Build Resilient Immunity in 2023
Last month, Dr. Ryan and I had the pleasure of attending a seminar taught by Dr. Dan Murphy, DC. Dr. Murphy is one of the foremost experts on nutrition and functional medicine in the chiropractic profession. He lectured on topics such as brain injury and concussion, nutrition for cognitive and immune system health, the beneficial effects of red laser therapy, and the prevention of dementia and Alzheimer’s disease using nutrition and lifestyle modification.
Perhaps the most impactful topic for me was Dr. Murphy’s lecture on ‘host immunity.’ Host immunity refers to the strength, resiliency, and adaptability of a given patient’s immune system. The better the patient’s immune system, the more effectively that patient can combat all forms of disease and illness affecting the body. Dietary and lifestyle modifications such as exercise, proper sun exposure, and evolutionarily consistent eating are examples of techniques patients can use to improve their host immunity.
In my opinion, mainstream media does not focus enough on host immunity. Instead, we are told strategies such as staying up to date with the latest vaccine or booster, avoiding close contact with sick individuals, wearing masks in public, or taking medication for any physical or mental stress your body is subjected to. When did we become so weak we had to start relying on all of these external, synthetic inputs to keep us healthy? Since when did being around other people endanger us, rather than strengthen our immune system by presenting our immune system with a wide array of pathogens and creating a more robust immune system? I recall when ‘chicken-pox’ parties were the norm. Each individual has the opportunity to have an extremely strong, smart, and resilient immune system.
Dr. Murphy suggests a number of vital supplements for optimizing host immunity. First and foremost are omega-3’s and vitamin D. Aim for around three grams of omega 3’s each day. For many, this means supplementing with a high quality fish oil supplement. Omega 3’s help with the inflammatory balance in the body and foster an environment where immune cells can combat external infections and diseases. Next up is vitamin D. Your goal should be around 5,000 mg per day. Getting vitamin D from natural sunlight is the best option, however, during the winter months supplementation is often necessary. Nearly every cell in the body, including our immune cells, possess a vitamin D receptor and is positively activated when this hormone is at proper levels. Vitamin D is also great for bone mineral density, memory, and mental health.
No lecture on immune health is complete without mentioning vitamin C. Did you know the benefits of vitamin C were first discovered among sailors with scurvy? Scurvy is a connective tissue disease causing gum disease, hair loss, excessive bleeding, and poor healing from wounds and infection. When the sailors were given oranges, which are high in vitamin C, the symptoms of scurvy all but disappeared. Alas, the immune benefits of vitamin C were front page news! Vitamin C has a host of health benefits including reducing the duration of the common cold, helping with the synthesis of collagen so you can have healthy skin, hair, and nails, and acts as a strong antioxidant with some research suggesting anti-cancer and anti-Alzheimer’s benefits. Vitamin C is found in the highest quantity in citrus fruits. If supplementation is deemed necessary, liposomal vitamin C is your best option. Liposomal vitamin C is encapsulated with a fat or lipid coating improving absorption and decreasing gastrointestinal distress.
The final three nutrients are magnesium, zinc, and vitamin A. Magnesium is a mineral acting as a cofactor in over 600 reactions in the body, and is important for normal immune function, energy production, blood pressure regulation, and blood sugar control. Magnesium deficiency is common in developed countries. Aim for about 300-600 mg per day of magnesium from a whole food source or supplement. If supplementing, I recommend taking either magnesium threonate or magnesium glycinate, since these have the best absorption in the body and brain. Zinc is an essential mineral associated with proper wound healing and immune system function. It is an antioxidant and important for maintaining proper testosterone levels. I recommend 15-30 mg of zinc daily. Vitamin A refers to a group of chemical compounds composed of retinol and its metabolites. Vitamin A is essential for optimal immune function, and is also important for our skin and vision. Take around 5,000 IU of vitamin A each day.
Coming up soon, I will take a deep dive into the importance of exercise and sleep for healthy host immunity. At the surface level, a balanced combination of aerobic (endurance) and anaerobic (strength) training will help develop a robust individual with a strong immune system. Consistent, quality sleep each night is essential for immune health because melatonin benefits the immune system by decreasing inflammatory reactions in the body, notably the ‘cytokine storm’ seen with covid-19. Supplementing with 3-10 mg of melatonin while symptomatic may provide some benefit, however, I do not recommend long term supplementation of melatonin. Melatonin is a hormone produced by the body, and long term supplementation may decrease our body’s capacity for producing the hormone on its own.
Make 2023 the year for improving host immunity. With covid-19 in the rearview mirror, prepare yourself now for any future health crises that may affect our society. If we all commit to focusing more on healthy host immunity, the need for societal wide shutdowns and vaccination may not be necessary!
Post written by Dr. Riley Kulm, DC. Check out his bio here:
Anemia may be the root cause of many chronic conditions such as headache, migraine, mood disorders, and fatigue. Getting assessed by a functional medicine provider trained in the diagnosis and treatment of anemia may be the missing link towards optimal health. In this blog post I will be focusing on iron deficiency anemia as it is the most prevalent in our clinical practice. While both males and females can be affected by anemia, females are affected at a much higher rate.
What is anemia?
Anemia is defined as a low red blood cell count (RBC), low hemoglobin (Hgb), and a low hematocrit (red blood cell concentration in whole blood). Iron deficiency anemia, or IDA, is defined as a microcytic, hypochromic anemia, where the red blood cells are small in size and pale in color due to poor hemoglobin concentration. These red blood cells do not carry oxygen as efficiently, and your tissues can become hypoxic or starved of oxygen. As a result, your heart pumps faster to try and bring more oxygen to the tissues. Additionally, your brain gets less oxygen which causes headaches and mental fatigue. Symptoms of anemia include fatigue, cold hands/feet, rapid or irregular heart rate, headaches, dizziness and lightheadedness, pale or yellow skin, and shortness of breath. When iron status is addressed, we have seen issues like anxiety, depression, and insomnia improve drastically in our patients.
There are many types of anemias that can affect the body. For instance, Vitamin B12 (cobalamin) and Vitamin B9 (folate) deficiencies can cause anemia. These anemias will present as a ‘macrocytic’ anemia where red blood count is low and the red blood cells actually become larger as part of the deficiency. When assessing your bloodwork for anemia and any other condition, make sure to consult with a physician trained in functional medicine.
How do you measure it?
To assess iron status, we order a simple test called plasma ferritin. Ferritin is your body’s storage form of iron and is in largest concentration in your liver, spleen, and bone marrow. Small amounts of ferritin circulate in your bloodstream in direct proportion to the amount of ferritin stored in tissues. Normal values for ferritin vary with age and sex, and good laboratories will provide age and sex specific reference ranges. The lab reference ranges for ferritin are typically quite large, e.g. 16-154 ng/ mL for a 40 year old female, meaning stricter ‘functional ranges’ need to be used for clinical decision making. Using functional medicine standards, we prefer to see ferritin levels above 100 ng/ mL. It’s important to note too much iron is also a problem, and can cause conditions such as iron overload or hemochromatosis.
What to do:
If your ferritin levels are low, look to optimize digestion of iron by taking a hydrochloric acid supplement which will help increase the acidity of your gut. Having an appropriately low stomach pH (more acidic) is necessary for the proper digestion of iron, vitamin B12, calcium, and magnesium among other vital nutrients. For more information, refer to my blog post on stomach acid and digestion here.
To improve iron status it’s important to consume foods high in iron. Animal protein is one of the best ways to get iron. Red meat, organ meats, shellfish, and turkey are excellent ways to increase iron status when paired with optimal digestion. Cooking daily with a cast iron skillet is another easy way to improve iron status. One of my favorite iron and vitamin B12 rich meals is a grass fed ribeye steak cooked with butter or coconut oil in a cast iron skillet. Another option is to use an ‘iron fish’ which can be dropped into warm beverages and will safely release iron into your drink. Consider using an iron fish in hot water with honey and apple cider vinegar. The apple cider vinegar will help increase gut acidity and improve iron absorption.
If you can relate to the symptoms described above, make sure to get a ferritin and complete blood count (CBC) test as soon as possible from your doctor. It’s always better to ‘test rather than guess’ because too much iron can also be problematic. The tests are simple and inexpensive so don’t hesitate to ask your doctor to order it for you. Having healthy red blood cells is essential for optimal health, and a CBC test looking at iron levels will help determine what steps you may need to take to improve your overall well-being.
Post written by Dr. Riley Kulm, DC. Check out his bio here.
For years it was thought the cause of indigestion, stomach ulcers, and gastric reflux was the presence of too much acid in the stomach. However, research shows the cause of these issues is actually too little stomach acid. Stomach acid, or hydrochloric acid (HCL), is necessary to ensure the proper digestion of your food, protect you from pathogenic bacteria, and prevent the backflow of food into your esophagus and throat. If our stomach is not acidic enough, our gastro-esophageal sphincter will not close and we can get back flow of acid into our throat (esophagus) which causes heartburn (gerd). Without adequate stomach acid, vitamins and minerals such as calcium, magnesium, iron, and vitamin B12, are not fully absorbed into the body. For example, if you are supplementing with calcium and magnesium in an effort to improve the strength of your bones but do not have enough stomach acid, the supplements will not be effective.
To determine whether you have adequate stomach acid, your doctor will have you perform one of the two tests below:
- First thing in the morning, before eating or drinking anything, mix ¼ tsp baking soda in 4 to 6 ounces of cold water. Drink the baking soda solution and set a timer for 5 minutes. Record and note the time anything happens over the next five minutes and bring the results to your doctor at your next visit.
- The betaine HCL test requires some trial and error, but you will finish the test with an exact dosage for how much HCL you need supplementally. For this test you will start by taking one betaine HCL pill right before eat. If you do not feel a “burn”, you will then take two pills right before your next meal. You will continue to up the pills one by one for each meal until you feel a burning sensation. Once you feel a burn, you will take one pill off and this will become your dosage. Once you begin to feel a burn at this dosage, you will again drop by one pill. This is not a long-term solution for lack of stomach acid, but it is a good way to kick start your digestion. It will also aid in vitamin and mineral adsorption so you have the energy and motivation to improve stomach acid naturally through weight-bearing exercise, improved posture, and stress management strategies. When dosing the supplement if you have an uncomfortable burn you can drink some baking soda in water to neutralize the acid. Make sure to lower the dosage at the next meal.
If your doctor determines your stomach acid levels are too low, here are some natural ways to boost HCL production in the stomach and ensure healthier digestion:
- Consume apple cider vinegar. Put ½ tablespoon up to 2 tablespoons in 8-12 ounces of water. Drink this solution first thing in the morning and before bed. If apple cider vinegar makes you nauseous, start with ½ tbsp and slowly build up to 2 tbsp.
- If you don’t struggle with heartburn add fresh squeezed lemon or lime juice to your water and drink throughout the day.
- Eat grapefruit and fermented foods (sauerkraut, kombucha, pickled foods (pickled beets, etc) to help stimulate HCL production. Eat pineapple and papaya to increase digestive enzymes.
- Use vinegars (red wine, white wine, balsamic, etc.) as a salad dressing or marinade.
- Drink celery or cabbage juice.
- Chew on celery, pumpkin seeds, or beeswax throughout the day. In addition to stimulating HCL production, this will also help heal your stomach lining, and boost metabolism for fat loss.
- Mindfully chew your food. The physical act of chewing will stimulate HCL production and help digest your food via adequate release of salivary enzymes triggered in the mouth by chewing.
- Limit fluid intake with meals as it dilutes your stomach acid. Drink your fluids in between meals.
- ONE glass of wine with a meal can help add some acidity to your stomach to aid with digestion
- To improve digestion after meals limit sitting and laying down, go for light walks, perform light chores, stand, etc.
Finally, make sure you are in a calm and relaxed state before eating your meals. When you are in a stressed state (sympathetics), your body does not produce stomach acid or digest your food. Take 4 deep, slow breaths prior to eating, reflecting on how lucky you are to have an abundance of healthy food to fuel your body. Gratitude is excellent for your brain and digestive health!
If you have sensitivities or allergies to any of the suggested foods on the list please continue to avoid them and consume the ones you can tolerate. Food allergies and sensitivities start because of increased sympathetics and therefore decreased stomach acid. As we repair your gut, increase stomach acid, and decrease sympathetics you will begin to tolerate foods you couldn’t tolerate prior.
If you struggle with heartburn (GERD) it is best to avoid citrus, caffeine, alcohol, spicy foods, peppermint, and eating after 7pm as we repair your stomach. These foods and activities can cause relaxation of your stomach valve which can cause regurgitation of acid into your throat/chest.
Post Written by Dr. Riley Kulm, DC, and Dr. Ryan Dunn, DC.