately.
Collagen type 2,500 mg daily
Hyaluronic acid 50 mg daily
Vitamin C 1,000-2,000 mg daily
Curcumin 500 mg three times daily
Vitamin D3 5000 units daily
One a day multivitamin with B complex and minerals