An 18-Month Observational Case Report: Self-Monitored Speech Fluency During a Multi-Compound Nutraceutical Regimen in a Pharmacist with Developmental Stuttering

Abstract Developmental stuttering is a complex neurodevelopmental phenotype linked to cortico-basal ganglia-thalamocortical (CBGTC) circuit dysfunction, impaired sensorimotor integration, and focal metabolic bottlenecks within speech-motor networks. Standard pharmacotherapy relies heavily on central dopaminergic blockade via D2 receptor antagonists, though extrapyramidal adverse effects frequently limit long-term compliance. This report documents the 18-month longitudinal speech fluency trajectory of an industrial pharmacist self-administering an unblinded multi-compound nutraceutical protocol targeting central bioenergetics, N-methyl-D-aspartate (NMDA) receptor tone, and autonomic reactivity, presented as a single-subject, unblinded observational case report. Speech dysfluency was quantified via structured mirror-reading tasks (5,000-10,000 syllables per session) across solitary and observed conditions. The maintenance regimen comprised Ashwagandha (500 mg/day), Thiamine Hydrochloride (400 mg/day), Sulbutiamine (400 mg/day, five days/week), Magnesium Glycinate (500 mg nightly), L-Theanine (400 mg/day), and Creatine Monohydrate (10 g/day, initiated at Month 5). Self-tracked dysfluency decreased from a pre-intervention baseline mean of 8,508 stuttered syllables per 10,000 (n=19, Feb 2025) to ~4,000 within eight weeks. Following Creatine initiation at Month 5, metrics stabilized further, yielding a final maintenance mean of 2,138 stuttered syllables per 10,000 (n=17, Aug 2026). Direct calculation from session-level means demonstrates a 74.9% relative reduction in dysfluent events, accompanied by self-reported attenuations in tension headaches and speech-induced physical exhaustion. Unblinded single-subject observations cannot establish clinical causation or rule out expectancy bias, task habituation, and unisolated additive synergies. These quantitative observations establish an operationalized, bioenergetically oriented framework to guide future randomized controlled trials in speech-language pathology. Files Included in this Deposit: Manuscript - Full working paper detailing the 18-month N=1 observational study. Impact of Therapy on Stammering Raw Data_Log - Supplementary tracking logs containing syllable counts, percentage dysfluency (%SS) calculations, and phase transition notes across the 18-month trial period. Data Availability Link: Supplementary logs are also hosted on the Open Science Framework (OSF) at: https://osf.io/hzx9y/files/ygrbj?view_only=b0924b25ebf14bf190d047a8cfc12491