VIP (Vasoactive Intestinal Peptide)

Structure: 28-amino-acid neuropeptide, member of the secretin / glucagon / GHRH peptide family. Endogenously produced in the gut, lungs, and brain. Binds VPAC1 and VPAC2 G-protein-coupled receptors.

Dosage (Shoemaker CIRS protocol, intranasal):

• Standard: 50mcg per nostril 4 times per day (200mcg total daily dose)
• Test dose first: initial single dose under blood pressure monitoring (orthostatic hypotension is the main acute risk)
• Compounded by specialty pharmacies as a nasal spray with phospholipid carrier

Administration:

• Intranasal spray is the dominant route in CIRS protocols (compounded preparation)
• SubQ and IV exist in clinical research settings but are not used outside trials
• Take with patient seated; remain seated 5 minutes after dosing to reduce hypotension risk

Key Notes:

• Strong anti-inflammatory and immunomodulatory peptide. Inhibits NF-kB, suppresses Th1 / Th17 cytokines, promotes regulatory T cell expansion.
• Used by Dr. Ritchie Shoemaker as the late-stage rebuilding step in his mould / CIRS protocol, after binders, antifungals, and MARCoNS treatment. Outside this niche it is rarely used in bodybuilding.
• Acute hypotension is the primary safety issue. Anyone on antihypertensives or vasodilators (PDE5 inhibitors, nitrates) needs caution.
• Has been investigated in pulmonary arterial hypertension and sarcoidosis with mixed results.
• Pancreatic effects: VIP receptors are expressed in pancreas; rare reports of transient lipase elevation in users on prolonged nasal protocols. Discontinue and check amylase / lipase if abdominal pain develops.
• Not an appetite, recovery, or hypertrophy peptide. Bodybuilding relevance is limited to athletes with documented mould or chronic inflammatory issues.
• Monitor: blood pressure (especially first dose), CRP, amylase / lipase if symptoms suggest pancreatitis.

References:

• Delgado, M., Pozo, D., & Ganea, D. (2004). The significance of vasoactive intestinal peptide in immunomodulation. Pharmacological Reviews, 56(2), 249-290. DOI: 10.1124/pr.56.2.7
• Said, S. I. (2008). Vasoactive intestinal peptide and pulmonary hypertension. Annals of the New York Academy of Sciences, 1144, 148-153. DOI: 10.1196/annals.1418.013
• Prasse, A., Zissel, G., Lützen, N., Schupp, J., Schmiedlin, R., Gonzalez-Rey, E., Rensing-Ehl, A., Bacher, G., Cavalli, V., Bevec, D., Delgado, M., & Müller-Quernheim, J. (2010). Inhaled vasoactive intestinal peptide exerts immunoregulatory effects in sarcoidosis. American Journal of Respiratory and Critical Care Medicine, 182(4), 540-548. DOI: 10.1164/rccm.200909-1451OC
• Shoemaker, R. C., House, D., & Ryan, J. C. (2013). Structural brain abnormalities in patients with inflammatory illness acquired following exposure to water-damaged buildings: A volumetric MRI study using NeuroQuant. Neurotoxicology and Teratology, 45, 18-26. DOI: 10.1016/j.ntt.2014.06.004