Start Tracking Your Health Using Basic Blood Testing – EP18: Alexis Shields (Naturopathic Doctor)

In this eighteenth episode, Alexis Shields explains that blood biomarkers may be obtained directly and the results used to reduce chance of future disease occurrence, as well as remedy any subclinical symptoms. She provides a tour of some of the common biomarkers. Along the way she describes her virtual functional medicine practice.

Lee: Hello, and welcome to the show Alexis.

Alexis: Thank you for having me.

Lee: So you’re a naturopathic doctor.

Alexis: Correct.

Lee: And in Europe, I think if you say you’re a naturopath, people imagine you’re going to bring oils and candles and so forth. So maybe you could introduce any listeners to what the difference is, at least in American trained naturopathic doctors, as opposed to homeopathic and allopathic.

Alexis: Sure. So naturopathic doctors in Europe and the US are trained very differently. In the US we go to medical school, so four year medical schools, and do residencies and have a very similar kind of science evidence-based training in the beginning, or evidence-based training throughout. But it’s very heavy in the sciences in the first two years. And the last two years are more kind of training us to become primary care doctors. So whereas allopathic medicine is kind of the management and treatment of disease and more managing symptoms. Naturopathic medicine is more of the treatment of the underlying cause of disease. So why it started in the first place, and really specializing in a drug free natural approach to healing the body through using things like diet and lifestyle modifications and natural medicines, herbs, vitamins, supplements. The area that we specialize in is really restoring optimal function to the body. And then homeopathic medicine or homeopathy, is just a treatment tool. It’s a treatment tool that some allopathic and naturopathic doctors use. It’s not necessarily a branch of medicine. It’s just a treatment modality.

Alexis: All of these were words, functional medicine and holistic medicine, naturopathic medicine, they all kind of, there’s similarities and things that kind of string them together. Functional medicine also is kind of the treatment of underlying cause of disease, specializing more in a drug free approach when it’s appropriate for that particular patient, really dealing with diet and lifestyle modifications. And so there’s a lot of crossover between naturopathic and functional medicine. Functional medicine is not necessarily a, you don’t have to go to a specific medical school to become certified in functional medicine. It’s something that you become certified in after you graduate. So there’s a lot of allopathic medical doctors, for example, and osteopaths who are becoming more interested in naturopathic or functional medicine. And they go on to get kind of a separate certification in functional medicine. So a lot of naturopaths already practice functional medicine. That’s kind of what we are learning as we’re going through medical school is functional medicine and how to restore function and optimal function to the body. So it’s kind of another name for something that’s similar, the training and certifications are a little bit different.

Lee: So you are a fan of blood work. And why are you a fan of blood work?

Alexis: Blood work is really, it’s a window into the inner workings of your body. So it allows you to monitor trends over time, as you make changes to your health or as time progresses. So just by the nature of time going on your health changes, you’re getting older, your life situation changes. So, basically there are really effective, easy ways that you can monitor, year after year, what’s happening with your health. And if it’s going up, if it’s going down, if it’s staying the same, as well as monitoring things like your diet and your fitness routines and lifestyle changes, and your supplements that you’re taking or herbs, really determining how effective those things are in improving your health over time. So using blood work, you can monitor all of that and make better decisions, really make more informed evidence based decisions, and really do that with very little data.

Lee: A previous guest, Daniel Maggs, CEO of Bisu, he is bringing to market a home urinalysis device. And he’s an advocate that blood is good sometimes, and urine is good sometimes. And he makes a case that people often think that blood is a gold standard, I most certainly did, but he makes a case that in a number of cases, urine is superior.

Alexis: Yeah. And urine can be really effective, and the way that I’m using urine right now is I use it for something called the Dutch test, which gives you a lot of different information about your hormones and your stress hormones, your sex hormones, like testosterone, estrogen, progesterone, your levels of melatonin in your body, which is the sleep hormone. Different nutrients can be measured in your urine. You can measure heavy metals, for example, there’s a lot of different kind of biomarkers that you can get from urine. I’d be really interested to see and hear more about what specific type of tests that he’s using. But definitely there are times, for example, when reproductive hormones like testosterone, estrogen, progesterone, when I will recommend someone do urine over something like blood, for example, which is more of the gold standard of tests.

Alexis: But a lot of times we’re able to get more information as to kind of what the body’s doing with that hormone, not just the level of it, but how is it breaking down and how is your body producing it in different areas? How is it balancing the breakdown products, for example. That’s more of those detailed information you can get from urine rather than from blood, which is just kind of a snapshot in time. Urine’s also easier to get kind of serial measurements because with blood, it’s a lot more effort to kind of get many measurements throughout the day, for example, but with urine, you can do that easily. So there definitely is some big benefits to using urine for some tests.

Lee: And you live in Europe, and do you find it’s easy enough to get people to order their own Dutch test in Europe?

Alexis: There is a company that I just recently discovered, actually, I believe they’re called Nordic Labs. I’d have to double check on the name there, but they are taking a lot of the tests that are a little bit more easier to get when people are in the United States and making them available to European markets. And so I’m starting to be able to get access to those and get them to people throughout Europe.

Lee: In terms of what you’re doing, if I understand correctly, you are sort of like a virtual, can I call it functional medicine doctor?

Alexis: Sure. Yeah.

Lee: You do virtual consultations. So you’re mainly dealing with people who are, I would imagine, not acutely sick.

Alexis: Yes. When people, so anytime that I’m kind of working with someone, I make sure that they have a doctor in their immediate area in case they were to get sick, in case they need to get an exam, or anything that needs to be done kind of face to face with that person where they need to go into an office and actually see a doctor or a physician. I make sure that they have easy access to that. And then I can help people through different acute illnesses when they have them, but I’m not their first point of contact. So I make sure that they have that in their home area. And then I’m working with people on whether it’s chronic diseases or health optimization, or just kind of depends where the person is at.

Lee: Is it an art or is it a science?

Alexis: I think anybody in the medical or health field, there’s a little bit of both. It’s definitely, the foundation needs to be science. And when you’re veering too far from science, I think you’re going to run into problems. So I think the foundation very much has to be the science, but there is an art to working with people, to helping them to understand their data. There’s a lot of individuality in data. So for example, I have some clients that test their blood every month. And so they’re doing a lot of similar to you, they have lots and lots of data. So they’re able to track these really long-term trends. And so what we can do is figure out from a small change in their sleep routine or a supplement they’re taking, how does that affect their blood work?

Alexis: And there’s not a lot of good double blind placebo studies on that kind of thing. We don’t really know how different changes affect individual people. And so that’s where the art comes in, is figuring out then as people make changes and there’s not a lot of evidence to say exactly what’s going to happen to that person when they do this one thing, a lot of self experimentation. When that happens, there is an art to it and you got to figure out what the best way to interpret that data is based on using the science that you know, and using that art form.

Lee: With, not the last guest, which was Liz Parish. The previous was William Davis. He wrote Wheat Belly, a well known book, controversial. I was saying to him, so sorry to listeners hearing me repeat myself again. I said to him that I spent quite large sums on testing, however, I could summarize most of them simply by doing triglycerides divided by HDL. If triglycerides divided by HDL is a good value. Everything else, pretty much lined up, inflammation, cholesterol of all kinds, no damaged lipids, et cetera. So you obviously look at ratios and do you particularly favor triglyceride to HDL ratio? Because often they speak of total cholesterol to triglyceride as a ratio, but I find triglyceride over HDL better.

Alexis: Yeah. I think that’s a really good observation. If I had to pick one ratio, one lipid ratio that I’m using the most often, I think that is most-

Alexis: One lipid ratio that I’m using the most often, I think that is most predictive of what’s going on, triglyceride HDL would be a big one. When I’m talking about most predictive, I’m talking more in the realm of cardiovascular disease risk, diabetes disease risk. So if we’re looking at all the main, chronic diseases that are killing a vast majority of people, especially in the US cardiovascular disease, heart disease, and diabetes are two things that are huge. Then also it’s definitely considered a chronic disease to have elevated levels of inflammation. Inflammation can elevate for various reasons, but definitely for most of the top chronic diseases, inflammation is a component of that. So definitely triglyceride HDL ratio, I would say, correlates to those things. Yeah, I think that’s a really good observation.

Lee: Yeah. It was one that would save a lot of money because I think it’s only five euros for both. I don’t even think that.

Alexis: Yeah. It’s really cheap.

Lee: Yeah. That’s the thing I like about blood work. There’s a lot I could say, so I’ll keep this short. I categorically believe that the full power of blood work has not been realized. The good thing about blood work is it goes back decades. We’ve got lots of research, we’ve got lots of historical data. It’s super cheap. I think going forward, we’ll be able to leverage AI more and more on blood work and get a lot more from it, so you don’t need the fancy tests. As I was saying, the triglyceride over HDL is good. When people show me one and it’s like one and a half to two result in value, I’m thinking, no, you are definitely stopping in the bakers on the way to work. You can almost guarantee how much processed carbohydrates they’re eating or lack of sweating and movement going on.

Lee: But there’s so many domains I haven’t been able to look at simply because it’s not my full time job. For example, thyroid is an area I would like to look at. So I don’t know if you do thyroid, if you ask people to go for thyroid. I know earlier this year I just didn’t feel it was handling stress well on, so I had done a normal thyroid panel, but this time I asked for reverse T3. Reverse T3, yeah, it was well outside upper values of lab range. I don’t know what that means, but I’ll come to discover that in time. Maybe you have a comment on that now.

Alexis: Yeah. So with thyroid testing, oftentimes someone will come, they want me to look at the thyroid testing they’ve had done in the past, and it’s very incomplete. So we don’t really know what’s going on with their thyroid, for example, if just a TSH was tested. Your thyroid is a whole cascade of hormones. It starts with your brain telling your thyroid what to make. Thyroid is a butterfly shaped organ that’s in your neck. It’s a gland that secretes hormones that then affect every cell in your body. So basically, you want to test your thyroid at different points. You want to know, is the brain telling the thyroid to do what it needs to do? Is the thyroid then able to produce what it needs to produce? Then do those hormones get activated in a way that they can adequately and optimally affect all of the cells in your body? Your thyroid’s like the engine of your body.

Alexis: So you have to look at all the different pieces of that engine to figure out, are they all optimal? If they’re not, where is the missing link? Where is the problem occurring? Because it’s not always just one. It’s not always just a thyroid issue. It could be an issue of not having enough minerals to convert the free T4 to free T3, for example. Free T3 is a test that not oftentimes is added to a full, complete thyroid panel. I think it’s really important because it’s one of the end of the line hormones that does a lot of biological work on the cells in your body. So having, for example, low iodine, low selenium, magnesium, zinc, having low mineral status in general or intaking not enough minerals or eating food that is not grown in soil that’s rich in minerals, that can make it so that you are unable to convert to the most active form of thyroid. It can make you have all the same symptoms of hypothyroidism, but have a normal appearing thyroid test, if only TSH was tested or free T4, for example. Reverse-

Lee: I test TSH, free T4, free T3, and consistently for your interest, for years since I’ve been testing and I test frequently. My free T4 is always just an edge of maximum, TSH fine, T3 fine or medium, but the T4 is always on the upper bound consistently. I never tested the reverse T3 before. As I say, it’s off the lab range on the high end.

Alexis: Yeah. So reverse T3, there’s the core tests, the TSH, free T3, free T4, then there’s some other additional tests that I think are really helpful, especially when you’re assessing someone’s thyroid for the first time or they’re having problems that we think might be a thyroid issue. One of them is reverse T3. Reverse T3, you can think of it as the stop sign that stops some of the active hormones. So it might look like you have enough active hormone, but if your reverse T3 is really high, then it’s blocking that hormone from being able to do the work on the body that it needs to do. So if you have a lot of reverse T3, usually to me what that means is that you could be having a lot of hypothyroidism symptoms or symptoms of hypothyroidism, but have normal appearing test.

Alexis: The problem isn’t minerals, it’s not actual thyroid producing the hormone. It’s not your brain telling the thyroid what to do. The problem is more of a stress issue and a stress management issue. So that’s where you might look at your ability to handle and deal with stress, for example, which there’s some other tests and basic blood work that can indicate that. So it points you towards an area that could be a problem that’s in the downstream affecting your thyroid function. Because if your body is under a lot of stress, then your thyroid will down-regulate itself so that your body doesn’t operate at a really high capacity. It’s trying to slow you down a little bit. You can imagine it in that way. Your body’s under a lot of stress, it needs to down-regulate a little bit to preserve energy and the function of the more critical organs in the body.

Alexis: The other couple of tests that I think are important for people to do once a year, for example, are two antibodies that are related to Hashimoto’s disease, which causes hypothyroidism. So Hashimoto’s is a autoimmune disease that would, for example, if someone has thyroid issues that look like hypothyroidism, the next thing you want to know is it caused by an autoimmune disease or is it not caused by an autoimmune disease? Because the treatments are a little bit different from a functional medicine standpoint. From a functional medicine standpoint, if you have elevated thyroid antibodies like thyroid peroxidase antibodies and thyroglobulin antibodies, that would indicate that there’s an immune system component to the cause of the thyroid.

Alexis: Because in naturopathic medicine, we’re looking for the underlying cause of disease, it’s really important to know if there’s an autoimmune component going on because there’s different natural treatments, different diet decisions, different fitness decisions, lifestyle decisions that you would make if you have an underlying autoimmune disease, even if the conventional treatment for it doesn’t really change. For example, if you have Hashimoto’s versus just hypothyroidism that isn’t autoimmune related, the medication protocol would be exactly the same, but from a functional medicine standpoint, it’s really important information.

Lee: I did those tests and indicated it wasn’t autoimmune, so I’m quite satisfied it was stress. By the way, found ashwagandha helped.

Alexis: Very helpful. Yeah.

Lee: And rosalia rodalea (sic rhodiola rosea), I think it’s how you pronounce it.

Alexis: Yeah. Ashwagandha is super powerful herb. It’s something that helps. The thing that I really like about ashwagandha is that it is adaptogenic, meaning that it helps … Herbs have different components because there are plants, they work at different than drugs. They don’t just have one singular action that have been isolated in a lab. Herbs, because there are whole plants, some of them especially tend to modulate things when they’re overactive and modulate them when they’re underactive. So ashwagandha can do this. There’s a lot of other herbs that do this as well, but helps your body to achieve optimal normal function by up-regulating or down-regulating things when it needs to, by helping your body to create that homeostasis or that balance.

Lee: Yeah. Do you think you maintain homeostasis better when you give yourself hormetic challenges? Because it’s my belief that you do maintain a stronger homeostasis when you give yourself hermetic challenges. So you do follow that?

Alexis: Yeah, yeah, for sure.

Lee: I don’t know. It seems to be the case. I notice when I look at my tests, another consistent pattern I notice is the lymphocytes [sic leukocytes] are always low and the neutrophils are always high.

Alexis: Mm-hmm (affirmative).

Lee: MCH, the mean corpuscular hemoglobin, is always high, but the main pattern is the lymphocytes [sic leukocytes] are always low, the neutrophils are always high, and it’s been like that five years.

Alexis: So it’s really hard to say because, basically that’s a pattern that you want to identify. What we need to know is, is that a pattern that’s normal for you? So it depends on how high and how low because within a certain margin of error, I do see that people have outside of what the optimal reference ranges for that particular lab test. It might outside of-

Lee: It’s just off the edge of each end.

Alexis: Just off the edge.

Lee: So lymphocytes [sic leukocytes] are just off the edge on the left and the neutrophils are always just off the edge on the right.

Alexis: Yeah. So what you might be seeing there is an individual reference range for you that’s optimal for you. So if it’s not way outside of the range, it could be that your levels are normal within that range. There’s not necessarily a problem to be investigated when you’re seeing that. So it’s really hard to say. You also have to look at all the other blood tests surrounding that and see if there could be something that could be explaining that difference in the reference range compared to your level. I use this tool called the bloodsmart prediction tool, health prediction tool. So it basically is machine learning algorithm that has a database of tons of people. Basically, you take your blood work, compare it to this huge database of people.

Alexis: It basically helps to pull out patterns that are similar in your blood work to other people and make predictions based on those. So that would be an interesting thing to run your data on because it could maybe pull out some patterns of underlying issues that we hadn’t really thought of, whether it’s a nutrient issue or a hormone issue or heavy metal issue, or an issue with toxicity in general, or the way that your organ systems function that help with detoxification like your liver and your kidneys. Using machine learning algorithms in that sense are really helpful because we might be looking at that and say, “We might be just seeing an individual pattern for you,” but then when we run it through the machine learning algorithm, when we’re comparing your data to 100,000 people, for example, it might be able to pull out some things that we can’t necessarily know just looking at blood work patterns.

Lee: You mean bloodsmart.ai?

Alexis: Yes.

Lee: It used to be called Blood Calculator. Yeah. So Chris Kelly. I had Dr Tommy Wood on the show him a long time ago and I loved that tool. So I take it you offer that to clients also because it’s quite expensive if you’re not a practitioner.

Alexis: Right. So that’s included in part of my first consult with somebody when I-

Lee: Oh, that’s really nice. It’s really nice to add that on.

Alexis: Super useful. It’s really useful. I think it also gives you your five-year wellness score, which is a tool that bloodsmart didn’t develop, but it’s from a highly adapted tool in scientific research that gives you a score on a level from zero to 100. It gives you a numerical value that you can really use to track over time, how is your overall health progressing in a numerical value? So that’s really helpful. It also gives you a biological age. So by looking at your blood work it without knowing your age, it actually makes a prediction of what it thinks your age is, which is also a really useful tool.

Lee: Yeah. So I find I’ve ran the … Again, I spend money I shouldn’t have spent testing myself and other people and running reports. It seems silly when I don’t have my own practice. You’re just paying for tests for those around you and yourself. I do have a backstory on it. I won’t go into, but basically I just fell in love with playing with health data. I found that tool to be very good. I remember it said I most likely have heavy metals and mercury in particular. I used to have amalgams – four.

Alexis: Interesting.

Lee: Then I got them removed instantly in ways I wouldn’t do nowadays, by an ordinary dentist, shall we say, who didn’t have any care about gases and so on. But I also had them in for a couple of decades and then I did blood testing for mercury.

Lee: I was stupid. I didn’t realize it’s only going to show acute exposure in blood before it’s cells and soft tissue. So I wasn’t sure how to check for in soft tissue like your brain. I’m not sure you can. I don’t know. Then when it came to detox, there are so many protocols and possible ways to chelate it, I just didn’t. I just started going to infrared a lot in the week. Then now with corona, nowhere is open.

Lee: So, yeah, that was top of the list. Also predicted I had had cryptosporidium at some point, and that’s true. 15 years ago, I did catch that from a swimming pool, but it’s amazing how a machine learning platform detected that I’d had a cryptosporidium infection. So fascinating stuff, but that if you go to bloodsmart.ai now, you’ve only got a subscribe, there’s no graphics or anything. So I’m not sure how it’s getting marketed at the moment.

Alexis: That information is an incredible tool, but it really is something that a professional should guide you through that data, because the interpretations that you make on that data, it takes training in how to look at blood work and identify disease and take that person’s blood work and make it real by knowing the person’s health history and diet and lifestyle. So many other factors inform that information that I think it’s better suited to have that information and have a professional, have a physician, have someone that’s really trained in looking at blood work from the optimal health perspective and having them interpret that data for you. So I think it’s an incredible tool, but it really is exponentially more useful when you can have someone accurately go through the information to explain what it means. So I think a lot of who that tool is for is health professionals.

Lee: Okay. I have jumped ahead quite a lot, so I wish to make it clear that you do virtual, what I call functional medicine, consulting. You typically take on, I guess, entrepreneurs, executives – as a presumption?

Alexis: Yeah. Typically, yeah. I’m usually working with a busy professional who really wants to improve and optimize their health using their basic blood work data or just their health data, their biomarkers in general, and to use that data to make more informed decisions about their health choices, such as diet and fitness routine supplements and the like. I’m doing virtual consulting with that crowd and others as well. I have a really varied client base. They’re all across the world. Actually I forget what my country count is up to now, but I see people from all over, which is great because it really is a challenge for me to figure out how do I support someone who is from all over the world and has totally different resources available to them? So it’s really helped me to create labs that people are using all over the world, resources, places to get supplements, places to get good quality food, and finding what those resources are across the globe.

Lee: So for the States, are you asking people as part of your onboarding to go to Quest or LabCorp and take biomarkers?

Alexis: In general, the cheapest way to pay for a really comprehensive blood work panel in the US is to have me order it through a lab wholesaler that goes through LabCorp. So typically I’m sending people who are working with me who have access to LabCorp to LabCorp to get their blood tests done. Then the results come directly to me. That makes it the most inexpensive. There’s also different resources online where you can order your own blood work. It’s a little bit more expensive, but still really affordable for basic testing where you can use Lab or Quest. Then also you can take the list. I’ve had a lot of clients who just take the list of blood work to their local physician and have them do as much of it as they’re able to do and maybe even use insurance. So it just depends on what the person’s situation is. I would say the easiest way to do it is just to have me order it for you, go to LabCorp, get it done, and it’s pretty affordable.

Lee: What happens in Portugal? Do you have clients in Portugal?

Alexis: I have a few, but most of my clients in Europe are in Italy and Spain, a few in France, and majority of them in the UK. So I have a list of labs basically, depending on where you live. If you’re in or near a major city within Europe, I generally have a good lab to send people to. Then I have a few, like in the UK, for example, there’s a particular lab company that is throughout all of UK. So I’ll have them go to one of those, basically. It hasn’t really been an issue for people to actually find blood testing. The only place I have maybe a few issues is in Australia where there’s not a lot of direct to consumer blood testing, but everywhere else there pretty much is.

Lee: So to mention a couple of tests here. So it seems nowadays iron is frowned upon. Let’s just say it’s not conducive to longevity, particularly in men. So when it comes to iron testing, can you distinguish between iron and ferritin?

Alexis: So basically, iron is very influenced by what you just ate. So if you’re looking at serum iron in the blood, there are some tests, for example, that are highly influenced by what you just ate. Some that are more long-term markers. Serum iron is more of a short term marker, so it is influenced by how much iron you’ve had in your recent meals. Ferritin is more of a measurement of iron storage, so how much iron you have stored up in your body for future use. So you can think of serum iron as a snapshot in time of what your iron status is at that moment. Ferritin is how much iron is stored up in your body for future use of making red blood cells, for example. The reason why iron gets a bad rep is iron is very necessary for men and women in certain amounts to create healthy red blood cells, which help to deliver oxygen throughout your body and your brain.

Alexis: So extremely essential nutrient. If you have low iron, you’re going to be in lots of trouble in terms of health related issues, especially energy and brain function and athletic performance. There’s a huge list. When iron is too high, it’s extremely inflammatory. For women, because of monthly menstrual cycles, we have a method for getting rid of iron that is maybe at too high of a level that would otherwise cause inflammation. For men, you don’t have that same monthly cycle where you get rid of red blood cells. So it’s more common, although it can happen in women too, but it’s more common for iron to build up into really high, dangerous levels in men, because at a certain point, that iron can build up and you can think of it almost in rust, rust that grows on a nail, for example. It basically cause rusting of your pipes or it can cause damage in your blood vessels, creates high levels of inflammation like C-reactive protein. It is just highly inflammatory, can lead to liver disease for example.

Alexis: And it is just highly inflammatory and can lead to liver disease, for example.

Lee: So do you think it’s a great idea adding iron shavings to breakfast cereals to fortify them?

Alexis: You know, a lot of those breakfast cereals, I wouldn’t recommend people eat anyway, but I don’t necessarily think it’s a great idea. Depends on where those cereals are being eaten. If it’s in an area of the world where the iron levels are extremely low due to malnutrition and that breakfast cereal is something that’s used to help bring up iron, then that’s a totally different situation. But in someone who has access to good quality food and has access to food that are high in iron, like animal proteins, for example, it’s not a good idea to eat a lot of fortified foods with iron because that can contribute to creating more inflammation and building up your iron levels, especially in men.

Lee: When it comes … the big issue we will need to bring up is cholesterol. It’s top of most people’s minds when it comes to health testing. My own is, it’s of the order in US units … Let’s look here, it’s 260 [mg/dL = 6.72 mmol/L].

Alexis: Okay.

Lee: So say about 6.9 in the rest of the world type units. That’s total, sorry. That’s LDL. And I am not overly concerned because I’ve done high resolution analysis. I’ve done LIPOPRINT. I know people do NMR. I think I heard you somewhere mention VAP by Atherotech Incorporated, which is a high resolution. So I had mine looked at many times and it was pattern A. You know, it didn’t have small, dense LDL. But if I changed and started eating breads and processed food, it did change to pattern B. So as part of your onboarding, you don’t normally do that high resolution because of the expense I would presume?

Alexis: Correct. I don’t. If someone comes to me and they already have it, that’s great. I don’t necessarily even recommend it for everyone. It kind of depends on what their cholesterol picture is telling me, what their inflammation markers look like, what their blood sugar markers look like. And if there’s kind of questions that I have, that I can’t answer with that basic data that’s really inexpensive then I might take it one step further and recommend it for that subset of people. But it can be really helpful just to see what pattern you have. And if that pattern is more inflammatory, then we would want to be more aggressive in what we were doing to lower those levels if it was needed, more or less aggressive. And so it can, it can definitely inform the picture, but I think there’s a lot of information that you can get before having to do the specialized tests.

Lee: I presume you don’t consider LDL a predictor in itself of heart disease.

Alexis: No, the research doesn’t really support total cholesterol by itself or LDL by itself as really predicting much of anything very consistently. And so you really have to look. Cholesterol is a necessary and crucial, crucial thing to have in your body to create hormones and repair cells. And to build all the cells of your body. It’s crucial to have an adequate level of cholesterol, just like it is crucial to have an adequate level of iron, but when the levels become too high, that’s when we’re wondering are you at increased risk for atherosclerosis or cardiovascular disease? Stroke? And the only way to really know those things is to look at the whole picture. One marker isn’t really going to tell you anything because sometimes that could completely steer you wrong. Just looking at a high LDL, for example, or even at just a high total cholesterol. You really have to look at the ratios. You have to look at …

Alexis: It’s really nice to have two markers that are not just calculations. They’re actually actual protein measurements, the apolipoprotein B (ApoB) and Lp(a). Those are two that are really nice to have because they translate more to cardiovascular risk, just looking at them by themselves than looking at some of the cholesterol markers. Lp(a) is also highly genetically driven. So that can give you an idea about your kind of genetics of the picture, which is also something you have to consider when looking at total cardiovascular risk. So it’s really that’s the, I would say the dangers of people testing and looking at one measurement and making an assumption about what that means about their health. That, or just Googling, for example, let’s say you do a test on yourself because you want to be proactive. You want to figure out what your cholesterol and your cardiovascular risk is.

Alexis: Maybe you have family history of cardiovascular disease, and it comes back where you have an LDL of 180 or 190. So you Google that and it tells you, oh that means you could have, you could die from a stroke because it’s always the worst case scenario when you Google it. That’s kind of a scary thing because you’re not looking at the whole picture and it might be that when we look at the whole picture of what that cholesterol means in context, it’s actually a very good cardiovascular risk profile. So it’s something that’s a little bit more complex that has to be weeded through.

Lee: Well, I have the belief that may or may not be supported by data, I’m still pondering this one. I certainly have collected enough to do some correlation, but I am of the belief we’ll call it that … Okay. So another fact I’ve never had a testosterone measurement that was not off the charts high. I’m 44 years old and I have more than double people who I’ve went to lab with in their twenties. I don’t know if that’s a bad thing to be that high, but I believe it very much correlates with LDL. With a high LDL, I believe that the testosterone is higher.

Alexis: I actually have seen that pattern, especially in the opposite. So when someone has a really low cholesterol, oftentimes that really their testosterone takes a hit. So from looking at that, you can also assume that if their cholesterol was super high, that some people would then use that cholesterol to create extra sex hormones. Whether that’s genetically driven or something that’s individual to you, based on your lifestyle, if you’re someone who does a lot of like heavy lifting and weights and eats a high protein diet and has adequate levels of sleep and sunshine. Those people tend to create more testosterone than the average person. And so if all of those kind of factors including genetics are right then high levels of cholesterol in general could then translate to higher sex hormones.

Lee: I think that cholesterol, higher levels of cholesterol are related to anti viral properties, but I’m not versed in that in the least.

Alexis: There are, there’s definitely some research that it’s kind of all across. It’s kind of all over the board, but cholesterol definitely impacts your ability to, I would say, balance your immune system. And so absolutely either low or high cholesterol can impact the way that your immune system functions.

Lee: I’ve also heard that cholesterol is anti-inflammatory, I’m not quite sure what was meant by that. But I’ve been told that it’s acting in a good way to de-flame. I have no idea of the physiology.

Alexis: So cholesterol, you can kind of imagine it as the duct tape of the body, it floats around. It repairs damage. It builds cells. So in a sense, it is very anti-inflammatory to a point. For example, HDL cholesterol is a type of cholesterol that helps to remove cholesterol from the extremities or out basically from the liver and bring it back to the liver to be processed and eliminated by the body. And so HDL cholesterol is something that we consider it the good cholesterol, although there is good and bad HDL cholesterol, the same with LDL. HDL cholesterol can be pro-inflammatory or anti-inflammatory, it kind of goes into the pro-inflammatory stages, meaning that it increases inflammation once HDL is 70 and above. It doesn’t mean that if you have an HDL that’s very high that it’s causing inflammation, but there is … What we see in research is there are patterns of people with HDL cholesterol higher than 70 that can relate to inflammation or be a prooxidant at too high of levels. And so it can elevate and things like autoimmune disease and different diseases that are from immune system dysregulation.

Lee: Years ago, when I looked at cholesterol, I came to the conclusion LDL is bad when it’s bad, good when it’s good. HDL is good when it’s good and bad when it’s bad. And it was kind of, this really doesn’t help explain that when people want a much more simplified model.

Alexis: Right, yeah. You really, you got to look at all the pieces as like … Cholesterol, especially is one that is a puzzle and you have to put all of the pieces together and look at them all together and then make an assumption about cardiovascular risk from all the pieces.

Lee:  So when it comes to adrenal testing, I don’t think I’ve done adrenal testing. And because I mentioned, I think I have what I’ll call stress issues. Remember earlier I mentioned I have reverse T3, then I would like to do adrenal testing. And I think that there’s talk of, I don’t know how it works, but sodium divided by potassium somehow gives some kind of measure of body stress.

Alexis: Yeah. So really a better way to look at it is if your sodium levels are on the low end of normal or low, and if your potassium levels are on the high end. When your sodium is really low and your potassium is really high, that pattern is a common pattern that will show up when someone has adrenal dysfunction. And I’m not talking about adrenal disease or any diseases that happen when the adrenal tissue is physically diseased. I’m talking more of a dysfunctional issue with the way that your body deals and handles with stress and it produces the stress hormone cortisol. So this is one of those scenarios when, and I know when you were mentioning the, I forget the name of the person that’s creating the…

Lee: Daniel Maggs. bisu.

Alexis: And I know now what you were referring to is the different types of testing, but this is one of these scenarios when urine testing is really helpful because you can’t really look at the kind of function of the adrenal gland in blood very easily.

Alexis: You’re really screening for disease with it, like doing a cortisol test for example. That can be a little bit of a screening tool, but it’s almost never done just one singular cortisol test in conventional medicine because it doesn’t really tell you much. And sometimes it’ll show up a little bit high if someone’s under big amounts of, large amounts of stress. But it doesn’t really give you that much information. It’s much easier to figure out the health of your adrenal gland from a functional medicine perspective, looking at urine output of some of the adrenal stress hormones and how that changes throughout the day. Because it should be highest in the morning when you wake up and then it gradually goes down.

Lee: So we’re back to the DUTCH test?

Alexis: Exactly. So the DUTCH test is super helpful for that. There’s other functional labs that do urine testing, or you can do saliva testing as well with adrenal dysfunction detecting kind of some causes of, or the adrenal cortisol patterns throughout the day.

Alexis: And so one kind of screening tool that I’ll use is I’ll look to see is the person’s sodium on the low end, their blood sodium and the potassium really on the high end, high normal, or even higher than the lab report range? And if it is, then that and they have symptoms that support and other blood tests that support stress hormone being kind of dysregulated, then that would make me kind of go down that pathway of, do we need to do further testing and look at the actual output to see what the adrenals are doing? Or can we treat based on the symptoms? Because the picture is pretty clear.

Lee: I think that the pH of blood is more tightly controlled in urine. So urine, how could I put it, is better to show if you’re alkaline or acidic. If I understand correctly.

the research doesn’t really support total cholesterol by itself or LDL by itself as really predicting much of anything very consistently
Alexis Shields

Alexis: Somewhat. Urine testing of pH is really tricky because you’re correct when you say that pH of blood is definitely more tightly regulated. Absolutely. Because your body really wants your body pH to be in a certain, your blood pH to be in a certain level so that different biological processes can happen at their optimal, in their optimal way. With urine pH there’s a lot of things that can throw it off. And so it’s depending on the person, how regulated they are when they do the testing and how in general, I don’t use a lot of urine pH strips to really tell you about much.

Alexis: I did actually for a period of time when I first started practicing and getting into a lot of this and testing it out and I didn’t find it to be very consistent, I didn’t find it to tell me that much information that I couldn’t find from looking at blood work. And so I don’t really do it anymore, not to say that some people don’t find benefit from it, but I just didn’t find a lot of consistency in it. Even though testing your urine does tell you, you do get a pH level for sure. It’s just, I don’t know that it gives you that much information.

Lee: I’ll jump back a touch. When it comes to cholesterol, often people think that it’s dietary cholesterol that puts up their blood cholesterol. So maybe you could just clarify that before I speak about electrolytes and blood levels.

Alexis: Sure. So dietary cholesterol only affects your cholesterol output by let’s say around 20%, it could be a little bit less or a little bit more, but the majority of the cholesterol that your body is producing you make, your liver actually makes, your body makes. And so what you’re looking at in blood cholesterol is for the majority of it, is what your body is producing, not really what you’re eating. Which is why some people can, for example, I’ve had a lot of people experiment in terms of how they eat and how it affects their cholesterol. And I’ve had people who, for example, ate lots and lots of eggs and eggs contain a lot of dietary cholesterol. It’s one of the foods that people avoid when they need to lower their cholesterol or they’ve been told they need to avoid. And I’ve had people do that and their dietary cholesterol actually goes down.

Alexis: So some people, and this is also very genetically driven for some people, their dietary cholesterol will go down or sorry, their blood cholesterol will go down when their dietary cholesterol goes up. And so what’s happening there is your body downregulates the amount it produces because you’re eating enough. And so usually your dietary cholesterol doesn’t affect your body’s cholesterol that much, unless you’re eating massive amounts or you have specific genetic profile that makes you really sensitive to certain types of cholesterol or fats. Sometimes that can influence your cholesterol. But that’s really, I would say more rare. I would say 80% of people generally don’t have to worry about the cholesterol that they’re eating. As long as it’s cholesterol from healthy foods like eggs, healthy animal proteins in general, that is something that supports healthy cholesterol, not hinders it.

Lee: And so I went to buy double cream the other day. And I asked for four and the lady there, I’m not joking. Maybe it’s funny cultural differences because I find here where I am at the moment, Slovenia. Sometimes people refuse to sell you something if they don’t think it’s appropriate. For example, ordering food, they don’t think you should have ketchup on it, they won’t actually give you the ketchup because they’ve decided, I don’t know. I’ve never managed to get my head around it. So, it’s just like this sort of like, I’m the customer, I’m always right. How can you be telling me how to consume something and refusing to sell? But often when I go to her, because she has the best sweet cream, nice local. But she’ll refuse to sell me more than two some days, because she’ll say she doesn’t want me to have a heart attack because her husband had one.

Lee: And so there’s this, I’ll say myth that cholesterol causes heart attacks. And yeah, I’m quite sure her husband has tried to cut cholesterol down, but has not paid attention to sugar. And I would certainly believe it’s the sugar items which are the driver of heart disease, not traditional fat and cholesterol.

Alexis: Absolutely. I mean, most of the research that you see when you really look to see what the data supports, just as many people have heart attacks with low cholesterol as have high. And so cholesterol is clearly not the only thing that we’re looking at here. And it’s not that it’s not important. I think a lot of people hear that and then they think, oh, it’s not important at all. It definitely is a piece to the puzzle and different people respond to their diet in different ways. And so that’s why it’s important for you to figure out kind of what your individual responses are to the diet choices that you make to know whether it’s supporting healthy cholesterol or not supporting healthy cholesterol, or if there’s some change that you need to make to continue to support it. But you know, it’s really, it’s a tricky thing because a lot of the … I’m sorry, I completely forgot my train of thought.

Lee: Cholesterol is a tricky thing. And the lady at the shop had been refusing to sell me too much sweet cream.

Alexis: Oh right, right. Right. Sorry. Completely forgot my train of thought. So really what we’re looking at here is people who are eating lots of sugar, not moving. Lots of processed foods, or foods that are not rich in the vitamins and minerals that they need. And it’s a lot more of a blood sugar issue than anything. When we’re looking at someone’s cardiovascular risk and we’re looking at their inflammation levels, which is highly influenced by body weight. Because for someone who’s obese, for example, that creates … someone can have high inflammatory markers just from that alone, just from carrying extra body weight, especially in the abdominal region and blood sugar markers, also a big component of calculating risk. Cholesterol, also a component, but I think those other two are definitely weighted a little bit stronger when we’re looking at cardiovascular risk and stroke.

Lee: Yeah. I won’t guess at the moment as to why an industry focuses on them. So jumping back to where we were. So when it comes to electrolytes and minerals, so sodium, potassium, calcium, phosphorus, these do not relate to our diet either from my understanding. So if you’ve got high sodium, it might just be that you’re dehydrated. It’s not that you’ve had too much salt and the same with potassium and calcium. So if you eat more cheese and milk, your calcium blood levels don’t typically rise.

Alexis: Somewhat. It’s a little bit tricky, because this is also a little bit individual in terms of how someone responds when they take, for example, a calcium supplement or they increase their calcium in their diet. Calcium and magnesium are two that tend to move a little bit with diet, but sodium, potassium, chloride, bicarb, those which are used to calculate something called the anion gap that tells you about, which is like a calculation of pH in the body. Those measurements are tightly regulated because your body really wants to control the pH of the blood. It wants to be between 7.35 and 7.45. There’s a very tight control. And so it will do whatever it needs to do to kind of keep the body within that range. And so dietary sodium maybe can impact it if you’re eating tons and tons of sodium or you’ve just run a marathon you’re really dehydrated or you’ve been sweating a ton because you’re been outside and exercising a lot.

Alexis: So those kinds of more severe or those things that are a little bit more on the severe side of things can affect those electrolyte calculations. But in terms of just the average amount of calcium that you’re getting in your diet, affecting the pH of your body, that much in terms of that pH calculation, it doesn’t really affect it that much. But I have seen that when someone’s really deficient in electrolytes, they’re not eating enough minerals, that can affect it over time by in small amounts.

Lee: And calcium, I think is one of these what I’ll call nasty supplements along with iron. I mean, it seems to have changed days. I mean, I think that most people do not and should not supplement with calcium.

When your sodium is really low and your potassium is really high, that pattern is a common pattern that will show up when someone has adrenal dysfunction.
Alexis Shields

Alexis: It’s true up unto a certain point. I would say the average healthy person should not be taking lots of calcium. Calcium is a really abundant mineral in food. And so if you’re eating a healthy diet, which is where you should be getting most of your minerals, not supplements, that’s going to be sufficient in terms of calcium levels. If you have a little bit of dairy, even, that will increase your calcium even that much more. A lot of dairy can sometimes be harmful because it throws off the balance of calcium and phosphorus. So with calcium and making sure that when you look at your blood test, basically, and you’re looking at your calcium level, if it’s really, really low and you are someone that has osteoporosis or osteopenia, and you’re worried about your bone health, you just broke a bone or just had a fracture. You’re an athlete. You know, there’s different groups of people that maybe would want to take a little bit of calcium here and there, but it’s generally just taking a ton of calcium and nothing-

Alexis: It’s generally, just taking a ton of calcium and nothing else and not making any changes to your diet, it’s not generally a good idea.

Lee: There are many people claiming that an acidic body is more of a breeding ground for disease like certain cancers. So, do you agree it’s better to swing towards a more alkaline body? Or is this just hearsay?

Alexis: I think it needs to be balanced. The thing with pH and the reason why it’s important, is that it’s one piece of so many different factors that contribute to health. So, it’s only one piece, I wouldn’t say it’s a huge predictor. But, in general, people who have a more balanced pH and are not extremely acidic or extremely alkaline, tend to have more optimal function in health. And the reason why is because enzymes, so enzyme in your body does work, it creates energy in your body, it does some kind of a function for your body, some kind of a work function. Enzymes, the way that they function optimally is at certain pHs in the body. And so, if your body’s pH is off, then your enzymes aren’t going to work as optimally as they should, which means your body’s not going to create energy as well as it should. It’s not going to do work as well as it should.

Alexis: So, I think when you’re looking at it from a larger perspective, pH affects the way that your body’s biological processes happen. And there’s many things that affect that, not just pH of your body, but there’s many, many things, including what you eat, and your stress level, and how you sleep, and how much sunshine you get, and how you breathe, and a lot of those things affect all of this. It’s very multifactorial. But definitely, having a good, healthy pH, and not being too acidic or too alkaline, generally comes down to what you eat, how you sleep, how stressed you are, and the nutrient makeup of what you’re eating. So, if you’re eating lots and lots of sugar, that, in general, makes you more acidic. If you’re eating lots of leafy greens and colorful food, that helps to give you lots of minerals and that helps to balance your pH. So, it’s very multifactorial, but it’s an important piece.

Lee: So, do you think most people should supplement with potassium and possibly bicarbonate?

Alexis: Most people, no, but definitely there are a group of people that benefit from that, for sure. I’m really not a… I’m not someone that likes everyone to be on a multivitamin. For example, I really like to make those decisions individually, based on the person, and they change over time. So what one person might need, maybe they need some potassium that month, the next month, or the next three months, or six months down the line, they might not need it anymore. And so, I think if, for the most part, if you’re using supplements appropriately, you shouldn’t need them forever. There’s some exceptions. There’s some exceptions because people have certain chronic disease, or they’re on a medication that depletes that mineral or vitamin. So, there are definitely exceptions, but for the average healthy person, just taking a multivitamin, I would say, oftentimes, is not necessary. It’s better to look at what you need at that time, and make your diet adjust to what is needed. Or if a little bit extra is needed to help move things forward a little quicker, then supplements come into play then.

Lee: When it comes to magnesium, I’ve persistently had low magnesium, and I mean significantly low, years ago. Now it’s magnesium RBC shows low. And I can take a gram and a half per day, divided into, say, four doses. And I can mix the bindings all day long, and put on transdermal magnesium. And my magnesium RBC, intracellular, it doesn’t raise. You got any thoughts on the inability there to get magnesium to go above low?

Alexis: I’d be wondering if there’s a genetic reason for that. I’ve definitely seen some people that no matter what we do nutrient wise, we’re trying to get, whether it’s their magnesium or something like glutathione, and we’re trying to build those up and it just won’t build no matter what we do. So in those instances, a lot of times genetics come into play. It might also be that there’s another nutrient that is needed to help the magnesium to get intracellular, for example, so that it can be detected when you do the RBC magnesium test.

Alexis: It could be that your needs for magnesium, for whatever reason, are just much higher than the average person and so the dosages that you need are also much higher than the average person. It’s kind of… It’s a matter of doing that, and a lot of experimenting, like it sounds you’ve done with different forms, and types, and dosages, and routes like transdermal and that kind of thing. So that, it’s tricky, but I think it possibly could be indicating there’s some genetics there and there’s just some more experimenting that might be helpful or possibly another nutrient that would be helpful too when paired with magnesium to help it be integrated into the cell.

Lee: I’m going to try magnesium water, that William Davis spoke of, and maybe one day a magnesium IV. I see the time we have, I’ve just got a couple more directions to look at. Actually I have a lot more questions, but I see, we simply don’t have time so I’ll need to begin wrapping things up. When it comes to blood sugar. I used to have a low blood, fast blood sugar. I can dig you out exact values actually. So if I just say low, but then I did a five day fast. This is going to sound a crazy story, I think. I did a five day fast at the end of the five day fast, my fasting blood sugar was much higher every morning, thereafter that five day fast. I assumed it would go away, and month after month, it didn’t. It persisted to be high.

Lee: And then I left it over a year thinking it’ll go back down. And then one night I got drunk. First time in over a year, I drank nine glasses of red wine. And when I woke up, it was back down again. Then it stayed down for a few months, slowly began to rise. Then I did another five day fast. And at the end of that five day fast, the fasting blood sugar was even higher than ever. And it was 6.3, which is 113 and I was alarmed. Now it gets even crazier. So then I’m like, I was cooking a lunch to break the five day fast. And when I saw a 6.3, I thought, “Oh my God.” And I went running instead. And when I came back and measured, it was still 6.3 and it didn’t matter what I was eating nor exercising. The fasting blood sugar was stuck at 6.3, that’s 113. And I even decided to meter must be broken, like it’s impossible. And I got an identical meter and it was 6.3 and that persisted for a while.

Lee: And I came across ‘physiological insulin resistance’, like the muscles adapt [to spare glucose for the brain], but I can’t understand why the sugar would remain high and even exercise or even food didn’t alter it. That just seemed… And after that, I sort of gave up on sugars because I just understood I didn’t understand enough. And maybe people don’t understand enough. Because for example, often people check your fasting blood sugar, but it could be low, but that could be mean you’re in late stage diabetes when it goes low. It rises and then it’ll invert with insulin, it’ll crash back down again, it could mean you’re in late, late stage, a low fasting blood sugar doesn’t mean you don’t have insulin resistance.

Alexis: Right. So, yeah, it’s a really interesting pattern. And following fasting glucose can take you on a wild ride. I’ve gone, definitely people that do continuous glucose monitoring, I’ve worked with a lot of clients who are using that. And so looking at things very closely and what’s happening to glucose, and I think what’s happening in that situation. You need to inform what’s happening there with a few other tests, for example, looking at your insulin levels and your hemoglobin A1c and your triglycerides. Because when you’re fasting, a lot of times, glucose will go up during a fast and after a fast, because your insulin levels go down. And so there’s this temporary change that happens in your body as you need less insulin, as your cells become more insulin sensitive, your glucose actually goes up for a period of time, which makes it look like things are worse, but actually it’s a sign that there’s some insulin resistance and your body’s repairing, or it’s just a function of doing a fast.

Alexis: And so it really, when you’re trying to make sense of fasting glucose, and it doesn’t make sense, that usually means you need a little bit more information. And the key markers that I look at are fasting glucose, hemoglobin, A1c, triglycerides, fasting insulin. I calculate the HOMA-IR score, which is like an insulin resistance score from some of the tests that I just mentioned. And occasionally I’ll look at IGF-1. So there are this group of tests that I think when you have more data points, it kind of more accurately gives you an idea of what’s happening. Is it that your body’s just becoming more sensitive to insulin and that’s throwing off your glucose for a period of time. If it’s staying elevated for long time, like it sounds like it did for you. There may have been some insulin sensitivity issues that needed to work themselves out. And so the fact that it was high may not have been a bad thing, even though it looked like it was, or the fact that it was low may not have been a bad thing.

Alexis: The other thing with glucose is things like melatonin can influence glucose. And I notice a lot of people who don’t sleep very well, who don’t have good sound, sleep cycles, who maybe don’t produce enough melatonin as you get older, you also tend to produce less and less melatonin, that can affect glucose in different ways. And so some people will just show up to have a high fasting glucose all the time, but all their other blood sugar markers look normal, sometimes that can indicate a sleep issue actually and a need for more melatonin. So it’s really, there’s a lot of different things that are coming to mind as you’re kind of describing that scenario. But I think the most helpful thing in that situation would be to make sure you’re looking at the optimal values of fasting glucose and insulin and hemoglobin A1c and triglycerides, and then looking at all of those together to get a more accurate picture of what’s going on.

Lee: That was the conclusion I came to that would let me just forget about it, not be some kind of panic. So triglycerides, ultra low IGF-1, and the optimal sweet spot. HbA1c 5.5, not as low as I would like it more 4.95, but okay, 5.5. It never goes above that. I can bring it down by exercising more, but without pushing it and being “somewhat lazy,” it sits at 5.5, which, isn’t ideal, but it’s not alarming me. And with the testing, I used to freak out a lot with numbers and I used to make my life miserable years ago. And nowadays I can laugh at values, which are way off because I go with how I’m feeling. And most of the time I’m feeling absolutely well.

Lee: I’ve only got two more questions for you and they are, what are you doing in the face of COVID-19? Or is there testing you’re doing is? Is there immune function tests that you can do? Because people do want to check, “Am I in a peak state in coping with COVID-19?” Because a significant portion of population will get it to over the next two years. And also are you taking any supplements or changing routines at all in the face of COVID-19?

Alexis: So, in terms of, specific tests, blood tests. I would say the only thing that I’m really pushing people to make sure that they’ve done is, is their vitamin D level. You want to optimally have it around 50. So between 50 and 70 seems [ng/dl] to be… There’s been a lot of research recently that have come out that supports the role of vitamin D in making it so that people who do get COVID-19 don’t have as severe reactions and complications. And so definitely I think that is, there’s only so much, research can only move so fast and because this is newer, I’m kind of waiting to see if there’s anything else science-based that research will tell us we should really be testing. So far the only thing that I’m really kind of lobbed onto and I’m trying to make sure all of my regular clients have really good, optimal vitamin D levels that they’re getting regular sun exposure. If they have other additional risk factors that they’re taking vitamin D.

Alexis: And then the other tests that I would say there isn’t research to support, but that I, just from knowing how the flu seasons go and other viral illnesses, I think it’s also important to make sure that your inflammation markers are at low levels. So things like hs-CRP. And really hs-CRP, I would think, the high sensitivity CRP, and homocysteine fibrinogen, those are basics, but if you just did one, the high sensitivity CRP would be good. And you want to see that under 0.5 milligrams per liter optimally. Under one is pretty good, but really optimally, what research shows is that under 0.5 is is kind of the best level to have. So those are the two tests in terms of supplements and things that I’m doing. Vitamin D, vitamin C. Elderberry…

Alexis: There’s not a lot of research with this particular, SARS-CoV-2. And so we need to be careful about making recommendations for the specific treatment of that. What I’m telling people is, “We don’t really know in terms of supplements at this point, other than vitamin D reducing complications. And so I think it’s really important to do things that are in support of your immune system in general, that you would do for any other viral illness.” And for me, what those are, are taking a little extra vitamin D especially cause mine tends to be on the low side, taking vitamin C, which helps to reduce the severity and longevity of, or not longevity, but the length of how long you’re sick when you do get a viral illness. And then again, we don’t know if that will happen with SARS-CoV-2, but there’s been some treatment with IV vitamin C, some high dose vitamin C that has been shown to be helpful in hospital settings. So I think it is a good idea to take at least a gram of vitamin C a day.

blood cholesterol is for the majority of it, is what your body is producing, not really what you’re eating
Alexis Shields

Alexis: Elderberry helps to reduce viral load and research of other viral studies. So I do that. NAC is something that inositol cystine helps to reduce mucus and thin mucus in the lungs. And because SARS-CoV-2 really targets lung tissue and basically making sure that your lung tissue is healthy as possible. And so that’s something also that I think is a worthwhile supplement. And then things like propolis and honey, throat sprays and to the back of the throat where the viral replication occurs for this particular virus, I think is a smart idea.

Alexis: And then really the main things that I think are even more important than supplements are making sure you’re getting adequate sleep, because if you don’t, then that lowers your ability to… Or basically makes you more susceptible to getting a virus, making sure you’re getting adequate sun and your vitamin D level’s optimal, making sure that you’re exercising and really regulating, or not regulating, but really stressing in a low level of good stress to your lung function, and increasing your breathing rate and your heart rate.

Alexis: And then the last thing that I really liked to have people do is end their shower on cold. So do a cold spray to the front and back of the body, that little bit of a stress, those little good stresses like exercise and cold showers, they help to build up your resilience when bigger stresses come around. So I like to have people do that. It really helps with breathing and lung function, as well as doing things like meditation and breathing exercises, which are also found to be really important with this particular virus. If you do get it, breathing exercises can be really lifesaving in this situation. So that’s kind of the…

Lee: Yeah, the Wim Hof style breathing.

Alexis: Exactly. Yep. Very much so.

Lee: Yeah. I agree with you there. I also started taking olive leaf extract, lysine, quercetin.

Alexis: Yep.

Lee: And on the hs-CRP site, I was 0.5 or 0.4, actually. And by taking a liposomal curcumin C3, it dropped by 0.1. So then it was 0.3. I don’t think it’s critical. And I should have mentioned in the hallmark IR I was fine calculation, but I was still paranoid. So I did a two hour version of the craft assay and it indicated no insulin resistance, just dysregulated fasting blood glucose. So then I relaxed and stopped measuring sugars.

Alexis: Yep.

Lee: And so, where can people find out more about you?

Alexis: My website is a good place, dralexisshields.com. I have a Facebook page under Dr. Alexis Shields.

Lee: I wish we had time to cover liver enzymes, kidney function, etc.

Alexis: Maybe I’ll have to do another one.

Lee: Exactly. So I feel this was only a cursory quick chat, and I see I’ve got another call and so do you, so we’ll need to dash but greatly appreciate you taking the time and letting us know what you do with your virtual functional medicine consultations.

Alexis: You’re so welcome. Thank you for having me.