Personalized Supplementation: Test, Don’t Guess

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Listeners, we are back today for a really cool conversation around a common question that Kelly and I get repeatedly in our practices. What supplements should I take? You know, you've probably been there and maybe asked that question before. If you didn't ask it out loud, you probably asked it. I'm sure you did. Kelly and I seem to think that the right question to be asking is.

How do we know what we should be taking? Right.

Yeah.

But I just have to ask you. You only get that question in your office.

No, you're right.

I get that question at cocktail parties, at dinners, at family gatherings.

You're exactly right. Yeah.

Oh, man. I just want to scratch my head because that's such a loaded question. What should I be taking?

Yeah, it is. And it really is.

Yeah.

And we're glad. I mean, we're glad you're asking.

Yes, we're super glad you're asking. It's a really good question. But it's a very complex question.

It is. And one that has to be asked over and over and over again. Because as seasons change, as needs change. So we're gonna dig into that today. So we hope that you lean in and you listen up. Cause we've got some good little tidbits here.

Yeah, Just enjoy the conversation. So when we think about supplementation and we think about how do we know what to take? There are certain things that Lori and I consider foundational. There are certain things that we figure if you live in America, right. And you eat out and you travel and you do life, which I hope we all do those things and enjoy those things, then there's a certain amount of supplementation that's just necessary today in the world that we live in today. Would you agree with that?

I do. I do. And I think. How do you know? It really starts with one fundamental principle, which is test, don't guess. And if you've been around with us long enough, you kind of know that's permeated in all of our educational curriculum, is that we need to test. We need to understand where you are. So that's key. And what kind of testing? Let's talk about that a little bit.

Yeah. There's some pretty standard testing, serum testing, blood testing that we do in our offices that we can glean a lot of information from. Right. We can look at patterns of how your body's expressing itself through those biomarkers and kind of determine, you know, what does this body need? And then there's more sophisticated testing that we can actually look intracellular and see what are your Cells uptaking. And we do that testing through spectracell.

We do. There's plenty of companies out there that do it. But I think over the years I have really stayed in love with, if you will, with Spectracel because of just the technology of their testing and the reporting the way that it's reported. And I think there has to be some consistency with your testing too. I think if you move from test to test to test, you're really not trending and having those comparisons that you need. And what I like about it so much is looking at the functional utilization of it. It's more of a dynamic test that looks over a longer period of time, not just what's in your bloodstream when you come to the clinic, but more important how your body is utilizing those over a period of time based on, you know, how you feel. So.

Yeah, yeah, that's a good point. So I still believe in foundational labs to look at like how you're. I wouldn't, I wouldn't sacrifice typical labs in efforts to just do a nutrient panel.

Correct.

Right. I feel like they both. It's not this test or that test, it's a test. And, but I think anytime you're really wanting to know, number one, are your strategies working? You know, do you have holes that you can't see? Right. Based on traditional testing. To Lori's point, oftentimes when we do serum testing in the lab, we can look at intracellular red blood cell magnesium, red blood cell zinc. There are certain nutrients that we can look intracellular with traditional labs, but there are a lot that we can't see.

Right. And I think, you know, the other thing we wanted to highlight in addition to just, you know, kind of talking about the test, don't guess, is understanding the difference between and understanding the utilization of supplements. Right. Supplements fill in nutritional gaps and at the end of the day, foundational is whole food farm to plate, nutrient dense diet. And it's understanding that it also has a lot to do with how you digest and absorb them. So gut health is a key pillar in all of that too. Right?

Yeah. I often say you can't out supplement a poor diet. Now there are times when your diet is less than ideal that you may need to enhance your supplementation. That's not what I'm saying. I'm saying eating a seeder American diet and popping your supplements, you're not really doing yourself any favors. Right. In the long run. Oftentimes what happens is the gut microbiome becomes unhealthy and you're not Even absorbing those supplements that you're taking, because you can't absorb those in an unhealthy gut environment, Correct?

Yep. So test, don't guess. And we talked about serum and intracellular, and then really talking about the quality of supplementation, too. We can't have a conversation like this without talking about quality, because you could find yourself in a position that you're taking a lot of things. And, you know, sometimes we. We all get there, right? You hear, you know, a podcast or a webinar on something, and we add it to what we're currently taking. But we really have to get down to the key. The key nutrients that we need and in quality forms. And what does that mean? What does quality mean?

And we actually did a full podcast on supplement quality probably a year or so ago. So I would definitely encourage you to go back and kind of glean the nuggets from that podcast, because it's very essential. When we think about quality, we're thinking. Lori and I both do a lot of vetting for companies that we would recommend in our practices, and we want to make sure that they're pharmaceutical grade, meaning they're testing that product, the raw ingredients that they're using in that product, and then they're testing the end product to make sure potency and purity are adequate for consumption and beneficial for the patient. So that's a big part of what we spend our time doing.

Right. And shelf life. Right. So, you know, products should have an expiration date on them, and we all know that that is best used by date, very similar to that of what's food in your refrigerator. There's a best use by date. And oftentimes those products still are good products beyond that date, but you need to be looking at that date. Right. So you don't want to be leaving those products around for a long period of time and then going back to them when they're well beyond that best use by date. And then storage, right? Storage of those where you keep them and the heat and just the humidity as well, and how you store them. So those are all very important around the question of what supplements should I take. But more importantly is the question that we brought up with the real question, right?

So when we talk about foundational supplements, what does that mean?

Yeah, So I really like the conversation about supplements is how do I know what to take? Well, now we know we have to test. Once we've tested and we've understood better what is needed, we partner that with what are you eating? Right. So together, what can we do from an nutritional standpoint first. Food first. Taking a food first approach. What we can't replace alone through the use of food. Then I like laying out, mentally, products into three categories. Foundational, as you just mentioned. What is that? We'll talk about that. Repletional and optional. And I think when it comes down to budgeting for those things, it helps you also to budget because you know what you're taking them for. Is this something long term? Is this something. I'm just filling in the gaps because I'm healing and repairing something so it's temporary, or is this optional? It's not because I have a deficit in something, but maybe it's because I have a higher risk, maybe for a disease state or a risk factor that I am trying to buffer a little bit more. So what does foundation mean? Foundation really is very similar to foundational nutrition. What you eat. Foundational supplementation is those key things that we know the body needs. And without them, you can do all that work, but at the end of the day, you're only gonna get so. So we consider those to be.

Yeah, like our multivitamin. Right. And that also includes minerals. You know, minerals are your spark plug for a lot of metabolic activity. So we need those minerals to be repleted. And oftentimes because our food quality is not the best, we're not getting the minerals from the food, or perhaps we're not absorbing it from the food. So a multivitamin and mineral. You know, I love multivitamin and mineral powders and oftentimes liquids just because of helping that body absorb those. Well, a lot of times you'll see them in tablets, and you may or may not be breaking those tablets down. And so I do believe that using those in a liquid or powder form can be beneficial to most patients.

Yep. So fish oils are next, I would say, you know, very, very important. You know, every cell in your body requires a permeable membrane in which things can get into the cell that need to get into the cell, but things need to get out of the cell too. And so fish oils are really good for the hair and the skin and for insulin resistance, which is definitely a topic, you know, a hot topic. So fish oils are really important. Now. There's a multitude of different types of fish oils. And, you know, some people eat fish and they're getting. They're getting a good amount. They don't need to supplement as much.

Right. But other things we can actually look at, you know, what does the body need in the way of omega 3s? There's an omega 3 index that we can run through lab testing. Back to the test, don't guess. But then also we measure something called phase angle on our body composition measurement. And that's speaking to what Lori was talking about. That buoyancy of the cell. Is that cell bouncy? Can that cell take in nutrients? Can that cell excrete toxins? We can actually look at that by looking at that phase angle. And I really like watching that phase angle improve as your body's healing.

So quality multivitamin, fish oil, probiotic. And I think before probiotic, one of the things you and I were talking about is what do you put before that? And you mentioned fiber. And it's a food.

It is a food. And I think fiber is a separate food. I feel like we need to be really thinking about how much fiber we're getting in. We need about 30 to 50 grams a day. And that's hard to do in the diet. And I laugh and tell my patients, oftentimes I don't have that much chew time in a day. And I really should reevaluate that because I probably need more chew time than that. But true enough, it's difficult to get that fiber in. And so supplementation with fiber oftentimes, I think is necessary and foundational, especially in the subset of patients that are using hormone replacement therapy. I just really feel like it needs to be on the table for sure.

And then vitamin D, you know, I don't care if you live in Florida, if you live in the islands, or you live in Mississippi or wherever. At the end of the day, I have rarely found a person to have optimal vitamin D with environment alone.

Right.

And food. Environment of food.

Yeah, I would agree with that. I'm seeing more and more people today have better vitamin D levels because Covid got our attention with supplementation.

Right.

So a lot of people are supplementing with vitamin D prior to coming into the clinic. And so I don't see as many deficient today as I used to. However, I will see some patients taking over the counter vitamin D and they have single digit numbers or double digit numbers. You may be there 9 or 18, and they're like, but I've been taking this vitamin D for two years. Well, that goes back to quality. Or it may go back to their gut microbiome. If their gut microbiome is not able to take in that nutrient, perhaps it's absorption issue. But oftentimes it does go back to quality.

Absolutely. Yeah. And so supplementation with vitamin D is really important. And the Amount is very unique to the individual. Right.

And oftentimes unique to the season.

Absolutely. For sure. Good point. Yeah, good point. And the type of vitamin D that we take, you know, combining it with K2 in most cases for better absorption, but that comes down to quality. Most of the products now are including the two. That is not an always right. Again, seek your own medical advice. Right. For your own with your own provider and your unique situation. But I do think that that is very important. And then the probiotic, we didn't hit that because we put fiber above that, which I think is. Which, you know, is something we talked about, is wanting to give them to you in somewhat of an order of sorts.

Yeah. And I would say with probiotics, I'm super cautious there because a lot of the probiotics on the shelf are genetically modified organisms. And I think the message. I'm hesitant to say that everyone needs a probiotic. I think that most Americans do because of our poor food quality. We've gotten to the place where our gut microbiome is not very diverse, and we need diversity. But we also, in trying to create diversity, probiotics are something that we need to be mindful of rotating. We don't want to get on one formula and stay on that formula for extended periods of time. So that is definitely a situation where you want to be working with a qualified provider. There are ways to assess your gut microbiome so that you know that that probiotic is benefiting you and you know when and how to rotate those probiotics.

Yep. And I think that's a key point too, in getting back to quality and shelf life. They are live organisms, and it is extremely important to be storing them in the proper way, taking them at the right time. Not all probiotics are created equal. And it is very, very important to work with a qualified healthcare practitioner to determine when is the right time, how much and what kind is necessary. And then those were. That's multivitamin, fish oil, probiotic, vitamin D and fiber. We would say those are foundational, again, filling in this nutritional gap. And the goal is for them to you to take them regularly. Regularly, so that you have to. When labs come back, you have less to replete. So that moves us to repletional. Repletional category is what do we need to replete? We're deficient and we need to replete it. And one of the things you have to understand is multivitamins were never, ever, ever intended, as by themselves, a single modality to replete you. If you are deficient in multiple nutrients, you're going to have to take a multivitamin. And.

Most of the time, if you're deficient in multiple nutrients, there is an issue with absorption. Sometimes it's strictly an issue of lack of intake. That can happen. Right. But that's not as common as lack of intake and a disturbed gut microbiome that just can't absorb. And so a lot of the repletion category has to do with repair. What are we trying to repair so that ultimately we can absorb better and we will need less supplementation. That would be the goal. That would be the ultimate goal.

Yeah. But wrapping our head around, you know, the honest facts are when you didn't get this way overnight, so if you're just starting your journey, facts are you're going to have a lot more nutrient deficiencies and insufficiencies and you're gonna need to replete more. So it's gonna seem kind of like, ugh, maybe arduous, hard, like I'm on a lot. It's because you're, you're on products to replete your nutrient deficiencies. And in addition to it, you're on products to heal or repair what got you in that situation to begin with. And so just lean into that kind of understand it. The goal isn't to be that way.

Long term and always ask questions. We never get offended when you ask us, why am I taking this and how long will I need to take this? Sometimes we don't know how long. Sometimes it's like until I assess you again and we'll determine that at that point because it has to do with your ability to heal and repair, as to how long this repletional supplementation will be necessary. But we welcome the questions. I think it's wise to question that. And I think looking at your supplement protocol, to Lori's point earlier, depending on what you have going on, how your stress level is being managed, what you have on your plate, oftentimes working with executives, they are running their body like a trained athlete and they are not repleting well at all. And oftentimes they have that tipping point where they just can't keep up. And so that's what we're really trying to get ahead of that curve and really work on repletion and repair so that again, you need less supplementation long term.

And there's different delivery mechanisms. And you kind of hit on that earlier. You know, is liquid better or powders better or sublingual better or injectable better or IV therapy better? And when you're working with your qualified healthcare practitioner, many of them, you know, we have access to a lot of those things, which is. Is very, very important to be working with one, because to replete, it may take many different types of delivery systems. You may do injections at the same time as you're taking it orally. So asking those questions too, of in a day, how much, right? Your B vitamins being water soluble, you know, if you're doing injectable, you may or may not do your B vitamins on that day too. So again, those instructions are gonna be really important. Some other examples of repletional could be any of your vitamins, minerals, or nutrients, but they could also be your gut. Gut restoration program, right. Your protocol that's designed by your. By your qualified healthcare practitioner. So those are some repletional. And remember, I just want to go back. It's more difficult to replete than it is to maintain. So. And repletion is a combination of food, gut repair and healing, as well as offloading body burden. Because when your body's more inflamed, you need more while at the same time supplementing.

So what about optional?

So I bet you get a lot of questions.

Yeah, I get a lot of questions about, you know, should I be taking this? You know, my patients tend to be seekers and they're constantly listening to podcasts, and, you know, I have them come in with their sheet of notes where they have taken notes on all these podcasts that they want me to listen to. And I love doing that, but there's a lot, a lot, a lot out there, right? And it's hard, it's difficult to get through the weeds and to understand. So I always go back to the question is, what are we trying to accomplish? You know, what are you wanting this supplement to do and what are you trying to accomplish with that supplement before I can help them make a good decision about those optional supplements.

So optional may be things like your protein powders, honestly. So they fill in nutritional gaps, and they may be to you, you might be like, no, they are not optional. I need the extra protein, and I'm not gonna be able to get it right now due to maybe I've had dental work and I have to drink my food instead of eat my food, so they float a little bit. There's a dynamic nature with these, and I think you have to be aware of that. But protein shakes could be that way. It could be, you know, your protein powders, it could be your collagen powders, it could be a Range of things. You know, if you don't necessarily have a vascular issue, but you understand how important your vascular system is, you may be taking products to specifically increase nitric oxide. Like, those are some of the examples I can come up with. Do you have.

Yeah, I'm thinking peptides like the BPC157. Oftentimes, I think about the nootropics for brain health. A lot of people are really wanting to maximize cognitive benefit, and I do believe in that. I think that's oftentimes wise. But if we're not doing the foundational things and we're just relying on that optional supplement, oftentimes we're not gonna get the result that we think we will because we haven't taken care of the foundational needs of the body.

Yep. Yeah. And there's so much to unpack in what you just said. But I'm gonna start with optional. Optional being, you know, if your budget. If your budget doesn't allow for a period of time, and we all go through tight times, those are gonna be the ones that you'll probably pare down first. And I would hope that, you know, that would be the consideration to do that. And that's why we label them optional. We're not using them to specifically heal a repair or fill in a nutrient gap. But you're choosing to do them for the goals that you have in mind. Yeah. More to unpack to what you said, which is. I mean, it's good stuff at the end of the day, if you're not doing your work. And I think so many times people come in and they're so discouraged, honestly, about their results, maybe to their Spectra cell, their Total Immune Index, their Spectrox, which is the antioxidant. And they look at the overall nutrients, and they look at it, and they're overwhelmed by the results. And I've looked at them for years, and there are patterns that you see. And one specific pattern I think of, that I think is worth talking about is blood sugar patterns. So if blood sugar's not regul, your B vitamins are gonna be a mess, your minerals are gonna be a mess, and your antioxidant, your chromium's gonna be down, your ALA is gonna be down. So a lot of times, again, you're not just buying this test online, which I know that a lot of these companies do offer direct. You know, you're just getting the results at that point. The value of having a functional medical provider or a qualified healthcare practitioner is to look at that data in relationship to what you're trying to improve. Where are you currently at? And look at those patterns. Look at those patterns. Because if you don't correct the dysfunction, you're gonna continually find yourself in the same situation, taking all of those supplements. And in the short term, that's not a bad thing. But you have to go on a discovery and you have to be willing to make those changes. Otherwise you're gonna be trying to supplement yourself to death. And it just.

I would totally agree with that. And I think that's where the value in working with a provider that's pretty savvy in looking at those tests, because you can get that test report back and just plug the holes. Well, I need some vitamin C and I need some alpha lipoic acid, and I need some chromium and I need a B vitamin. You can plug those holes for sure. And you may feel a little bit better, but that is a sign that you have dysregulation in blood sugar and insulin. And really working to that end is what's going to help in the end repair those nutritional gaps that you have.

And then looking at it through the, you know, the subset of time. Right. So you just had Covid or you've been really sick and run down, and you typically wouldn't do a test like that, usually for four to six weeks after a pretty significant sickness. Right. But sometimes you didn't know you were sick. You didn't necessarily feel bad. You want an immune system like that, Right? Like we want an immune system that fights on our behalf without us even knowing it. So sometimes we'll see patterns of your antioxidants are just trashed. They're super, super low. And in that inquiring of, okay, like, how are you feeling? What was around you? Have you recently travele. Because maybe it's not about increasing your antioxidants, every single one of them. Maybe it's really working on, first of all, understanding what caused that and kind of looking at what is bogging the immune system down.

Right. What is the oxidative stress burden? Right. So what are the stressors that are depleting antioxidant utilization? Function and numbers.

Yeah, for sure, for sure. I do want to go back to foundational for just a second because I think you and I have really struggled for years at finding a very clean source of chlorella and spirulina. And for that reason, we pulled them off of the foundational list. I know I did in my practice.

And I remember you saying, yeah, for sure. And those were such cool Nutrients to utilize because they're whole food based. And it felt very congruent with our mission of food first. And so it was really sad when we couldn't, we just couldn't. We couldn't get it for the longest time. And then when we finally found it, we realized that that particular product was inferior and it was contaminated and so we chose not to use it.

Right, right. Yeah, yeah. Which can happen. You know, we can recommend a product and you know, ongoing research and looking into companies change, they become owned by someone else. I know y' all are listening to what's out there right now. Right. So products change. And so in that we decided mutually to pull it off of our shelves and not recommend it. Not because we don't like spirulina and chlorella, we really do. But if you can't find it clean, then it's better not. So in saying that we have recently found. And I'm so happy and excited because I do feel like, you know, algae is a superfood. It was around long before we were here. Right. And there's a lot of benefits to it and it really incorporating it earlier in your plan I think will have long term benefits on many levels of not feeling like you're having to replete as much. Sure. So I definitely wanted to go back to that on foundational.

Yeah, it'll be. We're kind of new to adding that back and I can't wait to see kind of the results that we are able to, to glean from adding that to a foundational program. But I do think it has its place there because again, we're looking at food first. We're looking at that is a food that we're adding to the diet versus just a supplement.

Absolutely. So it's a complex topic and it's a complex question that you find yourself, I'm sure, asking. If you haven't asked it yet, you're gonna ask it. If you haven't asked it out loud, you've probably asked it. But it's really not about what so much supplements do I need to take, but more of, you know, the long term strategy around supplementation. Always being mindful of a food first approach. Always if we can replete it with food, we want to do that, but at the same time we have to also do the repair work that has to happen. And I really think that this should challenge you as you kind of think about your supplement list. It's so, so important for you to continually bring your supplement list, not what we've recommended to you. Here's the challenge. Because a lot of time, because it is dynamic, right? And we've recommended this to you. You know, you have your list of recommendations, but the reality is what we need to know when you're coming into your appointments is what are you actually taking and how are you taking it? Because that's gonna flux. Cause we're teaching you to do that, particularly those that have been around for, you know, a long time. So providing that list to your provider of care so that as we are reviewing whatever it is, how you're feeling, maybe it's not a lab review visit that particular day, or maybe it is a lab review visit that we have that in advance, I feel like, of your appointment. So we can look at it through that lens and then talk to you about what are the things that need to happen or change lifestyle wise, what are the things that really need to change from the standpoint of your supplements, what you need to take, how much of them you need to take. Maybe it's the delivery system that needs to change, but that's a constant work in progress. You and I talked about healing phase versus maintenance phase and the flux between that too, right?

Life changes things. We get thrown curve balls sometimes. Sometimes we need to revamp that supplementation strategy for you and so never be afraid to bring that up, regardless of your healthcare provider that you're seeing. Supplementation and the strategy behind supplementation needs to be an ongoing conversation.

So lean into the information that you gleaned here today and tune in to the rest of our episodes. We would love to see you there. The Synergy Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional healthcare services, including the giving of medical advice, and no doctor patient relationship is formed. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their healthcare professionals for any such conditions.