Achilles Rehab Supplement Protocol: Dosage Evaluation

Prepared by: CCLabs Research Date: 28 March 2026 Protocol source: Handwritten/typed Achilles rehabilitation recipe For: Internal clinical review — not for consumer-facing use

Protocol as Presented

100ml water, 5g BCAAs, 5g EAAs, one heaped teaspoon each of: Glycine, Glutamine, Arginine, OAKG, Citrulline, Creatine, HMB, Leucine, Blueberry Extract, Raw Cacao Nibs, Manuka Honey

One heaped teaspoon of amino acid or botanical powder ≈ 5 g. Manuka honey (semi-liquid) ≈ 12 g per heaped teaspoon.

Ingredient Stated format Estimated dose
BCAAs 5 g (stated) 5 g
EAAs 5 g (stated) 5 g
Glycine Heaped teaspoon ~5 g
Glutamine Heaped teaspoon ~5 g
Arginine Heaped teaspoon ~5 g
OAKG Heaped teaspoon ~5 g
Citrulline Heaped teaspoon ~5 g
Creatine Heaped teaspoon ~5 g
HMB Heaped teaspoon ~5 g
Leucine Heaped teaspoon ~5 g
Blueberry extract Heaped teaspoon ~5 g
Raw cacao nibs Heaped teaspoon ~5 g
Manuka honey Heaped teaspoon ~12 g
Total solids ~72 g

Critical Formulation Issue

72 g of powder cannot dissolve in 100 ml of water.

Aqueous solubility of mixed amino acid powders is approximately 25–35 g per 100 ml before the solution becomes an undissolved slurry. At 72 g total solids in 100 ml, the majority of each ingredient will not dissolve. The resulting osmolality (~4,000 mOsm/kg) would cause osmotic diarrhoea in most individuals.

Minimum recommended preparation volume: 400–500 ml.

Ingredient Assessments

1. BCAAs — 5 g

Evidence dose: 5–10 g per serving at a 2:1:1 ratio (leucine:isoleucine:valine) [1]

Verdict: Redundant. EAAs already contain all three BCAAs. Adding a separate 5 g BCAA dose produces direct double-dosing of leucine, isoleucine, and valine. Combined with standalone leucine (below), total leucine reaches ~9–10 g per serving — far beyond the mTORC1 activation threshold of 2–3 g.

2. EAAs — 5 g

Evidence dose: 10–15 g for maximal muscle protein synthesis stimulation [2, 3]

Verdict: Underdosed. Studies showing reliable MPS stimulation use 10–15 g EAAs. At 5 g, leucine content (~2–2.5 g) is borderline for mTORC1 activation. Recommended: increase to 10–15 g and remove the separate BCAA and leucine additions to eliminate triple-stacking.

3. Leucine — ~5 g

Evidence dose: 2–4 g per dose as isolated leucine [4]

Verdict: Severely over-stacked. Leucine is present in three sources simultaneously:

  • BCAAs (2:1:1 ratio, 5 g total) → ~2.5 g leucine
  • EAAs (5 g) → ~2–2.5 g leucine
  • Standalone leucine → ~5 g
  • Total: ~9.5–10 g leucine

There is no additional anabolic signal beyond 3–4 g leucine per dose. Remove standalone leucine entirely.

4. Glycine — ~5 g

Evidence dose: 3–5 g for connective tissue support; 3 g for sleep quality [5, 6]

Verdict: Well-calibrated. 5 g aligns with collagen synthesis research. Shaw et al. used 15 g hydrolysed collagen (providing ~3 g glycine) alongside vitamin C and doubled collagen synthesis markers [7]. Standalone glycine at 5 g is safe, appropriate, and the best-calibrated ingredient in this stack.

5. Glutamine — ~5 g

Evidence dose: 0.3–0.5 g/kg/day in surgical/critical care (21–35 g at 70 kg); 5–10 g/day in outpatient/athletic contexts [8, 9]

Verdict: Appropriate for outpatient use. For an Achilles rehab patient, 5 g is safe and supports gut barrier function and nitrogen balance. It will not replicate the wound-infection and healing-time reductions seen in major burn trials, which use 21–35 g/day. Increasing to 10 g/day would be more functionally meaningful.

6. Arginine — ~5 g

Evidence dose: 3–6 g/day for NO/vasodilation; 6–10 g/day in surgical nutrition for wound healing [10, 11]

Verdict: Slightly low for a rehab context. 5 g is within the general performance range but below the 6–10 g used in wound healing and post-surgical nutrition protocols. With citrulline also present, arginine recycling via the citrulline–arginine pathway partially compensates, making the combined NO-supporting dose functionally adequate.

7. OAKG (Ornithine Alpha-Ketoglutarate) — ~5 g

Evidence dose: 10–25 g/day in clinical research for wound healing, nitrogen retention, and anabolism [12, 13]

Verdict: Substantially underdosed. The effective minimum threshold established by Cynober et al. is 10 g/day for nitrogen retention, gut trophic support, and GH secretion benefits. At 5 g, meaningful clinical effects are unlikely. Double the dose to 10 g minimum, or remove. OAKG has no meaningful toxicity at clinical doses.

8. Citrulline — ~5 g

Evidence dose: 3–6 g L-citrulline; 6–8 g citrulline malate (for performance/NO production) [14]

Verdict: Borderline, form-dependent.

  • If L-citrulline: 5 g is adequate for NO support
  • If citrulline malate (the most commonly sold form): 5 g provides only ~3.3 g L-citrulline — slightly below optimal

Confirm form on label. Functional overlap with arginine is not harmful but is mechanistically redundant.

9. Creatine — ~5 g

Evidence dose: 20 g/day × 5–7 days loading, then 3–5 g/day maintenance; or 3 g/day gradual loading over 28 days [15, 16]

Verdict: Correct for maintenance. 5 g aligns with the established maintenance dose. For acute early-phase Achilles rehab, a loading protocol (20 g/day × 5–7 days) would achieve PCr saturation faster, which is clinically relevant where time matters. Primary benefit during rehab is muscle preservation during immobilisation, not direct tendon healing.

10. HMB — ~5 g

Evidence dose: 3 g/day calcium HMB in divided doses (1 g × 3 times daily) [17, 18]

Verdict: Overdosed. Every RCT, meta-analysis, and the 2024 ISSN Position Stand consistently use 3 g/day. No trial demonstrates superior outcomes above 3 g. A heaped teaspoon delivers ~5 g — 67% above the evidence base. Reduce to a level teaspoon or weigh to 3 g. HMB's primary benefit is muscle mass preservation during bed rest and immobilisation — directly relevant to Achilles post-surgical recovery.

11. Blueberry Extract — ~5 g

Evidence dose: 100–300 mg anthocyanins per day; quantity from 5 g depends entirely on concentrate ratio [19]

Verdict: Uninterpretable without the extract concentration specification.

  • 5:1 extract → ~25–50 mg anthocyanins (below effective range)
  • 20:1 extract → ~200 mg anthocyanins (within effective range for exercise recovery)

Specify the extraction ratio on the product label before this dose can be evaluated.

12. Raw Cacao Nibs — ~5 g

Evidence dose: 200–400 mg flavanols for anti-inflammatory and cardiovascular benefit [20]

Verdict: Wrong ingredient form for a drink. Cacao nibs are solid pieces of cacao bean that will not dissolve in water — they will float or sink as particles, making the drink unpleasant and rendering the ingredient non-functional. 5 g of nibs provides only ~30–60 mg flavanols, well below the effective range.

Replace with cacao powder or a standardised cocoa flavanol extract.

13. Manuka Honey — ~12 g

Evidence dose: No established oral therapeutic dose; wound healing evidence is topical [21]

Verdict: Palatability agent only. Manuka honey's clinical evidence (UMF rating, methylglyoxal content) applies to topical wound healing. Oral consumption at 12 g provides ~9–10 g of sugar and trace antioxidants. It should not be counted as a therapeutic ingredient. It is appropriate as a natural sweetener to improve palatability of the drink.

Summary Table

Ingredient Protocol dose Evidence dose Verdict
BCAAs 5 g 5–10 g Redundant — duplicated in EAAs + leucine
EAAs 5 g 10–15 g Underdosed
Leucine ~5 g Remove Triple-stacked — remove entirely
Glycine ~5 g 3–5 g Correct
Glutamine ~5 g 5–10 g (outpatient) Acceptable; increase to 10 g
Arginine ~5 g 6–10 g (rehab) Slightly low
OAKG ~5 g 10–25 g Underdosed — double or remove
Citrulline ~5 g 3–6 g L-cit Acceptable (confirm form)
Creatine ~5 g 5 g maintenance Correct
HMB ~5 g 3 g Overdosed — reduce to 3 g
Blueberry extract ~5 g 100–300 mg anthocyanins Cannot evaluate without concentration
Raw cacao nibs ~5 g N/A Wrong form — use powder/extract
Manuka honey ~12 g No oral therapeutic dose Palatability only

Priority Fixes

  1. Increase water volume to minimum 400–500 ml — 72 g of solids in 100 ml is physically insoluble
  2. Remove standalone leucine — triple-stacked via BCAAs + EAAs + standalone; adds no benefit
  3. Use EAAs only (remove separate BCAAs) — use 10–15 g EAAs as the sole amino acid source
  4. Double OAKG to 10 g — 5 g is below every published therapeutic threshold
  5. Reduce HMB to 3 g (weigh or use a level teaspoon) — no evidence supports >3 g/day
  6. Replace cacao nibs with cacao powder or flavanol extract — nibs do not dissolve in water
  7. Specify blueberry extract concentration — dose cannot be evaluated without the extract ratio
  8. Consider adding silica (10 mg ch-OSA), selenium (150–200 mcg), and boron (3 mg) — highest-evidence micronutrients for tendon repair from the CCLabs Achilles PDF; all absent from this protocol

References

  1. Churchward-Venne TA, Burd NA, Mitchell CJ, et al. Supplementation of a suboptimal protein dose with leucine or essential amino acids: effects on myofibrillar protein synthesis at rest and following resistance exercise in men. J Physiol. 2012;590(11):2751–2765.

  2. Volpi E, Kobayashi H, Sheffield-Moore M, Mittendorfer B, Wolfe RR. Essential amino acids are primarily responsible for the amino acid stimulation of muscle protein anabolism in healthy elderly adults. Am J Clin Nutr. 2003;78(2):250–258.

  3. Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR. A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. Am J Physiol Endocrinol Metab. 2006;291(2):E381–E387.

  4. Norton LE, Layman DK. Leucine regulates translation initiation of protein synthesis in skeletal muscle after exercise. J Nutr. 2006;136(2):533S–537S.

  5. Bannai M, Kawai N. New therapeutic strategy for amino acid medicine: glycine improves the quality of sleep. J Pharmacol Sci. 2012;118(2):145–148.

  6. Meléndez-Hevia E, De Paz-Lugo P, Cornish-Bowden A, Cárdenas ML. A weak link in metabolism: the metabolic capacity for glycine biosynthesis does not satisfy the need for collagen synthesis. J Biosci. 2009;34(6):853–872.

  7. Shaw G, Lee-Barthel A, Ross ML, Wang B, Baar K. Vitamin C–enriched gelatin supplementation before intermittent activity augments collagen synthesis. Am J Clin Nutr. 2017;105(1):136–143.

  8. Wischmeyer PE. Glutamine: role in critical illness and ongoing clinical trials. Curr Opin Gastroenterol. 2008;24(2):190–197.

  9. Dechelotte P, Hasselmann M, Cynober L, et al. L-alanyl-L-glutamine dipeptide-supplemented total parenteral nutrition reduces infectious complications and glucose intolerance in critically ill patients. Crit Care Med. 2006;34(3):598–604.

  10. Barbul A. Arginine: biochemistry, physiology, and therapeutic implications. JPEN J Parenter Enteral Nutr. 1986;10(2):227–238.

  11. Stechmiller JK, Childress B, Cowan L. Arginine supplementation and wound healing. Nutr Clin Pract. 2005;20(1):52–61.

  12. Cynober L. Ornithine alpha-ketoglutarate as a potent precursor of arginine and nitric oxide: a new job for an old friend. J Nutr. 2004;134(10 Suppl):2858S–2862S.

  13. Coudray-Lucas C, Le Bever H, Cynober L, De Bandt JP, Carsin H. Ornithine alpha-ketoglutarate improves wound healing in severe burn patients: a prospective randomized double-blind trial versus isonitrogenous controls. Crit Care Med. 2000;28(6):1772–1776.

  14. Pérez-Guisado J, Jakeman PM. Citrulline malate enhances athletic anaerobic performance and relieves muscle soreness. J Strength Cond Res. 2010;24(5):1215–1222.

  15. Hespel P, Op't Eijnde B, Van Leemputte M, et al. Oral creatine supplementation facilitates the rehabilitation of disuse atrophy and alters the expression of muscle myogenic factors in humans. J Physiol. 2001;536(2):625–633.

  16. Rawson ES, Volek JS. Effects of creatine supplementation and resistance training on muscle strength and weightlifting performance. J Strength Cond Res. 2003;17(4):822–831.

  17. Deutz NEP, Pereira SL, Hays NP, et al. Effect of β-hydroxy-β-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults. Clin Nutr. 2013;32(5):704–712.

  18. Rathmacher JA, Pitchford LM, Khoo P, et al. ISSN position stand: beta-hydroxy-beta-methylbutyrate (HMB). J Int Soc Sports Nutr. 2025;22(1):2434734.

  19. McLeay Y, Barnes MJ, Mundel T, Hurst SM, Hurst RD, Stannard SR. Effect of New Zealand blueberry consumption on recovery from eccentric exercise-induced muscle damage. J Int Soc Sports Nutr. 2012;9:19.

  20. Buitrago-Lopez A, Sanderson J, Johnson L, et al. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ. 2011;343:d4488.

  21. Molan PC. The evidence supporting the use of honey as a wound dressing. Int J Low Extrem Wounds. 2006;5(1):40–54.

Prepared by CCLabs Research. Evidence current as of March 2026. For internal clinical review only — not for consumer-facing use. Clinical decisions should be made in consultation with a qualified healthcare professional.

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