I Am Stumped! Calling All Brilliant Minds 🙏

My fiancé has been dealing with some peculiar issues that I’m trying to connect the dots on and would love input. She had lower leg swelling in the past that eventually resolved, and a remote history of Morton’s neuroma that hasn’t been symptomatic for years. Right now her main struggles are poor sleep, consistently low energy, chronic back tightness, and most notably significant thumb pain with joint locking. She describes it as if the thumb “needs to be pulled out.” Both sides were affected at first, but interestingly the untreated side resolved spontaneously while the PRP-treated side continues to be painful and lock regularly. Her job as a personal trainer and working retail means a lot of daily standing, hand and wrist loading, and repetitive strain. Emotionally, she’s carried stress since her father passed away three years ago she handled it well but still has difficult days. Nutritionally, she was vegetarian for about 40 years before introducing chicken 5–6 years ago, but otherwise eats minimal animal protein. My working thought is that this may not just be an isolated tendon or joint problem but a systemic terrain issue possibly a fibrosis-prone environment that explained the paradoxical PRP result, along with lymphatic or vascular fragility from standing all day, circadian and mitochondrial dysfunction contributing to poor energy and recovery, long-term nutrient debt from decades of vegetarianism (creatine, carnitine, B12, zinc, glycine, proline, lysine), and stress physiology from her HPA axis that stiffens fascia and keeps her in sympathetic tone. I’ve sketched out a phased protocol: first reset terrain with circadian support (melatonin or Epitalon), mitochondrial stack (SS-31, Kenetik Pro, plasmalogens), lymphatic strategies (compression, walking, electrolytes), and add Amlexanox as a fibrosis/inflammation reset. Then in phase 2, move to matrix remodeling with BPC-157, TB4, Pentosan Polysulfate, phosphatidylcholine, local tendon glides, red light, topical magnesium, and NeuFit or PEMF for fascia and back tightness, alongside nutrient repletion with collagen peptides, vitamin C, glycine/proline, zinc, copper, and manganese. Finally in phase 3, focus on integration and resilience with Epitalon cycles, MOTS-c, sauna and cold contrast, tendon-friendly strength training, strict sleep hygiene, and nutrient support like creatine, carnitine, and DHA/EPA. I’d re-evaluate with imaging if the thumb pain and locking persist or run labs if swelling recurs. My questions are: does Amlexanox make sense as a first step to rebalance the inflammatory/fibrotic terrain before PPS or repeat PRP? Is the PRP paradox more likely a redox/cellular terrain issue or immune imbalance? And am I over-attributing her back tightness and energy issues to systemic inflammation/lymphatics, or does that reasoning fit? Would love to hear how you all would think through this.

@Elizabeth Yurth

anyone else! I’m here to learn and I want to be able to help her.

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