Methionine + Inositol + Choline + Cyanocobalamin (B12)
Subcutaneous Lipotropic Injection Protocol
Nightingale Rx™ Clinical Protocol — Provider Use Only
________________________________________
1. INDICATIONS
BioBoost Rx™ may be prescribed for adults seeking support with:
• Lipotropic fat metabolism
• Low energy or fatigue
• Liver detoxification support
• Metabolic sluggishness
• Weight loss plateaus
• Cognitive fog related to B vitamin deficiency
• Foundational metabolic support during weight loss therapy
________________________________________
2. ELIGIBILITY CRITERIA
Patients must meet all of the following:
• Age 18–75
• BMI ≥ 25 OR clinically appropriate need for metabolic support
• Stable vital signs
• Able to self administer subcutaneous injections
• Able to participate in telehealth follow up
• No contraindications listed below
________________________________________
3. CONTRAINDICATIONS
Do not prescribe BioBoost Rx™ to patients with:
• Known hypersensitivity to any MIC components or B12
• Severe hepatic impairment
• Severe renal impairment
• Active infection at injection site
• Pregnancy or nursing (provider discretion)
• Uncontrolled cardiovascular disease (provider discretion)
________________________________________
4. RELATIVE PRECAUTIONS
Use caution in patients with:
• History of hepatic disease
• History of alcohol use disorder
• Anxiety or mood disorders
• B12 related polycythemia
• Methylation disorders
• Prior adverse reactions to injectable vitamins
________________________________________
5. FORMULATION
Each mL contains:
• Methionine — lipotropic fat mobilization, methylation
• Inositol — liver detoxification, mood regulation
• Choline — fat metabolism, cognitive support
• Cyanocobalamin (B12) — energy production, neurological support
Compounded in a licensed 503A compounding pharmacy in Florida using FDA registered ingredients.
Each vial is custom compounded to order and shipped directly from the pharmacy.
________________________________________
6. DOSING PROTOCOL
Standard Dose
• 1 mL subcutaneously once weekly
Alternative Dosing (Provider Directed)
• 0.5 mL twice weekly for patients sensitive to injections
• Up to 2 mL weekly for patients requiring enhanced support (provider discretion)
Administration
• Subcutaneous injection into abdomen or thigh
• Rotate injection sites weekly
• Use supplied syringes and sharps container
________________________________________
7. FOLLOW UP & MONITORING
Initial Telemedicine Visit (Required)
Providers must complete:
• Medical history review
• Medication reconciliation
• Review of hepatic history
• Review of contraindications
• Injection technique counseling
• Informed consent
Periodic Digital Check Ins (Refill Authorization)
Patients complete brief digital check ins to confirm:
• Tolerability
• Absence of adverse effects
• No new contraindications
• Continued clinical appropriateness
Ongoing Follow Up
• Every 60–90 days, depending on clinical stability
________________________________________
8. EXPECTED CLINICAL RESPONSE
Patients may experience:
• Increased energy within 1–2 weeks
• Improved fat metabolism within 2–4 weeks
• Enhanced liver support over 4–8 weeks
• Improved adherence to nutrition and activity due to increased vitality
Weight Loss Contribution
BioBoost Rx™ is a supportive metabolic therapy, not a primary weight loss drug.
Typical outcomes when paired with lifestyle changes:
• 1–2 lbs/week gradual weight loss
• Improved fat to lean mass ratio
• Reduced bloating and water retention
________________________________________
9. RED FLAG SYMPTOMS (STOP MEDICATION + PROVIDER REVIEW)
• Injection site infection
• Severe nausea or vomiting
• New or worsening anxiety
• Palpitations
• Shortness of breath
• Dizziness or syncope
• Signs of hepatic distress (RUQ pain, jaundice)
________________________________________
10. LABS (IF CLINICALLY INDICATED)
Not required for all patients. Recommended for:
• History of hepatic disease
• History of alcohol use disorder
• Unexplained fatigue
• Metabolic syndrome
Suggested labs:
• CMP
• CBC
• Lipid panel
• B12 level (if symptomatic)
________________________________________
11. DOCUMENTATION REQUIREMENTS
Providers must document:
• Clinical rationale
• Review of contraindications
• Injection training
• Informed consent
• Dosing plan
• Digital check in compliance
• Follow up plan
________________________________________
12. DISPENSING & DELIVERY
• Compounded in a Florida based 503A pharmacy
• Shipped directly from the pharmacy to the patient
• Packaging may differ from marketing images
• “BioBoost Rx™” will not appear on the dispensed item
________________________________________
13. LEGAL DISCLAIMERS
Compounded Medication Disclaimer
BioBoost Rx™ is prepared by a licensed 503A compounding pharmacy using FDA registered ingredients. It is not FDA approved.
FDA Disclaimer
Compounded medications are not reviewed or approved by the FDA.
They are prescribed when commercial alternatives are not suitable.
Safety and efficacy are determined by the prescribing provider.
Platform Disclaimer
Nightingale Rx™ connects patients with licensed clinicians.
It does not manufacture, sell, or dispense medications.
