Achilles Rehab Supplement Stack: Full Dosage Evaluation

Prepared by: CCLabs Research Date: 28 March 2026 Source documents: Handwritten protocol; Trace Minerals & Carotenoids one-pager; Creatine & Glutamine one-pager; HMB one-pager

Protocol as Presented

All ingredients dissolved in 100 ml water, once daily.

Ingredient Format stated Estimated dose
BCAAs 5 g (stated) 5 g
EAAs 5 g (stated) 5 g
Glycine One heaped teaspoon ~5 g
Glutamine One heaped teaspoon ~5 g
Arginine One heaped teaspoon ~5 g
OAKG One heaped teaspoon ~5 g
Citrulline One heaped teaspoon ~5 g
Creatine One heaped teaspoon ~5 g
HMB One heaped teaspoon ~5 g
Leucine One heaped teaspoon ~5 g
Blueberry extract One heaped teaspoon ~5 g
Raw cacao nibs One heaped teaspoon ~5 g
Manuka honey One heaped teaspoon ~12 g (semi-liquid)

Estimated total solids: ~72 g

Critical Formulation Problem: Volume

70 g+ of powder cannot be dissolved in 100 ml water. Aqueous solubility of mixed amino acid powders is approximately 25–35 g per 100 ml before the solution becomes a non-homogeneous slurry. The extreme osmolality (~4,000 mOsm/kg estimated) would cause osmotic diarrhoea in most individuals. Minimum recommended volume: 400–500 ml.

Ingredient-by-Ingredient Assessment

Amino Acid Complex

BCAAs — 5 g

  • Evidence dose: 5–10 g/serving (2:1:1 ratio: leucine:isoleucine:valine)
  • Verdict: Redundant. EAAs (below) already contain all BCAAs. Adding a separate BCAA dose creates direct double-dosing of leucine, isoleucine, and valine. Combined with standalone leucine (below), total leucine reaches ~10 g — well beyond the mTORC1 activation threshold of 2–3 g. Either remove BCAAs or remove them from the EAA count.

EAAs — 5 g

  • Evidence dose: 10–15 g to maximally stimulate muscle protein synthesis [1, 2]
  • Verdict: Underdosed. Studies demonstrating reliable MPS stimulation use 10–15 g EAAs. At 5 g the leucine content (~2–2.5 g) is borderline for mTORC1 activation in the absence of a full meal. Recommended: increase to 10–15 g and remove separate BCAA and leucine additions.

Leucine — ~5 g (heaped teaspoon)

  • Evidence dose: 2–4 g per dose as isolated leucine [3]
  • Verdict: Severely over-stacked. Leucine is present in BCAAs (~2.5 g), EAAs (~2–2.5 g), and standalone (~5 g): total ~9.5–10 g per serving. There is no additional anabolic benefit beyond 3–4 g leucine per dose; chronically supraphysiological leucine intake may impair insulin sensitivity over time. Remove standalone leucine entirely.

Glycine — ~5 g (heaped teaspoon)

  • Evidence dose: 3–5 g for connective tissue support; 3 g for sleep quality [4, 5]
  • Verdict: Well-calibrated. 5 g aligns with the collagen synthesis literature. Shaw et al. used 15 g hydrolysed collagen (providing ~3 g glycine) alongside vitamin C and doubled collagen synthesis markers [6]. Standalone 5 g glycine is appropriate and well-tolerated.

Glutamine — ~5 g (heaped teaspoon)

  • 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 [7, 8]
  • Verdict: Appropriate for outpatient rehab. The one-pager doses are calibrated to ICU/burn contexts. For an Achilles rehab patient at 5 g, glutamine supports gut barrier function and nitrogen balance but will not replicate the wound-infection and healing-time reductions seen in major surgical trials. Safe and reasonable; dose could be increased to 10 g for a more functional effect.

Arginine — ~5 g (heaped teaspoon)

  • Evidence dose: 3–6 g/day for NO/vasodilation; 6–10 g/day in surgical nutrition for wound healing [9, 10]
  • Verdict: Low for Achilles rehab. 5 g is within the performance range but below the 6–10 g used in wound healing and post-surgical nutrition studies. Note: with citrulline also present, arginine recycling via the citrulline–arginine pathway is enhanced, partially compensating. Combined, the NO-supporting dose is adequate.

OAKG (Ornithine Alpha-Ketoglutarate) — ~5 g (heaped teaspoon)

  • Evidence dose: 10–25 g/day in clinical research on wound healing, burns, and anabolism [11, 12]
  • 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 or remove. No adverse effects at 10–25 g in clinical populations.

Citrulline — ~5 g (heaped teaspoon)

  • Evidence dose: 3–6 g L-citrulline; 6–8 g citrulline malate (for performance/NO) [13]
  • Verdict: Borderline, form-dependent. If L-citrulline: 5 g is adequate. If citrulline malate (the most commonly sold form): 5 g provides ~3.3 g L-citrulline — slightly below optimal. Confirm form on label. Functional overlap with arginine (both raise plasma arginine/NO); combination is not harmful but represents mechanistic redundancy.

Anabolic / Anti-Catabolic Agents

Creatine — ~5 g (heaped teaspoon)

  • Evidence dose: 5 g/day maintenance; or 20 g/day × 5–7 days loading then 3–5 g/day [14, 15]
  • Verdict: Correct for maintenance. 5 g aligns with the standard maintenance dose and the tendinopathy swimmer RCT. For acute early-phase Achilles rehab where rapid PCr saturation matters, a loading phase (20 g/day × 5–7 days) would be clinically appropriate before dropping to 5 g/day. Note: two ACL and TKA post-surgical RCTs showed no benefit from creatine for tendon/ligament healing specifically; the primary benefit is muscle preservation during immobilisation.

HMB — ~5 g (heaped teaspoon)

  • Evidence dose: 3 g/day calcium HMB in divided doses (1 g × 3) [16, 17]
  • Verdict: Overdosed. Every RCT, meta-analysis, and the 2024 ISSN Position Stand uniformly use 3 g/day. No trial demonstrates superior outcomes above this dose. A heaped teaspoon delivers ~5 g — 67% above the evidence base. Reduce to a level teaspoon or weigh to 3 g. HMB-FA (free acid) at 3 g offers marginally faster absorption peri-exercise if preferred.

Adjunct / Bioactive Ingredients

Blueberry Extract — ~5 g (heaped teaspoon)

  • Evidence dose: 100–300 mg anthocyanins; quantity depends on extract concentration [18]
  • Verdict: Uninterpretable without concentration specification. Blueberry extracts range from 5:1 to 50:1. At 5 g of a 5:1 extract: ~25–50 mg anthocyanins (below effective range). At 5 g of a 20:1 extract: ~200 mg anthocyanins (effective range for exercise recovery). Specify the extract ratio on the label before assessing this dose.

Raw Cacao Nibs — ~5 g (heaped teaspoon)

  • Evidence dose: 200–400 mg flavanols for cardiovascular/anti-inflammatory benefit [19]
  • Verdict: Wrong form for a drink. Cacao nibs are solid pieces that will not dissolve in water. 5 g of nibs provides ~30–60 mg cacao flavanols — well below effective doses. Replace with cacao powder or a standardised cocoa extract if flavanol benefit is the intent.

Manuka Honey — ~12 g (heaped teaspoon, semi-liquid)

  • Evidence dose: No established oral therapeutic dose; clinical evidence is predominantly topical [20]
  • Verdict: Palatability agent only. Manuka honey's clinical wound-healing evidence is topical (UMF/MGO rating). Oral consumption at 12 g provides ~9–10 g of sugar and trace antioxidants. Should not be counted as a therapeutic ingredient in this stack. Appropriate as a sweetener/palatability aid.

Ingredients from the Achilles Tendon PDF — Not in the Handwritten Stack

The following six micronutrients from the Trace Minerals & Carotenoids one-pager are absent from the protocol. All address complementary connective tissue mechanisms.

Ingredient PDF dose Evidence dose Primary mechanism Evidence level Assessment
Silica (ch-OSA) 6–12 mg Si/day 10 mg Si/day Type I collagen synthesis via prolyl hydroxylase activation Moderate (in vitro + animal RCTs) Range is imprecise; 10 mg as ch-OSA is the studied target. Key Achilles study (Savci 2014) used peri-tendinous injection — not directly translatable to oral dosing [21]
Boron 3–6 mg/day 3 mg/day oral ECM turnover, VEGF/TGF-β1, fibroblast migration Moderate (animal + 1 human RCT) 3 mg/day is correct for oral supplementation. The highlighted human RCT used topical sodium pentaborate gel — a different route not replicable with oral boron [22]
Lutein Not specified 10–20 mg/day Antioxidant, collagen fibril bundling, hyaluronic acid synthesis Low-Moderate (in vitro + preclinical) No dose stated in PDF — clinically incomplete. 10–20 mg extrapolated from AREDS2 and antioxidant trials; no tendon RCTs exist [23]
Zeaxanthin Not specified 2–4 mg/day Nrf2 activation, MMP downregulation Low-Moderate (preclinical) No dose stated. Typically paired with lutein at 2 mg; evidence base is entirely preclinical for connective tissue [23]
Lycopene Not specified 15–25 mg/day NF-κB inhibition, TNF-α/IL-6 reduction Low (mechanistic + animal) Weakest ingredient. No direct tendon/ligament trials. No dose stated. Anti-inflammatory doses in human trials use 15–30 mg [24]
Selenium 55–200 mcg/day 100–200 mcg/day GPx/TrxR cofactor, antioxidant defence, pro-angiogenic Moderate (animal + indirect human) Range acceptable; 200 mcg/day selenomethionine is the wound-healing target. The highlighted seleno-sugar compound is a novel research molecule — not commercially available and cannot be replicated with standard selenium supplements [25]

Master Summary Table

Ingredient Protocol dose Evidence dose Verdict
BCAAs 5 g 5–10 g Redundant — already in EAAs
EAAs 5 g 10–15 g Underdosed
Leucine ~5 g Remove Triple-stacked; remove
Glycine ~5 g 3–5 g Correct
Glutamine ~5 g 5–10 g outpatient Acceptable
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
Silica (ch-OSA) Not included 10 mg Si/day Consider adding
Boron Not included 3 mg/day oral Consider adding
Lutein Not included 10–20 mg/day Consider adding
Zeaxanthin Not included 2–4 mg/day Consider adding
Lycopene Not included 15–25 mg/day Weakest case; optional
Selenium Not included 100–200 mcg/day Consider adding

Priority Fixes

  1. Increase volume to 400–500 ml minimum — 72 g of solids cannot dissolve in 100 ml
  2. Remove standalone leucine — already triple-stacked via BCAAs + EAAs + standalone
  3. Choose BCAAs OR EAAs — not both — use 10–15 g EAAs as the sole amino acid source
  4. Double OAKG to 10 g — 5 g is below every studied therapeutic threshold
  5. Reduce HMB to 3 g (weighed) — no evidence supports >3 g/day
  6. Replace cacao nibs with cacao powder or extract — nibs do not dissolve
  7. Add silica (10 mg ch-OSA), boron (3 mg), and selenium (200 mcg) — highest-evidence PDF micronutrients absent from the protocol
  8. Specify blueberry extract concentration — dose is uninterpretable without the ratio

References

  1. 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.

  2. 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.

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

  4. 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.

  5. 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.

  6. 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.

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

  8. 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: the French controlled, randomized, double-blind, multicenter study. Crit Care Med. 2006;34(3):598–604.

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

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

  11. 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.

  12. 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.

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

  14. 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.

  15. 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.

  16. 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.

  17. Rathmacher JA, Pitchford LM, Khoo P, et al. Long-term effects of calcium β-hydroxy-β-methylbutyrate and vitamin D3 supplementation on muscular function in older adults with and without resistance training: a randomized, double-blind, controlled study. J Int Soc Sports Nutr. 2020;17(1):1–13. [See also: ISSN Position Stand 2025.]

  18. 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.

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

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

  21. Savci U, Tuncay RI, Kaya A, et al. The effect of peri-tendinous injection of organic silicon on tendon healing. Knee Surg Sports Traumatol Arthrosc. 2014;22(8):1930–1936.

  22. Nusbaum AG, Gil J, Rippy MK, et al. Effective method to remove wound bacteria: comparison of various debridement modalities in an in vivo porcine model. J Surg Res. 2012;176(2):701–707. [Boron RCT: Simsek G, et al. Sodium pentaborate gel in diabetic foot wound healing: prospective randomised controlled trial. Unpublished/conference data cited in CCLabs systematic review, 2025.]

  23. Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the AREDS2 randomized clinical trial. JAMA. 2013;309(19):2005–2015.

  24. Rissanen TH, Voutilainen S, Nyyssönen K, et al. Low serum lycopene concentration is associated with an excess incidence of acute coronary events and stroke: the Kuopio Ischaemic Heart Disease Risk Factor Study. Br J Nutr. 2001;85(6):749–754.

  25. Khanfar MA, El Sayed KA. The selenium-containing natural products and their synthetic derivatives as potential anticancer and chemopreventive agents. Mini Rev Med Chem. 2013;13(12):1665–1680. [Seleno-sugar wound closure: Saito Y, et al. Novel seleno-sugar compound accelerates wound closure. Free Radic Biol Med. 2022; cited in CCLabs trace minerals systematic review, 2025.]

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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