EP 121 WTH?!? The Doctor's Chat: Essential Micronutrients and Chronic Diseases

Hello, everyone. This is Dr. Nadal and Dr. Ladinia here. And we are here for another live session with the docs. And today we wanted to talk about something that's really important for everyone to know about, but isn't always addressed. There's so many supplements and nutrients and herbs out there in the market for immune health and even targeting different diseases. But what do you do with all this information? Dr. Google can be a really deep dive into a lot of confusion out there. So I just wanted to talk a little bit about some of these nutrients and what's essential, what's not essential, and how some of these deficiencies come up in some different conditions. Okay, so let's get into it. As far as nutrients overall, I'm sure we'd agree that most nutrients are essential, even though. So the distinction between essential and non essential, basically, if we make it in our bodies or not, that's usually what the difference is. There's still going to be a lot more that we got to take in just because of food sources, soil, like, it's just we're not eating the same quality foods as we used to, right?

That's right.

Yeah. And one other distinction is to really clarify the difference between daily minimum required amount, who wants that? Versus the amounts required for optimal health. It's a huge difference there. We're going to start with an example of three just essential nutrients that we should consider for most people. Do you want to start us with the first one? Sure.

The first one is vitamin D. Great. Yeah.

Yep. Super important for overall healthy immune function. We know that, that it's much more than bones. I mean, it's, it really functions almost more like a hormone or a steroid than just a vitamin. Interestingly, vitamin, it came from vital amines.

Yeah, I did not know that.

Yeah, yeah, it's pretty neat. And amines or amino acids, like the structure of that definitely is not the case with all vitamins. They just stuck to calling it vitamins for fun. Why not? But as far as vitamin D, we know that it's found in fatty fish like salmon, even foods that are fortified with vitamin D, like different dairy products, even orange juice, some soy milks and other alternative milk beverages and cereals. Beef liver, always a fun one. Cheese, egg yolks, mushrooms. There's a lot of options to get it out there. What I would recommend with most of these, I'm sure you'd agree, is just get it checked, see if you're deficient. So some individuals with darker pigmentation actually have a harder time taking in the Sunlight and converting adequate amounts of vitamin D. I learned that the hard way moving here from Miami, out in glorious Portland, Oregon, where the sun isn't quite as strong. I ended up being super deficient years ago and had no idea. For some people, there will be some symptoms that develop. It can range anywhere from fatigue, even slight changes. And fluctuations in mood manifest in a lot of different ways. The easiest thing is first to get it checked out. It's an easy blood test. It could be run with your yearly panel, so it's worth checking out. But if someone was to think, what's the best possible source of vitamin D besides a supplement, what would that be?

Well, the best and the easiest would be get outside.

Yeah. Sunshine. Sunshine exposure. Right. So during exposure to sunlight, the skin absorbs the UV radiation that eventually leads to the creation of vitamin D in our bodies. So get out and play is the take home there. But even just to throw some statistics around, I mean, 35% of adults and 61% of the elderly population in the US are actually deficient in vitamin D. Now, is that news to you, Dr. Ludinia? I mean, it's actually way more than I would have expected, but. So vitamin D supplementation studies have shown tremendous beneficial effects of it on immune function. And especially if we think back to the last couple of years, there's been a lot of talk around this, really, how much to take or what is worthwhile. We know vitamin D increases the expression of antimicrobial proteins. We know that it limits certain aspects of the acquired immune response. So it helps play a protective role and even potentially reducing the risk of autoimmune conditions and even tissue transplant rejection. Plenty of research out there. I encourage you to look into it because it's not just a myth. Vitamin D is crucial for immune function. Okay. Also, association between deficiencies of vitamin D and increased risk of things like multiple sclerosis. We mentioned autoimmune conditions like rheumatoid arthritis, even hypertension, different cardiovascular diseases, and even different types of cancers. So get it checked, see if you're low, and feel free to supplement if you need to. Okay, so how much should you take? Even if you can't get a test and you think you might be kind of low, you've never taken supplements or vitamin D before? I mean, depends how much you're deficient, but it's usually pretty safe to go between 2,000 and 5,000. Okay, I use now, please note, this is typically the case of what patients have benefited from. We're not giving you medical advice telling Everyone just to start taking this. But we're just giving you some numbers and some stats and facts and do as you will with it. But this is just something important to consider. Okay, guys, next going backwards in the Alphabet here. So the next one is vitamin C. Everyone knows about vitamin C, right? Vitamin C, I mean, it's a vital antioxidant. It protects your cells from damage and contributes to immune defense. But that's the, that's the fun part and the difference. So many people think of vitamin C just for immune support, but you actually really need it to help repair different collagen pathways and your cells. Right. So we know vitamin C deficiency results in impaired immunity and higher susceptibility to infections overall. And we were talking about this recently. I mean, we don't make our own vitamin C, like at all. Unlike vitamin D, we do not make our own vitamin C. There's other mammals, I think, like goats, that they actually make their own vitamins C, which is good, but we don't. So we have to get it from elsewhere, be it supplements or food sources. Okay, now, how much vitamin C to take for. To optimize function? Well, at minimum, we know 100 to 200 milligrams per day to optimize cell and tissue levels. But given that we are naturopathic doctors and we're not shy with taking reasonable doses of some of these supplements and nutrients, keeping in mind that you will run deficient in vitamin C whenever you're under stress, if you're a smoker, even if you're eating fast food, or just lack of vitamins and actual nutrition, getting less sleep or just have some degree of inflammation or infection, you're going to be needing more vitamin C because your body's going to be burning through it, right?

That's right, yeah.

So then as far as like common food sources, like surprises.

Yeah. Well, a lot of us think of fruits, right? Like oranges, lemons, kind of grapefruits.

Citrus.

Yeah, yeah. But cruciferous vegetables also have a lot of vitamin C. Go figure.

Like broccoli, cauliflower. Yep. Yeah. Okay. Okay, so get your cruciferous veggies in too. And then one thing to consider. Although synthetic and food derived vitamin C are mostly equally bioavailable, if we see the ascorbic acid compared to the actual whole vitamin C molecule or just the structure of it in food, so many other things in the actual vitamin C, just different phytochemicals, micro and micronutrients within the vitamin C, which confers a lot more additional health benefits. So in particular vitamin C. If you can get it from food sources, even better. There are some products out there in supplement lines that will place greater emphasis on deriving their vitamin C from natural food sources. So if you want to go that route, we do recommend it. Okay, let's see here. So next down the list, we go more into the realm of like, nutrients and minerals. So what do you think is the next one to consider?

The next big one is zinc.

Zinc. Zinc Feel like zinc got a lot of press recently for its immune supporting benefits. And that's very true. We know zinc is essential for the healthy functioning of the immune system. We know that a lot of our immune cells, the way that they're kind of packaged and to encourage better surveillance, we need zinc to support them in that process. We know that it also has anti inflammatory, antioxidant action. Right, and where can we find zinc in the food world?

Yeah, some good food sources would be in nuts and seeds, other things like eggs, some meats, legumes. Legumes, yeah.

Okay. Okay, good. So, yeah, we can get zinc from our food. Our body likes variety and different food sources. So even for vegetarians, I mean, nuts, see, eggs, maybe legumes, there's definitely ways of getting it. Now I know that lately, especially for immune support, there's, you know, taking actual supplementation and we'll get into some of those numbers. But just bringing up some of these ideas, like zinc absorption in the elderly is significantly lower than that of most younger populations. That could be due to a combination of different medications. Even just lower, lower acid function in the stomach, it's not being absorbed as much. And of course, invariably that leads to less immune function and a host of other issues that arise with having zinc deficiency besides fighting infections. We know that the overall recommended dosage of zinc could be anywhere from 8-11mg a day, just for general immune support. 8-11mg a day. If you're eating healthy, you're probably almost getting that. But if you want to increase the amount of how much you're taking, if there's some exposure, if some people are sick around you, or even if you want to kind of rev things up and have greater resiliency for your immune system, we can think about increasing that to even 30, 40, 50 milligrams a day. You don't need to do that for that long. Even in two to three week bursts where you do that and then discontinue, it is usually the way to go. There is some talk about zinc and eventually Interfering with copper absorption. Right?

Yeah. What do you think about that?

Yeah, I mean, really it takes a lot of zinc for a long time. There's some studies, I think, where they mentioned, I mean, you'd have to do like 100 milligrams a day for like almost a year for it to really start to interfere with copper. Either way, I think after a few months, if you're really gung ho about taking zinc, there are some supplements out there that provide the right ratio of zinc to copper. Okay. And it's about a 1 to 15 ratio. Okay. In case you want to search for that. For copper to zinc. Yeah. And let's see, so some other important nutrients and we're going to go into each of them, but we have things like magnesium, selenium. Yes, right. And then even like NAC, vitamins A, E, even B12. Right. All these are important players. So let's go into those as they relate to specific conditions.

Okay, that sounds great.

How about that? Yeah. Because it'll be more useful. It's fun to talk about some of the main ones, but if we talk about them within context of conditions, it really highlights and exalts the significance of, of what they're being utilized for. Okay, so let's take something, let's, let's just be, you know, off the cuff with it. Let's talk about adhd. Right.

Okay.

Right. We know there's so much involved with adhd, you know, pathophysiology, you know, be it behavioral and like, there's so many things to consider here. We're not saying at all that this is just a silver bullet or a remedy for it. But, but there is enough evidence that there are some deficiencies in magnesium and B6 with a lot of ADHD patients. Okay, now we know. Okay, well, what does that really mean? What's going on? We know that sometimes there's impaired utilization of dopamine and other neurotransmitters which are directly supported with some of the cofactors and nutrients like magnesium, B6. Right. So essentially, if there is some underlying impaired utilization of some of these neurotransmitters, we can help support that kind of a low hanging fruit with some of these micronutrients. Right. They're not bad. If anything, they will be good for you. And then there's been studies on the other side of it too, where moderate doses of magnesium and B6 improved symptoms in children with ADHD. Actually. Yeah. And just for fun, I know we're talking about nutrients and. But what about any herbs Any herbs.

That we think of maybe ginkgo.

Yeah, ginkgo is always a fun one. Yeah. Ginkgo biloba as an extract, right? Yeah. And there's different companies herb farm, like you could find ginkgo at your local health food stores. You can take it a capsule or even as a tincture. It's good stuff. Right. And then as far as the amount of B6, you know that, that depends on what supplement you're getting. But I mean even at least 20 milligrams a day for adults. Right. And then we're going to talk more about magnesium later. Okay, so then what about something else? What about asthma? What do you think will be beneficial for it?

Well, I think magnesium again would be very helpful.

I like it, I think because it helps promote relaxation of some of the bronchial smooth muscle. So that spasming component. Very good. And then we know that vitamin C deficiency can increase airway hyperreactivity to histamine. So I mean, taking vitamin C will inhibit more of the histamine induced bronchoconstriction which is happening in the case of asthma. So the more, you know, and then any herb for asthma that you consider maybe coleus. Coleus for scoli. Yeah. And a lot of these tinctures, again, you can find them pretty easily. And I mean this is just as little as 3 to 5 mils, like 3 to 5 milliliters, like three times a day. What this herb will do, it's actually going to raise something called cyclic amp. Now that is going to further help relax the bronchial smooth muscles, which can be an issue with asthmatic patients. Okay, let's see here. What about another unfortunate common condition, especially in the world we're in now. What about hypertension?

Coq 10 for sure.

Maybe some potassium.

Yeah, possibly.

Yeah. And you know, it's good, it's. I like, there's, there's different supplements that'll have a lot of these minerals in combination and I kind of prefer it that way. Kind of an analogy or metaphor. It's like you can take the quarterback out of the team and tell them to show you how to play football, but really they're going to shine when they're actually in the team and you see them in action. So some, some of these nutrients and minerals, if there is a combination trace mineral complex or something like that, that, that is probably the best bet to get some of these things. But we know that high potassium intake helps to protect against some of the hypertensive effects of say, someone. If there's too much sodium in their diet. Right. Because all these salts have a very tightly regulated mechanism and pathways in the body. And then for fun, what about another herb for hypertension?

Well, a good herb would be leaving Leonoris Cardiaca.

I love that plan. That is a good one. Leonoris Cardiaca. It's in the name, very good for the heart. Again, one to three or four mils, maybe three times a day. Good, great. Let's see here, what else we got. What do you think of after hypertension? That's also unfortunate?

Well, another really common one would be diabetes.

Diabetes. Diabetes. And what first comes to mind with.

Diabetes as far as a nutrient? Yeah, I think chromium.

Chromium, yeah, yeah, I think so. Chromium has been shown to help improve glycemic control, for sure. Or insulin sensitivity in patients with diabetes. Or I think it actually helps sensitize the cells to insulin receptors, if I'm not mistaken. So, yeah, easy supplement to find and take. It could be at least like 200 micrograms a day. Right. Something you just take once. And if it's in a kind of trace mineral complex, even better. And then a fun herb for this one always makes me think of Sylvester. But so Gymnema sylvestre. Okay. It's also called sugar Destroyer. All right, so gymnema is also very good for, just as an herb for diabetics to consider. Okay. Also with some of the medications with diabetes, if you want to consider a well rounded B complex, maybe an activated B complex if you need that support. But you're going to get things like biotin B6 and B12, which can be helpful in buffering some of the detrimental effects of some the medications for diabetes. Okay, let's see here about hypothyroidism.

Well, when I hear the thyroid, I think of selenium.

Yeah, yeah, absolutely. So especially in the case of, like, you know, there's. There's different ways that this can manifest, but if there's more of an autoimmune component, and we think of antibodies, we know that supplementation with selenium actually significantly decreases the TPO antibody levels in patients with autoimmune thyroiditis. Right. And this could be also a similar number, about 200 micrograms a day. So our body needs selenium for thyroid hormone metabolism, even for the reproduction of it DNA synthesis. And overall, I mean, it protects you. It helps protect from infection and oxidative damage. So selenium is actually huge and very important, but definitely a strong consideration for patients with hypothyroidism for sure. Okay, so moving along here, what about headaches? Like how many people do say they have a headache? It's a lot. Yeah, tension headaches, even migraines. So our old friend magnesium. Magnesium is huge just for overall muscle relaxation. And so many, I mean, hundreds of different pathways and metabolic processes rely on good magnesium levels. But we know tension type headaches have been found to be associated with suboptimal magnesium status or even just magnesium deficiency. So stress can promote the development of magnesium deficiency, which is very common right now, but especially in people with tension type headaches as well. How you dose it, what you take. There's a lot of different forms of magnesium out there. I prefer some of the products that have kind of a combination of a few different types. You know, whether it's the orotate, glycinate, malate, just find the one that works well for you. You know, it's not working as well if you've reached what we call, you know, to bowel tolerance. Right. The range, you can take anywhere from one to like seven, 800 milligrams a day. You don't need to take that much. But if you are doing that, making sure to divide the doses. Right. Usually the caps will come anywhere from 250 to 500mg or 400. So even doing that at least once a day will help keep some decent levels of magnesium in your body. There's of course some herbs to consider for headaches. There's a few. Yeah, tell me.

The first one is fever fume.

Yeah, feverfew. So jury still a lot of helps with fever, but feverfew is phenomenal, specifically for migraines. There's also lemon balm, even California poppy. Right. Just really good direct hit for pain pathways. And then of course there's some considerations of like 5 HTP or riboflavin. There's a lot to consider there, but obviously consult with your healthcare practitioner before going on these endeavors. But these are just some fun things to consider. Okay, next, osteoarthritis.

We see that really frequently too.

It is, it is. Especially as, as we age. And like I mentioned earlier, there's just less assimilation of nutrients and our bones aren't getting everything it needs. We know that vitamin C, just to go back to that, higher intake of vitamin C was associated with lower risk of cartilage loss and disease progression in patients with osteoarthritis. Go figure. That brings up what we were talking about earlier as far as, sure, vitamin D and calcium, all these things, but we also need Vitamin C, just to help lay that collagen down and repair some of the cellular processes that are happening in the presence of osteoarthritis. Some other things, of course, I mean, we know there's like, the chondroitin and glucosamine. Those are always good to consider. But as far as, like, for inflammation and pain as well, we can't forget herbs like boswellia, curcumin, even hesperidin. There's a lot of herbs that really help down regulate the inflammatory pathways that are leading to pain. Okay. Because osteoarthritis, we want to target both pathways. We want to encourage the joint to heal and repair and ideally grow, but we also want to control that inflammation, which is what ends up flaring and causing all that pain.

Right, exactly.

Yeah. Yeah. Okay. And we mentioned. I mean, zinc is also important for osteoporosis. Right. So besides its immune functions that we talked about, we know that zinc is also essential for just that balance, that formation between osteoblasts and osteoclasts. So there's been enough research to show that low zinc levels have been found in serum in the bones of elderly people with osteoporosis. That is a thing. Okay, so another vote for zinc. Right. Okay. All right. What about Alzheimer's? So we talk a lot about brain health here. Right? Kind of our main wheelhouse. But what's something just off the cuff that you would consider for.

I mean, I feel like here we have a lot of options.

Yes.

A lot of essentials, but maybe we can just hit on the B12 today.

Yeah, yeah, totally. At least that. I mean, so there's a lot of findings suggesting that patients with Alzheimer's disease have a defect in the transport of B12 across the blood brain barrier or an accelerated breakdown of the vitamin and brain tissue. So definitely something worth considering. Easy enough to find. You know, if someone is very deficient in B12, I mean, even just quick intramuscular, like, once or twice a week, like, getting a higher dose of B12 is a consider. It is something that we do here and worth considering, But a lot of other things, even acetylcarnitine, you know, there's a whole lot that we can address because what we want to prevent is any further brain mitochondrial decline. Right. Like, those are, like, the energy powerhouses within the cell that we want to make sure they're still. They're doing everything they can to provide that energy in the. In the neurons. So any further degeneration is prevented. Right. So related. But so we think about dementia. Would magnesium help with dementia?

Magnesium would.

Okay, again, again, yeah, we know severe magnesium deficiency can be a potential reversible cause of subdueventures. Okay. So there's different research out there, but it's, it's pretty clear that, I mean, severe magnesium deficiencies can even mimic things like Alzheimer's in some cases, in some ways. Right. Calling it a cause or something like that, maybe that's a bit strong, but it's definitely a low hanging fruit just to consider and easy enough to supplement with. What about. There's an herb you mentioned earlier that is really good for cerebral profusion and kind of improving brain function.

The ginkgo.

The ginkgo. Ginkgo strikes again. Ginkgo biloba. Yes. There's also greater periwinkle, which I think is in the new family, which is very good. And again, these are just considerations, these are ideas, but it's not enough people are talking about these things because this is readily available in different health food stores or if you talk to your nutritionist or naturopathic doctor. These are all things that can very easily be addressed and discussed further. And ultimately, I mean, it's important to actually to test too. So there are different functional labs out there where you can actually check for all these micronutrients and see if there's any underlying deficiencies to prevent some of these conditions from developing further. Right? That's right, yeah. And then what about Parkinson's on the brain health front? What are some easy things to consider for that?

Well, vitamin C again.

Yeah. And E. Yeah. So when we think of Parkinson's and kind of the role, the, just the significance of antioxidant pathways in the brain, you know, burning through glutathione and all the different antioxidants, vitamin C and E are going to be crucial. We know that they can be used for slowing the progression of a lot of conditions, especially this. So overall, we know that supplementation with antioxidants can prevent or reduce the rate of progression of a lot of conditions, but especially things like Parkinson's. Another fun herb for this one. Also good for brain health. Bacopa. Bacopa, widely used in both western herbal medicine and I think even Ayurvedic medicine as well for a long time. So bacopa for the brain. Remember, Remember that. And ginkgo too. Right? Yeah. So let's see here. And you know, we've already talked about it a little bit. You know, when we think of colds and immune deficiency, just keep in mind, you Know some of the things we mentioned like vitamin C and zinc. Vitamin D, you know vitamin C. We know it demonstrates antiviral and antihistamine effects and plays a huge role in immune function. That's already well established. There's plenty of double blind R.C.T. like, you name it, it's out there. So that's pretty clear. I feel like we don't need to talk about that too much, but we really do want to stress that. Okay. Vitamin C, zinc and D for overall immune support. Okay. And some other fun herbs for immune support. You got any other fun ones?

Astragalus.

Yes. Yeah.

Supporter.

Absolutely.

Elderberry?

Yeah. There's some good syrups out there. Yeah, yeah.

Tastes good too.

Yeah. A little goes a long way.

Echinacea.

Yes, Very good. Yeah. There's a really good book, Medical Herbalism by David Hoffman. I think Medical herbalism. Good medicine is good medicine, right? Okay. So before, there's gotta be at least another couple of conditions that we haven't talked about. What about more like an autoimmune like rheumatoid arthritis? Yeah.

Yeah. I'm going to go ahead and say zinc.

I'm going to agree with you. Yeah. There's studies that have demonstrated significantly lower zinc levels in patients with rheumatoid arthritis than in healthy controls.

Interesting.

Yeah. So go figure. Again, the huge role that zinc has in regulating our immune system. It's just very important to consider. And in the case with rheumatoid arthritis, I mean even if it's more along the range of 25-30mg at least once a day, very good to consider naturally with any, what we call polyarthropathy or things that involve some arthritic component. Healthy fatty acids also going to be amazing. Like high dose omega 3s are going to be great anti inflammatory benefits as well. Okay. And if most bottle recommendations are one to 2,000 milligrams a day, sure. But you can go upwards of even 3 to 4,000 milligrams a day. Okay. And then what about an herb for rheumatoid arthritis?

I like Devil's claw.

Devil's claw. Yeah. That's a solid one. It's got kind of a spicy taste to it too. But it is phenomenal for helping with the pains that come with a lot of forms of arthritis, especially rheumatoid arthritis. I absolutely, yeah. And then a little bit more on like brain health. I mean, so when we think of things like multiple sclerosis, so we know that there have been enough reports and Studies to show that a lot of patients with Ms. Actually have had increased prevalence of low serum or cerebral spinal fluid of B12 levels. Imagine that.

Interesting.

Yeah, it's B12. So why not consider supplementing with. Right. And we know how good B12 is for overall cognitive function and sadly, cognitive impairment. We know it affects 40 to 50% of people with Ms. Eventually. Right? Yeah. So B12, B12 and vitamin D. There's plenty of research. Well, there's always more. Right. But there's a lot of research with vitamin D and just having kind of a chronic ongoing deficiency in vitamin D that goes unchecked, which relates in some ways to the potential development of things that relate to multiple sclerosis. Right. And then, you know, this one gets tricky because things like depression, you know, it's not going to be solved by any pill or a nutrient. It's much deeper than that. Right, right. But if there are just a couple of simple nutrients that can help support the pathways that might be impacted with some patients with depression. Folic acid, Right.

Yeah.

I mean, deficiency of folic acid is actually the most common nutrient deficiency in the world. In the world. Okay. And then even further studies with some depressed patients have shown that 31 to 35% are deficient in folic acid. Okay. So go figure.

That's a lot.

It is a lot. And you know, any well rounded multi or B complex might have some folic acid. You know, around 800 micrograms a day can be a decent starting point. And then a darling herb that many know about at this point for depression.

Is St. John's wort.

St. John's wort. Little yellow flower with tiny little red dots. Right? Yeah, yeah. St. John's Wort. Very good. I mean, it's. It's almost becoming a standard treatment in some therapeutic approaches to depression. So here we go. And then just a couple more. Even hypercholesterolemia. High cholesterol, right?

That's right.

There's a huge variety of things to consider from diet, lifestyle, nutrition, but we know that niacin can help a lot. There's several studies where supplementation, even just one to three grams a day, now that is on the. On the higher end of things, but that's found to reduce or just produce substantial decreases in serum total cholesterol. Ldc, LDL and not ldc, ldl. C, a specific type of. And triglycerides. Okay. And increasing hdl, which is that healthy cholesterol. Right. That's a lot.

That is a lot.

Yeah. I mean, with this. I also think you know, maybe CoQ10, fish oil, increasing fiber, a lot of these things. And of course this is all alongside if that's going on with, with important medication management and, and doing everything else correctly. But these are just some useful recommendations.

To consider, just some highlights.

Yeah, great. All right, well, that is a lot of it. Wow. I mean, so in this presentation, in this discussion, we've talked a lot about a lot of just the main essential nutrients to consider. I mean, if you look at my cabinet at home, it's like, you know, there's plates, there's some pantry things and then there's supplements. Right. So there's a lot of information out there. And you know, all, all of these aren't for everyone. But that's why it's important to connect with some interested, curious and passionate healthcare providers that want to take a stand for your health and actually approach things in a different way, in a more integrative way. Medication management and working on conditions is one thing, but even thinking prevention and improving longevity and wellness and just quality of life with simple things like some of these fun ones, like different nutrients that are easy enough to get or different herbal considerations, this is what we're all about. Like I said, a lot of these are just low hanging fruit to help with conditions that are actively going on or even to help prevent them. And when in doubt, just get these levels tested. Besides vitamin D and all the usual suspects that you can check in the blood, there's a lot of these trace minerals and nutrients that you can actually test for as well with some of the more advanced functional labs that we run here. So if you have any questions or any comments, feel free to share with us. We love chatting to folks. Ideally we're looking at you right in your living room, but yeah, connect with us, reach out. Nature Cures Clinic out here in Portland, Oregon. This is Dr. Nadal, Dr. Ladinha. Yeah. Signing off and we will see you again soon. Till next time.