How Dr. Nemechek’s protocol works, why the choice of olive oil matters biochemically rather than for taste, and why our range carries exactly the fish oil and inulin brands the author names.
At a glance
- The protocol rests on three components: inulin, DHA-rich fish oil and extra virgin olive oil – plus removing high-omega-6 oils from the diet.
- Dr. Nemechek names two fish oil brands in his book: NOW Foods and Nordic Naturals; the official Starter Pack on his website contains Nordic Naturals Ultimate Omega.
- The olive oil must be authentic and undiluted – the author recommends COOC certification (California). At Kreta24 we stock Wild Groves, COOC-certified, and every oil in our EU 432/2012 health-claim olive oil category has current qNMR and biochemical lab reports – you choose the product and the dose from the measured total polyphenols and the D1 index.
- We ship across the EU, to the UK, the USA and worldwide – see our international shipping page.
- This article is educational and does not replace medical advice.
The Nemechek Protocol® for Autism and Developmental Disorders was developed by Dr. Patrick M. Nemechek, D.O., an internist and autonomic medicine specialist from Arizona. Its aim is to restore central and autonomic nervous system function in children on the autism spectrum, with developmental delay or ADD/ADHD, and in adults after brain injury or in neuroinflammatory conditions.
At Kreta24 we have watched for years as families from Poland, the UK, Germany, the Netherlands, Canada and the United States order olive oil and fish oil from us specifically for this protocol. So we have put everything in one place: what the approach involves, why the author is so firm about olive oil, and exactly which items in our range match his recommendations.
Sources: the book “The Nemechek Protocol for Autism and Developmental Disorders. A How-To Guide to Restoring Neurological Function” (Autonomic Recovery LLC, 2017; 2nd ed. 2021), the official site nemechekprotocol.com, the practice site nemechekconsultativemedicine.com, and COOC standard documentation.
Who Dr. Nemechek is and where the protocol came from
Dr. Nemechek trained at UCLA School of Medicine and spent around 20 years treating HIV patients in Kansas City; he co-founded the HIV Research Network funded by the U.S. Department of Health and Human Services. When, after 2004, he began seeing sudden cardiac deaths in otherwise stable patients caused by cardiac autonomic neuropathy, he turned to autonomic medicine, training among others at the University of Lisbon, one of the leading centres for autonomic research.
After opening his own practice in Arizona he noticed what he calls a “40-year downward shift of the disease continuum”: conditions once associated with the elderly (autonomic dysfunction, neuroinflammation, type 2 diabetes) appearing in ever-younger people, and a growing number of children with signs of autonomic dysfunction and small intestinal bacterial overgrowth.
In 2016 he filed a patent application for the method known as The Nemechek Protocol® for Autonomic Recovery. Its version adapted for children on the spectrum is the protocol discussed here.
What the protocol tries to fix: the “propionic acid + inflammation” model
In Dr. Nemechek’s model, two overlapping processes underlie autism spectrum disorders, developmental delays and many mood disorders in children:
- Small intestinal bacterial overgrowth (SIBO). Bacteria that belong in the colon migrate into the small intestine and produce excess propionic acid. It crosses the blood–brain barrier and acts as a neurotoxin, disrupting brain development and repair. The author stresses that around 20% of people with SIBO have no classic gut symptoms – the absence of reflux, constipation or food intolerance does not rule it out.
- Chronic neuroinflammation. Microglia – the brain’s immune cells – become “primed” into the pro-inflammatory M1 phenotype and overproduce cytokines. These block synaptic pruning (a key process of brain maturation), prevent the repair of small, cumulative brain injuries, and may switch on previously dormant genes – which, in the author’s view, explains the enormous genetic diversity seen in autism.
According to Dr. Nemechek, children with developmental delay, ADD/ADHD or mood disorders have the inflammatory component alone, while children on the spectrum have the neurotoxic component on top. The approach to both groups is very similar, because the source is shared: gut dysbiosis and excess cytokines.
The four steps of the protocol (plus an optional fifth)
- Rebalancing gut bacteria – reducing SIBO and propionic acid production. In children usually with inulin (a prebiotic fibre from chicory), in adults sometimes with a short course of rifaximin (a non-absorbable prescription antibiotic).
- Shifting microglia from M1 to M2 – DHA is the key, as the only form of omega-3 that crosses into the central nervous system in meaningful amounts. EPA and plant-derived ALA do not reach the brain in sufficient quantity to act on microglia.
- Rebalancing omega-6 and omega-3 – removing high-omega-6 oils from the kitchen and supplying DHA from fish oil regularly.
- Reducing inflammation driven by excess linoleic, arachidonic and palmitic acid – this is where extra virgin olive oil comes in, as a source of oleic acid (omega-9).
- (Optional) Inducing neuroplasticity – transcutaneous vagus nerve stimulation, sensory-motor therapies, neurodevelopmental programmes.
What the author does not recommend
Dr. Nemechek deliberately keeps the protocol minimal. His practice does not routinely use probiotics, fermented fish oil, krill oil, “omega 3-6-9” blends, digestive enzymes, glutamine, biofilm disruptors or antifungals. The reasoning is simple: the more add-ons, the harder it is to tell what is working – and some of them (probiotics, omega-6) may worsen the very problem the protocol is trying to solve.
Fish oil and DHA: why we stock Nordic Naturals and NOW Foods
In the book Dr. Nemechek writes: “I personally prefer high concentration DHA fish oil pills or liquids that are available from NOW® Foods or Nordic Naturals®. These are the brands I have used with my patients that have resulted in success and autonomic dysfunction improvement or recovery.”
That is not a casual mention. The official Starter Pack sold on the protocol’s website (nemechekprotocol.com) consists of Nemechek Blue inulin, COOC-certified Nemechek Gold olive oil and Nordic Naturals Ultimate Omega fish oil in liquid form – the author chose this brand for the kit that carries his own name.
That is why Kreta24 does not look for substitutes. We carry exactly these two brands, for several reasons:
- Protocol compliance without interpretation. A parent reading the book or the support groups sees the same names on the shelf. No converting doses to another product, no wondering whether a substitute is “similar enough”.
- High DHA concentration. The protocol is built on DHA, not total omega-3. NOW Foods DHA-500 and the Nordic Naturals Ultimate Omega line deliver a meaningful DHA dose without a handful of capsules.
- Purity and testing. Both companies publish test results for heavy metals, PCBs and oxidation; Nordic Naturals provides certificates of analysis per batch. For a child taking the oil daily for years, that is not a detail.
- Triglyceride form, not fermented, no omega-6. They meet all the author’s exclusions: not krill oil, not fermented, not a “3-6-9” blend.
- Formats for every age. Liquid for the youngest, gummies and “fishies” for children who cannot swallow capsules, capsules for teenagers and adults.
From our range, families most often choose:
- NOW Foods DHA-500 – high DHA per capsule, the author’s first choice for children from about age 4 and for adults,
- NOW Foods Ultra Omega-3 – an alternative with more EPA, for adults,
- Nordic Naturals Ultimate Omega (capsules and liquid) – the product from the official Starter Pack,
- Nordic Naturals Complete Omega, Arctic Cod Liver Oil and children’s formats (Children’s DHA, Omega-3 Fishies).
Dosing depends on age and the degree of inflammation – the tables are in the book. Two practical notes from the author: if there is no improvement after several months of consistent supplementation, he considers doubling the dose; if loose stools appear at the start, stop for 2–3 weeks and restart at 1/4 dose, increasing every 1–2 weeks, because the gut needs time to “learn” to absorb more fat.
Plant ALA (nuts, flax, chia) is an addition in the protocol, never a substitute for DHA from fish.
Extra virgin olive oil: why not every bottle qualifies
This is where mistakes are easiest – and where the author is uncompromising. The book says: “EVOO contains 70% oleic acid, and oleic acid not only blocks but it also reverses the underlying inflammation coming from excessive omega-6 fatty acid and palmitic acid toxicity.”
Oleic acid (omega-9), the dominant fatty acid in genuine extra virgin olive oil:
- blocks the inflammatory pathway driven by linoleic acid (omega-6),
- counters the toxicity of palmitic acid (processed foods, meat from grain-fed animals),
- supports the anti-inflammatory M2 microglial phenotype.
The author stresses that consuming omega-9 is an essential step and must be done regularly to achieve maximum recovery.
Dosing according to the book
| Age | Extra virgin olive oil per day |
|---|---|
| under 5 | cooking meals with olive oil is enough |
| 5–10 | plus 1/2 tablespoon |
| 11–18 | 1 tablespoon |
| adults | 2 tablespoons |
| pregnant women | 2 tablespoons + 2,000–3,000 mg fish oil |
The oil can be taken by the spoon, mixed into food, or – as some adults do – softened with a drop of lemon or balsamic vinegar.
The author’s most important warning
“EVOO is a largely unregulated product and agricultural fraud or adulterated imported products is a great concern for my patients. Some olive oils may be diluted with a high percentage of soy oil or other vegetable oils, the very things we are trying to avoid.”
In other words: some supermarket bottles labelled “extra virgin” contain soybean, sunflower or rapeseed oil – exactly the omega-6 oils the protocol tells you to eliminate. A badly chosen olive oil does not merely fail to help; it works against the protocol. Hence the author’s instruction that his patients use only olive oils certified by the California Olive Oil Council.
What the COOC seal is – and why it applies to California only
The California Olive Oil Council (COOC) is a regional trade organisation based in Atascadero, California, bringing together local growers and mills. Its Seal Certification Program was created to give American consumers confidence that they are buying genuine extra virgin olive oil, in a market where much of the imported oil failed that standard. The COOC certifies only its members’ oils, made from olives grown in California. An oil from Greece, Italy or Spain cannot receive this seal by definition – not because it is inferior, but because it comes from outside California.
How does certification work? According to the organisation (cooc.com/about-the-seal):
- Every year, after every harvest – each producer must re-certify every batch; the seal on the bottle shows the harvest year.
- Chemical analysis in a laboratory – parameters reflecting careful harvesting, milling and storage. The free fatty acid limit is ≤ 0.5%, while the international IOC standard allows ≤ 0.8%; other limits are peroxide value ≤ 20, K232 ≤ 2.5, K270 ≤ 0.22 and ΔK ≤ 0.01.
- Sensory evaluation – a recognised taste panel assesses the oil blind: it must show fruitiness and have no flavour defects. Defects reveal poor olives (damaged, mouldy, frost-exposed), too long a gap between harvest and milling (over 24 hours) or excessive milling temperature (over 86°F / 30°C).
- No chemicals and no extreme heat during extraction – a formal requirement of the programme.
- Both evaluations must be passed before the oil may carry the COOC seal.
For a family on the protocol this means two things. First: the COOC seal is a real, annual verification, not a marketing claim – an oil with this seal is fresh, 100% extra virgin and undiluted. Second: Dr. Nemechek’s instruction to use “only COOC oils” was written for patients in the USA, for whom Californian oil is a local product. For a customer in Europe, the equivalent guarantee of authenticity is laboratory testing of the specific batch – qNMR detects foreign-oil adulteration and measures freshness more precisely than the standard chemistry COOC requires. That is why we offer both: Wild Groves with the COOC seal for those who want to follow the protocol to the letter, and European oils with full laboratory documentation.
Dr. Nemechek himself notes that COOC oils vary a lot in taste, so it is worth trying different producers until the whole family finds one they will happily eat every day – consistency matters more than anything else.
Olive oils at Kreta24 used on the protocol
The oils in our range are selected by a certified olive oil sommelier, and each comes with laboratory results. For families on the protocol we keep two groups of products.
1. Wild Groves – the only COOC-certified oil in our range
A Californian producer, early-harvest oil, certified by the California Olive Oil Council – exactly what Dr. Nemechek lists as the requirement in his book. The COOC seal on the bottle carries the harvest year, because certification is renewed after every harvest. Naturally high in oleic acid and polyphenols, with a clean sensory profile. If you want to apply the protocol literally, with no interpretation, this is the product.
2. EU 432/2012 health-claim olive oils – each with current qNMR testing
The COOC recommendation was written in the USA, where adulteration of imported oil is widespread. The author himself writes that “many regions of the world produce excellent, high quality olive oil locally”. In Europe we have access to something the COOC seal does not provide: independent laboratory testing of each batch.
Our shop has a separate category of olive oils that meet the conditions of the health claim under Commission Regulation (EU) No 432/2012 – at least 250 mg/kg of hydroxytyrosol and its derivatives (5 mg per 20 g of oil). Every oil in this category has a current qNMR report for the present harvest and biochemical tests (acidity, peroxides, K232, K270). The results are available with each product, so a parent can choose the oil and the dose consciously, based on two numbers:
- Total polyphenols (mg/kg) – how much bioactive content (oleocanthal, oleacein, hydroxytyrosol, tyrosol, oleuropein and derivatives) a spoonful delivers. Polyphenols are not a protocol requirement, but they are anti-inflammatory and neuroprotective, so at the same dose of oleic acid they add value.
- D1 index – an oxidation marker, i.e. the biological freshness of the oil at the time of testing. The lower it is, the fresher the oil and the more polyphenols it has retained.
Important: not all “polyphenol” results are comparable. Three different measurement methods are in circulation, and each gives different numbers for the same oil:
- qNMR (quantitative nuclear magnetic resonance) – measures the individual compounds directly, without extraction or reference standards; it also shows the oil’s full “fingerprint” and detects adulteration with other oils. This is the method we use as our baseline.
- HPLC (liquid chromatography, IOC method) – precise, but requires extraction and hydrolysis of the sample; results can come out lower or higher than qNMR depending on the laboratory’s procedure.
- Folin-Ciocalteu (spectrophotometric method) – the cheapest and oldest; it measures total reducing capacity, not specific polyphenols, usually overstates the result and also reacts to compounds that are not polyphenols.
So when comparing oils from different sources, always check which method was used to measure the polyphenols. “800 mg/kg” by Folin-Ciocalteu and “800 mg/kg” by qNMR are not the same value – and the two cannot be equated. At Kreta24 we state the method with every result.
In practice families combine both: a COOC oil as the “safe default” for cooking and dosing, and an oil from the 432/2012 category with high total polyphenols by qNMR (above 500 mg/kg, often 800–1,000 mg/kg) as the morning spoonful, where bioactive density counts.
Inulin: the first step of the protocol
In children Dr. Nemechek starts with inulin – a prebiotic fibre from chicory root – at a starting dose of 1/8 teaspoon, increased slowly. Parents then often observe the so-called “awakening”: more attention, eye contact and awareness of surroundings. Inulin does not kill bacteria; it feeds the normal flora of the small intestine, which then crowds out the invading bacteria from the colon.
In children with marked aggression or anxiety the author uses a modified protocol: fish oil and olive oil only for 6–8 weeks, then a careful introduction of inulin.
We stock NOW Foods Certified Organic Inulin – a pure powder with no additives, one of the two brands the protocol materials refer to.
Why not probiotics? According to the author, probiotics can worsen SIBO – they add more strains to an intestine that already has too many bacteria. The protocol’s model is about reduction, not addition.
What the protocol requires in the kitchen
| Eliminate (high omega-6) | Allowed |
|---|---|
| soybean, sunflower, corn, safflower, cottonseed, grapeseed and peanut oil, margarine, shortening | extra virgin olive oil (COOC-certified or with qNMR testing), canola oil, coconut oil, palm kernel oil |
The author gives parents a mnemonic: “My patients can have canola oil” (canola = can have).
Traps in the shop:
- labels saying “may contain soybean or rapeseed oil” – buy only when the ingredients are 100% certain,
- olive oil in a clear bottle, with no harvest date and no lab reports – not on the protocol,
- dressings, mayonnaise, nut butters with soybean oil – read every label,
- dog food with sunflower oil – yes, that example is in the book too.
Storage
- Inulin – dry and cool, in an airtight container.
- Fish oil – capsules and gummies in a cool, dry place; liquid in the fridge after opening, to be used within 3 months.
- Extra virgin olive oil – away from light and heat, bottle closed straight after use. Polyphenols are sensitive to oxygen and light, so a bottle is best finished within 4–6 weeks of opening.
Parents’ most common questions
Can krill oil replace fish oil?
No. The author points out it is a different, longer molecule; his patients responded to DHA from fish oil.
What about an “omega 3-6-9” product?
No. Excess omega-6 is part of the problem, so adding it in a supplement deepens the inflammation.
Will algae DHA work if my child cannot tolerate fish?
The author answers cautiously: “maybe”. In his practice he saw clear improvements on marine fish DHA, not on algal DHA.
Will flaxseed or chia replace DHA?
No. ALA does not reach the brain in sufficient quantity to affect microglia.
Should I add enzymes, glutamine, antifungals?
No. The protocol is deliberately minimal; the author consistently advises against add-ons.
What if the propionic acid test is negative?
According to the author the test result is not decisive. If a child shows features of the spectrum, ADD/ADHD, developmental delay or mood disorders, the protocol is started anyway, because the inflammatory component can be present without propionate.
What you will find here when starting the protocol
COOC-certified olive oil: Wild Groves – full compliance with the letter of the protocol.
EU 432/2012 health-claim olive oils – each with current qNMR and biochemical testing; total polyphenols and D1 index stated with the product, so you choose the dose consciously.
Fish oil from the brands named by the author: NOW Foods DHA-500 and Ultra Omega-3; Nordic Naturals Ultimate Omega (capsules, liquid), Complete Omega, Arctic Cod Liver Oil and children’s formats.
NOW Foods inulin – organic prebiotic chicory fibre, no additives.
Disclaimer
This article is educational and is based on the publications of Dr. Patrick M. Nemechek and publicly available sources. It is not medical advice and does not replace consultation with your physician. The author himself notes that his model is theoretical, based on animal studies and patient observation, and still requires large controlled trials. The protocol also has critics in the medical community and among autistic self-advocacy organisations, who point to the lack of controlled studies. Introducing inulin, fish oil and olive oil at the doses in the book should be discussed with a specialist familiar with the protocol.
Sources and official websites
- Official protocol website: nemechekprotocol.com
- Dr. Nemechek’s practice: nemechekconsultativemedicine.com
- California Olive Oil Council – about the seal: cooc.com/about-the-seal
Support: Nemechek Protocol groups on Facebook
The protocol demands consistency, and the hardest parts are the first weeks and the first relapses (propionic acid relapse, inflammatory relapse – the book devotes separate chapters to them). Dozens of “Nemechek Protocol” groups run by parents exist on Facebook in many countries and languages – English, Polish, German, Spanish, Italian, Dutch, French. Search Facebook for “Nemechek Protocol” and pick the group in your language. Parents who have been on the protocol for several years are an invaluable source of practical knowledge: how to dose inulin, how to recognise a relapse, what to swap for a product your child refuses.
- UK – Nemechek Protocol Support
- International group
- Canada
- Additional support group
- Poland – Nemechek Protocol Support (Polish)
Knowledge from the groups does not replace the book and the author’s official websites, but it is their natural complement – and often the only place where someone has already worked through exactly your problem.