Your patients are entering surgery without structured perioperative preparation.
Standard pre-operative instruction addresses timing, fasting, and medications. It rarely addresses the hydration, metabolic, neurocognitive, and nutritional baseline a patient brings into the OR. PERIOME PROTOCOL is a 14-day perioperative protocol developed by a board-certified anesthesiologist — 7 days before, 7 days after — built to close that gap.
with no structured preparation standard
under-addressed at point of surgical care
the arc PERIOME PROTOCOL is built to support
Four variables routinely under-addressed at the point of surgical care.
These are not theoretical gaps. They are physiologic states your patients present with on the day of surgery and in the days that follow — variables that shape how they tolerate anesthesia, respond to surgical stress, and move through the acute recovery window.
Fasting-State Metabolic Depletion
Mandatory NPO status reduces hepatic glycogen and shifts metabolism toward catabolism in the hours before surgery. ERAS carbohydrate loading addresses glycogen partially. Mitochondrial substrate availability, amino acid pools, and cellular energy reserves remain largely unaddressed in standard pre-op instruction.
Pre-Operative Hydration & Electrolytes
Most surgical patients arrive in a relative state of electrolyte depletion — compounded by the NPO window, bowel preparation where applicable, and baseline insufficiency. IV fluids on the day of surgery address hemodynamic needs; they do not correct a depletion that began 12–16 hours prior.
Neurocognitive Baseline at Induction
Pre-operative anxiety, sleep disruption, and fasting-related metabolic shifts impair neurocognitive baseline prior to induction. Catecholamine precursor availability at the time of anesthetic induction is a modifiable variable — particularly relevant in elderly patients and POCD-risk populations where emergence quality carries longer clinical consequence.
GI Integrity & Recovery Physiology
PONV remains one of the leading causes of unplanned admission and patient dissatisfaction in ambulatory surgery. Simultaneously, gut barrier integrity is compromised by fasting, surgical stress, and perioperative antibiotics — affecting nutrient absorption during the recovery window when physiologic demand is highest.
PERIOME PROTOCOL is not intended to replace existing perioperative pathways. It is designed to complement standard care — bringing hydration, metabolic, neurocognitive, and GI support into a single patient-facing protocol that operates in the window standard protocols leave unaddressed.
Designed for the perioperative environment. Not adapted from wellness.
Every design decision reflects a perioperative-specific rationale — timing, ingredient selection, exclusions, and dosing — reviewed against the clinical demands of the surgical window.
Protocol Timing
Taken once daily beginning 7 days pre-operatively and continuing through 7 days post-operatively. On the day of surgery, patients follow their surgical team's fasting and clear-liquid guidance — the protocol is designed around this constraint, not in conflict with it.
Ingredient Review
We recommend clinicians review the full ingredient list in the context of each patient's procedure, medications, and perioperative plan. The Science page carries complete ingredient-level rationale and the reasoning behind notable exclusions — including omega-3s, curcumin, and high-dose vitamin E.
Evidence-Grounded Design
The formulation was built from perioperative physiology — not derived from general wellness positioning. Every domain reflects published rationale on surgical stress, fasting metabolism, anesthetic emergence, and recovery physiology.
Notable Exclusions
Several commonly used supplements are intentionally absent: omega-3 fatty acids (antiplatelet activity), curcumin at high doses (CYP3A4 interaction risk), and apigenin. Perioperative safety considerations were applied at the ingredient level — not assumed from general wellness data.
Five physiologic domains. One perioperative protocol.
Each domain reflects a distinct physiologic challenge of the surgical window — addressed through a targeted, perioperative-specific rationale. Full mechanistic detail, ingredient-level dosing rationale, and notable exclusions are on the Science page.
Pre-Operative Fluid Balance
Most patients arrive to the OR in a relative state of electrolyte depletion. This domain addresses that deficit in the days before surgery — structured electrolyte support formulated to support the physiologic baseline a patient enters surgery with.
Full rationaleFasting-Window Energy Substrate
NPO status initiates catabolism before the surgical insult has begun. This domain addresses the mitochondrial energy gap that carbohydrate loading alone does not fill — cellular energy substrate support and electron transport chain efficiency during the physiologic stress of surgery and recovery.
Full rationaleEmergence Quality & Cognitive Support
Catecholamine precursor availability at induction is a modifiable variable. This domain supports neurocognitive baseline entering the OR and cognitive clarity through post-anesthetic emergence — particularly relevant in elderly patients and POCD-risk populations.
Full rationaleMucosal Barrier & PONV Support
PONV is the leading cause of unplanned ASC admission and a top driver of patient dissatisfaction. Gut barrier integrity is simultaneously compromised by fasting, surgical stress, and antibiotics. This domain addresses both — mucosal barrier support and PONV support through the post-operative window.
Full rationalePerioperative Microbiome Stability
Perioperative antibiotics, fasting, and surgical stress disrupt the gut microbiome at the moment when immune function and metabolic recovery most depend on microbial stability. This domain uses the two probiotic strains with the most robust perioperative evidence.
Full rationaleActivated Forms, Surgical Dosing
The perioperative period demands micronutrients at rates that exceed standard dietary intake — for immune activation, wound healing, and methylation-dependent metabolic pathways. Dosed for surgical stress, not RDA sufficiency.
Full rationaleThree steps. Minimal friction.
Designed to integrate into existing pre-operative instruction without adding workflow burden. No accounts, no prescriptions, no portal integration required.
Tell Your Patient
A brief recommendation at the time of scheduling or pre-op instruction. No prescription needed. Review ingredient exclusions against the patient's medication list before recommending.
Clinicians should confirm no contraindicated medications or conditions prior to recommendation. Full ingredient list and exclusion rationale available at the Science page.
Direct Them to PERIOME
Patients join the waitlist at periome.com/pages/patients. PERIOME PROTOCOL launches soon. Each supply will cover the complete 14-day perioperative course. No subscription required.
Institutional Partnership
If your program is interested in deploying PERIOME PROTOCOL across your surgical pathway, visit the Health Systems page or reach out directly. We're actively building institutional pilot relationships.
Built from inside the operating room.
PERIOME is a perioperative health company founded by a board-certified anesthesiologist — not a wellness brand that found its way into surgical settings. The formulation emerged from a recognized clinical gap, reviewed against current perioperative literature and real-world ASC workflow considerations.
Chad R. Greene, D.O. — Founder & CEO, PERIOME
Board-Certified Anesthesiologist
Mechanism Over Marketing
This page is written around physiologic rationale, not outcome claims. The goal is clinical clarity — the kind you'd expect from a colleague, not a supplement brand.
Built for the Patient You're Already Seeing
ASC and same-day surgical patients receive limited structured perioperative preparation. PERIOME PROTOCOL was designed for exactly this population — the majority of elective surgical patients in the U.S.
Designed to Complement, Not Compete
PERIOME PROTOCOL fits alongside existing surgical pathways and clinical decision-making. It addresses the preparation window before your patient walks through the door — and the recovery window after they leave.
Building the Evidence Base
PERIOME is actively pursuing institutional partnerships and clinical observation opportunities. If your program is interested in a structured collaboration, reach out through the Contact page.
Recommend PERIOME PROTOCOL to your patients.
One structured perioperative protocol. No workflow burden. No prescription required. Evidence-grounded formulation built by a clinician who understands the OR.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Clinicians and patients should review the ingredient list in the context of the patient's surgical plan and medications.