Energy Restoration Protocol

A physician-supervised, integrative approach to restoring cellular energy production — targeting mitochondrial dysfunction, the root cause of deep fatigue that doesn’t resolve with rest.

At a Glance

What it targets: Mitochondrial dysfunction — the cellular root cause of persistent fatigue, poor recovery, and exercise intolerance that standard medical care often misses.

Who it’s for: Adults with deep fatigue, post-exertional crashes, post-viral fatigue (long COVID, EBV reactivation), or the sense their body is running at 60% despite doing everything right.

How it works: A physician-supervised protocol layering NAD+ replenishment, Sermorelin for overnight growth hormone restoration, targeted mitochondrial peptide support where appropriate, comprehensive nutrient repletion, and the lifestyle layer that biology actually responds to.

What to expect: Gradual, sustained improvement across an early-to-sustained phase arc. Outcomes vary by baseline mitochondrial status, lifestyle adherence, and underlying drivers — the protocol is not a quick fix.

Who This Protocol Is For

ALIV’s Energy Restoration Protocol is for adults with persistent fatigue that doesn’t improve with rest, sleep, or conventional medical interventions — fatigue often rooted in mitochondrial dysfunction, which standard bloodwork doesn’t typically detect. Many clients arrive specifically researching fatigue treatment, always-tired solutions, NAD+ IV drip, vitamin drip for energy, or post-viral exhaustion treatment in India — and want a physician-supervised programme rather than another supplement stack. Long COVID has expanded this presentation substantially in India, with persistent neurological and energetic symptoms documented years post-acute infection.

This protocol was built for you if:

• You sleep adequately but wake unrefreshed, with no recovery from rest
• Your exercise tolerance has dropped — workouts that used to feel routine now leave you drained for days
• You’ve had long COVID, EBV reactivation, post-viral syndrome, or a sustained period of significant burnout
• Your standard bloodwork is normal, your doctor says you’re fine, but you know something is off at a level standard medicine isn’t reaching
• You’ve tried supplements, diet changes, and lifestyle interventions — some helped at the margins, but the core fatigue hasn’t shifted

This isn’t about motivation or discipline. When fatigue persists despite addressing the obvious factors, the problem is often deeper — at the mitochondrial level, in the cellular machinery powering every function in your body.

How It Works — The ALIV Approach

Mitochondria are the energy factories of every cell, converting food into ATP — the molecular currency that powers everything from heartbeat to thought. When mitochondria are damaged by chronic stress, viral infection, inflammation, or sustained metabolic dysfunction, they leak energy instead of producing it. The result is the deep fatigue that doesn’t respond to more sleep or more vitamins.

Layer 1 — IV Foundation: Micronutrient and NAD+ Replenishment

This protocol typically opens with an IV foundation. ALIV’s Myer’s Cocktail delivers a clinically-established blend of vitamins (B-complex, B12, vitamin C) and minerals (magnesium, calcium) at bioavailability oral supplementation cannot reach. Layered on this is an introductory course of NAD+ Vitality IV: NAD+ is the most critical coenzyme for mitochondrial energy production.

Layer 2 — Sermorelin: Restoring the Overnight Growth Hormone Pulse

Growth hormone is one of the most potent drivers of mitochondrial renewal, with its largest pulse during the first deep sleep cycle. Two GHRH options support overnight GH restoration: Sermorelin — over 30 years of clinical use, gently amplifying your body’s own GH release while preserving the natural feedback loop — is the default for restorative-context fatigue. Tesamorelin is the alternative where metabolic-driven fatigue with visceral fat dominates.

Layer 3 — Targeted Mitochondrial Peptide Support (Investigational)

Beyond the foundational IV and Sermorelin layers, several mitochondria-targeting peptides exist as additional options — not as a stack, but as candidates whose use depends on physician assessment of your specific drivers. Elamipretide (SS-31) binds cardiolipin on the inner mitochondrial membrane, stabilising the structure that powers ATP production. MOTS-c activates AMPK signalling and has shown metabolic-restoration effects in mechanistic studies. Honest framing: both are investigational, with mixed clinical trial outcomes and unclear Indian regulatory status. Whether one, both, or neither is appropriate is a case-specific decision.

Layer 4 — Comprehensive Nutrient Repletion

Mitochondria depend on specific cofactors. Targeted repletion typically includes CoQ10 (ubiquinol) for electron transport chain support, L-Carnitine for fatty acid transport, Alpha-lipoic acid for mitochondrial antioxidant defence, NMN or NR as oral NAD+ precursors for ongoing maintenance after the IV foundation phase, Magnesium, and B-vitamin complex with methylated forms where MTHFR variants are present. Iron and ferritin status is checked particularly in menstruating women.

Layer 5 — Diagnostic Precision

Before any active intervention, your ALIV physician runs a comprehensive workup — thyroid with antibodies, metabolic and insulin markers, nutritional status, inflammatory markers, hormonal profile, and screening for post-viral or autoimmune contributors. Layers reflect your specific drivers.

What to Expect

Most clients begin noticing changes in energy and clarity in the early phase, with deeper recovery and exercise tolerance shifts emerging across the building and sustained phases. Mitochondrial repair is gradual, not instant.

Individual outcomes vary based on baseline mitochondrial status, severity, lifestyle adherence, and underlying drivers. ALIV does not guarantee specific outcomes or timelines.

What’s Involved

Before starting, your ALIV medical team runs the diagnostic workup described above. Based on findings, your physician designs a protocol specifically for you. Contraindications are detailed in the FAQ below.

The Lifestyle Layer

Peptide and IV therapy work best when biology is ready to receive them. The lifestyle layer amplifies and sustains every other intervention.

Movement: consistent moderate-intensity aerobic activity — sustained Zone 2-style work, not high-intensity — is one of the most potent stimuli for building new mitochondria. Your physician guides specifics.

Nutrition: eliminating ultra-processed food reduces free-radical damage to mitochondrial membranes. Whole-food eating with adequate protein, healthy fats, and polyphenol-rich vegetables provides the substrate mitochondria need.

Sleep: the largest growth hormone pulse occurs in the first deep sleep cycle — quality sleep is the foundation for mitochondrial repair. Where sleep is significantly affected, coordination with the Sleep Protocol is part of the design.

Stress regulation: chronic stress damages mitochondria through cortisol-driven inflammation and oxidative load. Consistent stress-regulation practice is mitochondrial physiology, not a wellness add-on.

Frequently Asked Questions

Why am I always tired even when I sleep well?

Common drivers of unrefreshing sleep include mitochondrial dysfunction (cells producing inadequate ATP regardless of sleep duration), poor sleep architecture (unconscious but not getting restorative deep and REM stages), undiagnosed sleep apnoea, suboptimal thyroid function, cortisol dysregulation, and depleted micronutrient status. Standard bloodwork rarely captures these directly — deeper diagnostics identify which is driving yours.

What does an NAD+ IV drip do?

NAD+ is a critical coenzyme in mitochondrial energy production. NAD+ levels decline with age, chronic stress, illness, and metabolic dysfunction. Intravenous NAD+ delivers the molecule directly to circulation, bypassing the absorption bottlenecks of oral precursors. Effects often noticed: clearer cognition, improved energy stamina, better stress resilience. ALIV uses NAD+ infusion as a Layer 1 foundation across multiple protocols.

What causes mitochondrial dysfunction?

Chronic stress, systemic inflammation, viral infections (COVID-19, EBV reactivation), ageing, ultra-processed dietary patterns, environmental toxin exposure, and certain long-term medications all impair mitochondrial function. In Indian urban contexts, air pollution and chronic sleep deprivation compound the load further.

Is this protocol safe?

All components are physician-supervised, with monitoring throughout. NAD+ and Sermorelin have well-established safety profiles. Mitochondrial peptides like Elamipretide and MOTS-c are investigational, used case-specifically with informed consent. Pre-protocol diagnostics screen for contraindications.

How is this different from just taking NAD+ supplements?

Oral NAD+ precursors face significant absorption and conversion bottlenecks. This protocol addresses mitochondrial dysfunction at multiple levels simultaneously — IV-delivered NAD+, growth hormone restoration via Sermorelin, targeted nutrient cofactors, and the systemic factors that determine mitochondrial health.

What if I’ve tried everything else?

Many clients who feel stuck despite lifestyle changes, supplements, and conventional medical investigations find the missing piece is mitochondrial. Standard bloodwork doesn’t typically capture mitochondrial function directly — addressing the gap can shift outcomes when other approaches haven’t.

Who should NOT do this protocol?

Severely elevated systemic inflammation requiring resolution first; active autoimmune flares; pregnancy or breastfeeding without specialist consultation; active malignancy; significant unaddressed thyroid or metabolic dysfunction; specific contraindications identified during screening.

Take the Next Step

If persistent fatigue is affecting your work, relationships, or quality of life, this protocol may be worth exploring.

To find out if the Energy Restoration Protocol is right for you, speak with our medical team:

• Pune (Bund Garden): +91 77199 88811
• Mumbai (Khar West): +91 98220 93069

Or book a consultation through alivtherapy.in.

Research References

1. Walker RF. Sermorelin: a better approach to management of adult-onset growth hormone insufficiency? Clin Interv Aging. 2006;1(4):307-308. PMID: 18046908

2. Khorram O, Yeung M, Vu L, Yen SS. Effects of [norleucine27]growth hormone-releasing hormone (GHRH) (1-29)-NH2 administration on the immune system of aging men and women. J Clin Endocrinol Metab. 1997;82(11):3590-3596. PMID: 9360512

3. Birk AV, Liu S, Soong Y, et al. The mitochondrial-targeted compound SS-31 re-energizes ischemic mitochondria by interacting with cardiolipin. J Am Soc Nephrol. 2013;24(8):1250-1261. PMID: 23813215

4. Campbell MD, Duan J, Samuelson AT, et al. Improving mitochondrial function with SS-31 reverses age-related redox stress and improves exercise tolerance in aged mice. Free Radic Biol Med. 2019;134:268-281. PMID: 30597195

5. Lee C, Zeng J, Drew BG, et al. The mitochondrial-derived peptide MOTS-c promotes metabolic homeostasis and reduces obesity and insulin resistance. Cell Metab. 2015;21(3):443-454. PMID: 25738459

6. Reynolds JC, Lai RW, Woodhead JST, et al. MOTS-c is an exercise-induced mitochondrial-encoded regulator of age-dependent physical decline and muscle homeostasis. Nat Commun. 2021;12(1):470. PMID: 33473109

7. Conlon NJ. The role of NAD+ in regenerative medicine. Plast Reconstr Surg. 2022;150(4 Suppl):41S-48S. PMID: 36170435

8. Singh AK, Kumar K, Singh M, et al. Neuropsychiatric manifestations of Long COVID in India: a persistent problem 2.5 years after disease onset. Front Neurol. 2025;16:1704801. PMID: 41312347

Disclaimer

The information on this page is for educational purposes only and is not intended as medical advice. ALIV therapies are not intended to diagnose, treat, cure, or prevent any disease. This protocol is integrative supportive care, not a replacement for specialist medical management where it is indicated. Outcomes vary significantly between individuals. ALIV does not guarantee any specific result. Please consult a qualified healthcare professional before starting any therapy programme.