We're all looking for ways to optimize our health and especially our immunity — things we tend to take for granted when we're feeling good and there isn't a pandemic going on.

The basic ways we strengthen our immune response are the same, whether we're worried about COVID-19 or the flu or staying healthier through menopause: wash hands often, don't touch your face, eat well, sleep well, exercise.

However, we live in world of pre-packaged food that's high in sugar, bad fats, salt, and calories, but low in nutrients — and it's easy to get, doesn't require much prep time, and let's admit it, it tastes pretty good. That can make getting the right nutrients in the right amounts at the right times more challenging.

To help women ensure they fill nutritional gaps, Gennev Director of Health Coaching Stasi Kasianchuk and Naturopathic Physician Wendy Ellis teamed up on a webinar all about how to supplement. See the video of their conversation on YouTube.

 

Wendy Ellis and Stasi Kasianchuk

Of course, there's no substitute for a healthy, balanced diet, but when that's just not possible, supplements can help. And stay turned for Gennev's supplement pack for women — created by Dr. Ellis to provide nutritional support but also to help manage menopause symptoms in this challenging time of life. Coming soon!

Also, check out Dr. Ellis' article on how to choose the right supplements, so you know what you're getting!

 

TRANSCRIPT:

Stasi Kasianchuk

I am Stasi Kasianchuk. I'm a registered dietician, nutritionist, exercise physiologist, and Director of Gennev’s Health Coaching Program. And today I'm really excited to have one of our consulting physicians Dr. Wendy Ellis. She's a naturopath and she also has her own practice in Seattle and I'm going to give her a chance to talk about her role with Gennev and a little bit more about herself. So Wendy, go ahead and introduce yourself.

Dr. Wendy Ellis

Sure, thank you. As Stasi mentioned, actually Stasi and I had the opportunity to work at another wellness company a couple of years back. So it's really nice to be working with people who already have a shared interest. I've been in practice since 2002, which is a long time and really focused more on menopause starting in 2005. So I've taken my practice really along the way. I've done work in genetics and I've done work with other physicians, but I'm currently in my own practice primarily focusing on menopause. But it's been really great to consult with Gennev since last summer with some of our products, which we'll talk about that are specific for menopause. 

But we'll also soon be doing telemedicine consultations for menopausal women as well. It's something that I feel very passionate about, especially as I approach menopause myself. But I really like menopause in practice because I feel like it's, it really doesn't just involve giving someone hormone replacement. It involves every aspect of their health, whether it be how well they're sleeping or are they exercising, are they, you know, we are at increased risks for so many things just by going into menopause. And so I feel like it's really great to hit on all the many aspects of health while helping them through menopause.

Stasi Kasianchuk

Excellent. Well, we, and I, are very glad to have you as a part of Gennev and excited about this topic today. You mentioned menopause puts women at greater risk or there are different challenges women face during menopause. And right now as we're going, as we're in this pandemic with COVID19, I'm getting a lot of questions from women of “What can I take? What can I do?” And I know you have a background with your medical training around supplements. So we brought you on today to really discuss the supplements. And just could you start off by talking about immune function COVID19 and how do supplements play a role here if they do? But give the audience just a basis on some of the things to be thinking about this virus and our immune system.

Dr. Wendy Ellis

Right? So if we think about the public in general, like what we've really noted with the data that's been collected thus far and Coronaviruses are not a new virus, although this is a new strain of Coronavirus that's new to all of us. And so when it comes to viruses like that, it really depends. I really liked a quote that I heard the other day that really said, we need to not so much focus on the virus so much as we need to focus on the host, which is, you know, which is us. And so whether we have a host that is a five-year-old person or an 85-year-old person, I think one of the most important things that we can do is have a, have good foundational health to be able to fight viruses off because the data there's a study out of Italy now that suggests that 80 are actually 43% of people that are infected have no symptoms.

And so, you know, we can't just, you know, as especially as we start to unfold our rollout of re-introduction to life, we're going to be exposed to people and what we can do to reduce our own risk as to the most important thing. And so that's when supplements come in. 

There are certain supplements that really help improve our immune system. And I know that if we look at data about, you know, traditional studies that have looked at supplements, oftentimes supplements fail. And it's because they'll take someone that's in a full-blown outbreak of something or a full-blown health condition. And just by giving them a vitamin, it's not going to just automatically take it away because you're looking at years and years or decades of damage. And just by taking, for example, vitamin D or a B vitamin, it's not going to undo that damage.

But what we can do is we can prepare our bodies with supplements to improve our immune systems. So our bodies are stronger and more able to actually fight off a virus because this more, this recent virus basically starts in the nose and it basically has all of the head symptoms. So people will have headaches, congestion, sore throats, you know, sometimes they'll have body aches. But if we can stop the replication of the virus by taking things like vitamin a and vitamin D those are the things that can actually help ramp up your immune system to fight the virus. So the counts are reduced. So it doesn't further travel down into the body and become a more aggressive viral illness.

Stasi Kasianchuk

Got it. So it's about supporting, again going back to that host, it's supporting what's already there. Not creating something new and not completely, you know, eliminating any symptoms you may have. It's more helping your body to fight the virus that's in there.

Dr. Wendy Ellis

Exactly. And what I think the challenge is... yes, there are some antiviral medications, but very frequently those medications have to be started at the first onset of the virus before it replicates and invades all of our cells and starts mutating. And so if we can support the body while the virus is in its lower counts by taking things like vitamin D or vitamin a or herbs and we can talk about some of the most important things that we recommend then you can basically try to keep that at Bay and help the body's innate ability to support this sort of immune system to work for us instead of against us. Exactly. Okay. So working with what you have, I guess is the summary of that piece of it. Yeah, exactly. And you know, it's like the virus attacks our bodies, basically, it sort of goes undetected for sometimes a week or two before our bodies are able to, before the immune system is saying, "Hey wait, there's something here that shouldn't be here. I'm going to mount a response against it."

So, to try not to get too technical, we have something called cytokines. And cytokines are there: they could either be pro-inflammatory or anti-inflammatory. So as most of us are on this webinar, we're sitting here in a chair and our bodies are producing more interleukin six which is an inflammatory cytokine. But if we got up and we went for a run after this, then our body is in response to exercise, produce more of the anti-inflammatory cytokines like interleukin 10 and so, you know, I think the most important thing is to support our bodies, not only with supplements but also with lifestyle factors that create more of an anti-inflammatory response with our cytokines versus further producing more of those inflammatory cytokines. So the whole idea of, you know, some of the medications that are being recommended or suggested by sort of laypeople, some of those really work to reduce that cytokine storm that they're discussing.

And basically, you know, we can, we can work on that with basic lifestyle things. And obviously, a cytokine storm is a very dangerous thing and that happens much further on in the, in the disease state. And also the people who are more susceptible to that are people who have high blood pressure. They already have lung conditions. They have. Actually I pulled some data on that and in some of the studies that have been done, I think one-third of patients who succumb to the disease had preexisting lung disease nearly as many had type two diabetes and then at least half as many as half have high blood pressure. So, of course, those are things that happen for a long time before. And so anything we can do at present to reduce our risk of those diseases is going to help us in the long run.

Stasi Kasianchuk

I love how you made that connection. It's not, there's no one-stop shopping. There's not a one fix-all for this. And so much, again goes back to how can you make yourself the healthiest environment and those lifestyle things, which we'll definitely talk about. You know, that's my, that's my favorite area to get into. On how that can help. How you can decrease blood pressure or improve blood pressure markers, improve blood sugar management, and then, in turn, decreases stress on your body and can support your immune system.

Dr. Wendy Ellis

Yeah, and I think there's a lot too. There's a lot to be said about, you know, we're working on things like a vaccine, right? But viruses, they mutate. So when they go into the cell, they start to replicate and they replicate at a very rapid pace. And then mistakes get made in the, in the RNA to, to would that replication. And so with this virus, it's actually a slow, a slower mutation. So a vaccine will be helpful for us. However, I always tell patients that, you know, this year it's the Covid-19  virus. In the next coming years, there will be other viruses that were not vaccinated against because they're new. And so vaccines, although are very important, just like flu vaccines, can be very important. We can't predict what viruses are going to come in the future. And so we need to prepare our bodies as best we can to help our bodies innately fight that off instead of trying to think of all the vaccinations that we could possibly need. Cause we just don't know.

Stasi Kasianchuk

Yeah, absolutely. And what a great way just to be more proactive than reactive. So we're setting ourselves up for success. Yep, exactly. Well, let's start talking with some of those supplements that can help with that. I know I've received questions from clients just tell me what supplements to take, what should I be buying? And it looks like the supplement industry is doing very well right now. So it's kind of interesting to see what's marketed out there. It would love to hear how you approach this as a credentialed, experienced practitioner with training and expertise around supplements. How do you approach this with your patients and what would you recommend right now?

Dr. Wendy Ellis

Well, when this first rolled out in March in the state of Washington I put a newsletter out that really was trying to help patients know which supplements are the best for this. And this was independent of any health condition that someone might already have. And so for those of us in the Pacific Northwest, actually, you know, most of the US, we're low in vitamin D. Most of us are low in vitamin D because we have jobs that have us working inside most of the time. And even when we're out in the sun, I mean, in Washington, read a latitude that even when we're out in the sun, we don't get a whole lot of vitamin D except for a few months of the year. And so because of that, and, and even when we're outside, we're covering ourselves with sunscreen because we're trying to avoid skin cancer.

So we're basically at risk of having low vitamin D levels. And I think that people who have darker skin pigment or even at more a higher risk of having vitamin D deficiency. And then as we're, we're a society with a lot of obesity and obesity also decreases our vitamin D levels. We just automatically, you know, are, have reduced vitamin D and so we have a lot of risk factors that are innately built-in. So vitamin D. If there was one supplement that I would recommend taking across the board, it's vitamin D and vitamin D is a very important antiviral. It's anti-inflammatory. Again, vitamin D is not, you know, you can't get a virus and just take a bunch of vitamin D and expect that it's going to cure everything. But it's a really important vitamin for our immune system, for mental health, for our bones.

There is just so much that vitamin D does for us. There's a lot of information about vitamin D and cancers and how it reduces cancer risk. And again, you can't get cancer and take a bunch of vitamin D and expect it to go away. But if you have a long history, or a longer history, of taking vitamin D that is protective for you and then the dose of how much to take. Of course, this depends on how old you are, what your skin color is, whether you are overweight, whether you're pre- or post-menopausal. And it's not so much, I think a lot of the data, it makes me a little crazy because it says, well, you know, it used to be 400 IUs, which was definitely not enough to get us up to a healthy blood level. So it really depends on your blood level more than it depends on the dose that you take. So when it comes to vitamins like vitamin D, it is a fat-soluble vitamin. You can take too much of it, which can be detrimental. But the sort of one of the most stringent it's the, it used to be, let's see. Oh my gosh, I can't believe this is my perimenopause moment. It makes her participants feel better.

But the endocrine society used to recommend like, you know, 400 units. And then it was like, well, our vitamin D levels in the blood need to be at least at 30. But they're safer. The upper limit is 4,000 units and that's across the board. And so most of my patients, I do recommend that they take 4,000 units per day. And what this does is it gets the blood level up to a point where usually around 40 to 50, which is a level that is sort of going to help our immune system help our bone density, reduce association with certain cancer risks. So I'd say 2000 to 4,000 I use depending on, you know, depending on the patient, but you can test your vitamin D in the blood. It tends to be a more expensive test. Insurance companies are very stringent on what health conditions it will pay vitamin D for. And so a lot of doctors just won't order it. So I would say that two to 4,000 units would be recommended, not only for longterm general health but also for helping avoid viruses.

Stasi Kasianchuk

Excellent. That's a good recommendation. And gives, it gives a range for people to work with. We have a couple of questions on vitamin D. So one is that the accumulation of taking vitamin D is what matters. So should we start taking it now or for not if we leave that...

Dr. Wendy Ellis

Definitely. Absolutely. And you know, if you're a post-menopausal female, vitamin D is one of the best things for your bone density as well. And there are pretty good studies on reducing breast cancer risk with adequate vitamin D intake. Of course, as with any health condition, it's never just one thing. And so you always have to consider all the contributing factors that play into that.

Stasi Kasianchuk

Okay. So vitamin D is a piece of the puzzle. It's not the be-all and end-all. Exactly. Another question here on vitamin D is, is there a supplement that you should not take with vitamin D at the same time if there are any counter counteractive effects?

Dr. Wendy Ellis

Not off the top of my head. It's a, it's a pretty well-known supplement that's very safe. I do recommend women take it in the morning because it can interfere with sleep if taken at night for certain individuals.

Stasi Kasianchuk

That's good to know. Alright, well vitamin D sounds like an important one to be starting with. And taking starting vitamin D if you aren't looking at your dose if you are. And then considering getting your blood levels tested, if you can if that works with your physician. And once we're able to go back to doctor's offices and do lab tests, what else are there? Are there other vitamins, supplements, minerals, herbs that you think?

Dr. Wendy Ellis

And again, there are so many and so I chose my favorites. So the other one that I am using a lot of is vitamin C. There's a lot of really good evidence for vitamin C as an antiviral. And so vitamin C is one of these nutrients that's readily available. It's easy to take if you take too much, you can get loose stools. There's actually a website that I really encourage patients to check out. It's the Linus Pauling Institute at Oregon state university. And what I really like about it is that it's really well-referenced and you can type in on the search at the top of the, at the top of the page and type in any nutrient and it gives you probably more than you ever wanted to know about every vitamin and mineral that we use.

And so vitamin C is, is being recommended generally below 2000 milligrams per day. They recommend that you should consult a doctor before taking any higher doses than that. Okay. There are some doctors that are using vitamin C, an IV form, for patients who are actively fighting the virus. And in IB form, you can use much higher values like 25 to 50 grams. However, most of us should be taking somewhere between 502,000 grams of vitamin C or milligrams of vitamin C per day. It's, you know, we also have to think about all of those underlying some systems. Like we want it to be anti-inflammatory, we want it to be an antioxidant and we also want it to be antiviral. So vitamin C is another really great, really safe over the counter supplement that it's really good at fighting viruses. There's also a lot of research on zinc and you know, if we think about all of the things that you would take if trying to avoid a cold or flu, you know, we think vitamin C, vitamin D, we think zinc and zinc is one of those minerals that is very well-tolerated by people.

There's one study that people developed a copper deficiency from taking too much zinc. It was actually people who were using Polident for putting their dentures in really high doses of zinc. But I'd say most multivitamins have 15 to 30 milligrams of zinc and usually they have one or two milligrams of copper. And zinc is also a very good antiviral. And then people who actually pulled some studies and it, it actually inadequate levels of zinc limited the individual's response to fight infection. But when actually given oral supplementation in the study and actually found that it reduces the incidence of acute respiratory tract infections, of course, we're worried about, we're worried about lung health right now. It reduced it by 5% and it shortened the recovery. Wow. so, and again, a lot of these things I pulled from the Linus Pauling website and you can have, you can find references there. But zinc is one of those minerals that can really upset your stomach if you don't take it with enough food. And so that is a big caveat for that is you have to take it with food.

Stasi Kasianchuk

All right. Good reminder there. And we'll make sure to link that Linus Pauling in the followup email to all of our participants. So thank you for providing that resource.

Dr. Wendy Ellis

Yeah, it's an excellent resource. And that's, that's the other thing, you have to be really careful about reading blogs and you have to know like, you know, just like we want good supplements and we can talk about how you find good supplements. You have to be really careful online. You know, what you read and where the data is coming from and you have to make sure it's referenced. And for every study that supports something, there's two studies that, that don't support that. And so, fortunately, we have an epidemiologist on staff Dr. Rebecca, and so she's really helpful in helping us determine, you know, is this a good study or is this not a good study? So that's an important thing.

Stasi Kasianchuk

Yeah, I like that you pointed that out, that we're here to support you. And when you're working with your patients, I'm working with my clients. I want you to have information that's going to help you. And that is really going to be reputable cause it can be easy to get bogged down by all the information that's out there. And if you don't have the background in health-related fields or the training that you and Dr. Rebecca have, you can get taken advantage of. And that's not fair either.

Dr. Wendy Ellis

Right? Exactly. Exactly. The other supplement that I have been using not only for my family but recommending for patients is vitamin A. Vitamin A is found in fish. Which, you know, we also, we, we see Cod liver oil is generally a good way to get your vitamin an in there if you want it to also get your Omega-three fatty acids. But vitamin a is really important for the health of the nasal pharynx as well. And so the mucosal membrane actually produces retinoic acid and we know that it's very antiviral and anti-inflammatory. You just like vitamin D, vitamin a is a fat-soluble vitamin and so you can overdose on that. So you don't want to use high doses of that for long periods of time. There are some studies and recommendations that recommend taking like 50 to 100,000 units of vitamin a, but that's something that a doctor should prescribe for you and something that you should be monitored for.

And the other thing is if you, obviously we're dealing with mostly peri and post-menopausal women who are not trying for pregnancy, but vitamin A can be very dangerous and high doses for fetuses. So you want it. So generally what I recommend is 10,000 units, which is very safe across the board of vitamin a supplementation just as further immune support to, to aid in the immune system that you mentioned that we already have. We're trying to, we're not trying to replace something, we're trying to give the nutrients to the body that it uses to actually improve and work our new system.

Stasi Kasianchuk

Excellent. Yeah. No, it's such a good point of theirs. Again, balancing and that there's not one pill that works. It's how, how does this work in conjunction, and what is it looking to support? Exactly. Exactly. What question I get with my clients is, Oh, well especially with vitamin C actually, well if, if a thousand milligrams is good, then why do I stop at 2000? I was, should I take more? Is it okay to take 5,000? I hear it's water-soluble. I'll just pee it out. With the things you've mentioned with each of them, I heard vitamin C and the zinc and vitamin A more does not necessarily equate to better. Exactly. Is there a parameter or risk, an awareness that people should be?

Dr. Wendy Ellis

Yeah. And, and, and the thing is, if it's water-soluble, you've urinated out with magnesium or vitamin C, it can give you very loose stools. And so obviously that's a negative side effect. But some vitamins like vitamin a can be toxic to the liver if you take too much. And so we worry about toxicity and clinical studies actually, you know, there's, there's a threshold to when things are helpful. And so, you know, there's a lot of research that hasn't been done on supplements. And so, you know, it's, if you, if you go to any major medical journal and you try to look up studies on nutrients, a lot of the studies will say, well, it's thought to do this, but we're really not sure. It's the same with pharmaceuticals. And so if we look at what we typically take in a diet, supplements are above and beyond that, but we want to make sure that we're not taking something that's going to damage our kidneys or our liver or create a nutrient deficiency, like the zinc thing. If you take too much, think you can deplete copper. And so too much of one thing can absolutely create tissue damage but also create other nutrient deficiencies.

Stasi Kasianchuk

Okay, good to keep in mind that more is not always better and there's a reason for those limitations. And then also from a cost standpoint, you don't want to be taking more than you need, that's going to cost more money and you're going to run out of those supplements.

Dr. Wendy Ellis

Exactly. And I will say that I spend a lot of time talking people off supplements because we read things and we want to avoid Alzheimer's or we want to avoid all these things. And so people take them presumptively, but your kidneys have to process those, your liver has to process those. And so I actually have seen liver enzymes or kidney issues secondary to people taking too many supplements. Yeah, that's it.

Stasi Kasianchuk

Great reminder. About some of those risks there. Are there any, if anything else that you would recommend, are those the three main favorites right now?

Dr. Wendy Ellis

Yeah, so there was some press about melatonin. And so I felt like I needed to bring up melatonin cause I thought someone would ask that. And melatonin is obviously what our bodies produce to help us sleep. And so our bodies are triggered to make melatonin when our rooms are dark. And so if you've gone through any of the, of the genetic programs especially the ones pertaining to sleep, we talk about melatonin, we talk about sleep habits and having lights off in your room and trying to go, go to bed, you know, when it's nighttime and wake up in the morning and get as much daylight as we can. And so melatonin is something that I think we're lacking because we're living in a society where our rooms are often not that dark and people are sleeping less or they're not sleeping enough because they're having hot flashes.

And so they're, the reason why sleep is beneficial to us is that it restores a lot of things, but we're making a lot of melatonin that's helping us sleep. But that melatonin is actually acting as an antiviral as well. So I pulled some data on this because it's kind of new to me as something that you would use to actually reduce your viral risk. And actually it's been shown to decrease some of the inflammatory markers that are, have been associated. So interleukin six is one of those cytokines that actually tends to be high and people who have coven and melatonin have been shown to reduce that. It also has been shown to reduce the reactive protein and also tumor necrosis factor, which is another inflammatory marker. So the studies have shown that at six milligrams this actually improved outcomes in people who are suffering from severe multiple sclerosis.

This was something that was 25 milligrams of melatonin. Okay. But also it's been shown to lower blood pressure. It reduces proinflammatory cytokines. And actually there's some research about whether it may help blood pressure, but again, too much, it's not good. And so melatonin has some anticancer properties and so I'll have, yesterday I had a patient who was self-diagnosing herself and was taking 60 milligrams and our bodies make about 0.3 to 0.8 milligrams when we're sleeping. And so my tendency is to get that naturally through actually going to bed in a darkened room instead of taking melatonin. If you do take melatonin, it’s recommended to take three milligrams or less. Okay. Yeah. So that's another one. That has gotten a lot of press. Well thanks for clarifying that. And again, going back to the more may not be better working with what your body has first and then you know, there's the whole, there's a lot of antiviral herbs.

And the thing about herbs is that we just haven't done enough study about them to know what the safe profiles, safety profiles are. So if you go onto the generic website and you look at some of the herbs that we use for hot flashes, we really include the safety parameters. And any drug, drug, drug, herb interactions. Because I think a lot of herbs, we just don't fully understand the mechanism of action and we don't know how they interact with other medications. And we're not sure if we're taking a good formula though. A lot of herbs come from overseas and the FDA doesn't regulate supplements. And so it's, you don't know whether you're taking something that has been grown in pesticide, you don't know whether it's actually just cellulose in the capsule. A lot of people take [inaudible] other herbs because they have a high potency of berberine, which is you know, we, it's almost like an antibiotic herb.

And so if we think about immune health and we think about antibiotics, like 90% of our immune systems and the GI tract. And so if you take an antibiotic and you basically decimate your microbiome temporarily, then your immune system is affected because of that. So if you take berberine long term to treat or prevent a virus, then you could be doing damage on the other side, with decreasing urinate and the other day by affecting the microbiome back to that balancing act. So I think the earth question is a really individual one and a hard one. And I think it needs to be discussed with your doctor because of all the potential side effects. Okay. Good reminder there. So the other thing is that certain health conditions or diseases or just living in this environment with depleted soil that we, we tend to have certain nutrient deficiencies as menopausal women not only because of life but also because of certain things that are increased over time secondary to, you know, just the aging female body.

And so some of those nutrients we've put together a vitality pack for women which is not a multivitamin. And I think it's really important to stress that it's not a multivitamin. It's really more of a vitamin specific for the clinical nutrient deficiencies that have been noted in women who are approaching or in menopause. So it's generally, it's, it's something that I created because I just kept supplementing the same nutrients to menopausal women over and over. And I'm like, we need to find something that has all of these things in it. And so and a lot of these support, not only the stress response, so the B vitamins are supporting stress response. It's also important in bone density. A lot of people are on birth control pills or have precedence over the course of time and a lot of nutrients are deficient secondary, some medications that we may take. Also, there's the environment. So we're exposed to a lot of chemicals that our bodies, Mt immune or inflammatory responses do because our bodies are like, what is this bisphenol a and this plastic. Like it shouldn't be here. And so our immune systems, sometimes it's hijacked fighting things that we're exposed to in our environment. And so NSC, they'll use cystine which is an amino acid. This is something that's in the women's vitality pack to help our bodies and our livers process some of these chemicals that we're exposed to throughout our lifetime. Awesome. Yeah.

Stasi Kasianchuk

Well, so I'm so excited about this, that we are launching this soon and that you were involved in creating it. And looking forward to being able to recommend this to my clients cause I get that question of should I take a multivitamin? If so, which one should I take? And you're right, there isn't one out there really for the peri or postmenopausal woman. There's women's multivitamins and then there's the older woman multivitamin. But there's nothing that's really addressing that.

Dr. Wendy Ellis

Exactly. And I feel like, you know if we look at populations and we determine what nutrients are deficient in certain populations, and then you go on this sort of the second circle of what health conditions does this person already has. So for example, if half the patients who developed very severe Covin symptoms, many of whom died, if half of them had hypertension and we can use magnesium to lower blood pressure and reduce that hypertension, then you know, that's another thing that we use a lot of in peri and post-menopause is we use magnesium because it reduces stress. It helps us sleep and helps blood sugar. And also it relaxes muscles. And so it can relax blood vessels. And so therefore, lower blood pressure, again, it's if you have high blood pressure, you can't just stop your blood pressure medication and take magnesium. However, it's something that can be supplemental and reducing your cardiac risk by lowering your blood pressure.

Stasi Kasianchuk

Excellent. That's a great reminder. And that is another supplement that we offer through our genetic shop online. And again, you picked out the form of magnesium for us, made those recommendations based on what's best for peri and postmenopausal women. So taking that guesswork out for people.

Dr. Wendy Ellis

Yeah. And there, you know, as far as magnesium, there are many different forms. Magnesium glycinate is an excellent form. Magnesium citrate can have a little more of a gastric effect and so has more tendency to give loose stools for people, which can be really helpful in constipation. But magnesium is one of those nutrients that makes my top five for sure.

Stasi Kasianchuk

Excellent. Well, and we had a question from someone about magnesium and hot flashes and the mechanism that magnesium works. Are you familiar with that and is that, what does the research say about that right now, if you're aware?

Dr. Wendy Ellis

Yeah. There, you know, I did come upon one small study in women who had had breast cancer who were suffering from hot flashes who because of breast cancer couldn't take hormone replacement therapy. And even though it was a small study, I think it was only 25 women, 50% of the women had improvement of hot flashes when taking 400 milligrams of magnesium. And so again, small, steady I don't know the mechanism of action. But magnesium again, it's a very safe supplement and if it can help hot flashes, you know, again, there may be an improvement in that.

Stasi Kasianchuk

Yeah. And I noticed too imagine you might come across this with your clients and especially during this time, everyone responds a little bit differently. There's not one approach. There's not one exercise plan, there's not one nutrition recommendation I give everyone. It really depends on the individual and it seems like we also recommend black cohosh to help with hot flashes. And I have some women that it works great for... other women don't notice a difference. So yeah, exactly. Would you say that's the same with some of these supplements?

Dr. Wendy Ellis

Absolutely. Well, I mean I would not for hot flashes, yes. But I would say that vitamin D, vitamin C, zinc, they're going to help all of us as far as the immune system goes. But when it comes to black cohosh, you have to make sure you're using, and we can sort of jump ahead a little bit cause we keep alluding to good quality supplements that, you know, sometimes patients will come in and they're taking supplements. And I'm like, well, I'm not, I haven't really heard of that company and I'm not sure if that's a good supplement. So let's try this brand. And it's, you know, it's not that I want to sell them a brand that I, you know, and get kickbacks from. I don't get any of those things. But I want to make sure that they're using a reputable brand, and so we use something called the CGMP practice and it's basically the good manufacturing process or practice.

And it's companies that basically hire a third party group to basically study what's in their supplements and make sure that it actually has what's listed on the label. I can't tell you how many studies I've read where they've actually done an analysis, a chemical analysis of a supplement. And it either has things that should not be in there. So it could have pharmaceutical medications in there or it could have only cellulose so it doesn't have anything that's listed in there. And so the good manufacturing process, make sure that you're actually buying a supplement that has everything listed on the label in the form that's indicated, but also that they've sourced the ingredients from a place that's testing for contaminants. And then the other thing is you want to make sure that that supplement company is ensuring that it has that same amount of active ingredient for the entire shelf life. So if I buy a supplement and it expires, you know, in 2014 I can be guaranteed that exactly what's on that label is exactly what's going to be there up until that date. Okay. And so, you know, we can go to Bartell's, we can go to Walgreens. I mean I think it's a smattering of good and bad products mixed into those things. And so that CGMP is a sticker that you can look for to make sure that they actually care enough to make sure that the product is a good product.

Stasi Kasianchuk

Good. That's great. If people are looking outside, you know, outside of what we offer and how to be a little bit more savvy and conscious around that. The one thing I've noticed and have heard even from clients too, and I tell them, you know, you want to have this higher quality and they say, well that's more expensive. I can get this brand for so much cheaper, but they might not be getting anything or they might be getting something dangerous or really is that worth, worth that cost?

Dr. Wendy Ellis

Exactly. Because there are certain, for example, calcium carbonate, calcium carbonate is, you know, it's a smaller molecule. Then calcium citrate, calcium citrate has a significantly improved profile for the absorption of calcium carbonate is what you're going to find in a lot of over the counter. So people say, I can take this calcium Chu and it's got 1200 milligrams of calcium, I'm good to go. But if you're only absorbing a fraction of that right then you know, then it makes a huge difference. And so it's not only the nutrient itself, it's the, it's basically the type of nutrients, whether it's citrate or carbonate or glycinate, all those different things.

Stasi Kasianchuk

And we actually have a question that came up when this person said that they're in their fifties and they're asking, should I take calcium citrate as well? I used to take it, but they stopped because it caused constipation.

Dr. Wendy Ellis

Yeah, that's actually pretty common. And again, that could come down to the form. And I would say that most calciums you offset that constipation piece by having enough magnesium. So a lot of people think that you should have a one to one ratio of calcium to magnesium. And if the world health organization is recommending 1200 milligrams of calcium a day, 1200 milligrams of magnesium is going to certainly send you to the bathroom and you can actually get magnesium induced magnesium deficiency by just losing all that nutrition out your stool because it's just moving too quickly. So I never recommend 1200 milligrams of supplemental magnesium because we are calcium because we get it in our diets. Okay. And so again, back to that line as the Pauling page, you can actually click on calcium and, and scroll down and then you can see what food sources of calcium are and then try to determine, I'd say most people get at least 500 milligrams of calcium in the diet. So I usually recommend about 750 for women who are post-menopausal. Okay. And I do like the citrate form for that. It tends to be pretty affordable. There are some other forms that are pretty good, but I try to avoid the carbonate form. The other thing to watch for is it could say calcium as carbonate citrates and there may be 800 milligrams of calcium carbonate and only 50 milligrams of citrate. So when you look at how it's listed on the label, the first type that's sourced is the highest concentration in most circumstances.

Stasi Kasianchuk

That's a good pro tip there, Wendy. And keeping people savvy on the label reading cause that's another layer of knowing what you're putting in your body.

Dr. Wendy Ellis

Exactly, exactly. So try, I always shoot for food first and what you can't get in your food supplement. And it's, I think most people don't know that a lot of bone density, bone density starts declining before your last menstrual cycle. So usually in that perimenopausal phase you start losing bone density and so you should up your calcium before you actually hit menopause. Okay. That's a good reminder.

Stasi Kasianchuk

Another question that came in going back to the conversation around melatonin was do you have any thoughts on CBD mixed with melatonin?

Dr. Wendy Ellis

Yeah, there's a lot of CBD available now and I know a lot of patients mix CBD and melatonin. What's interesting is that it can make, like you mentioned for other things, it can be really helpful for some and not helpful for others. And you know, one of the biggest issues is that most sleep issues are actually behavioral. And so most of the things that you're taking for supplementation or even pharmaceuticals can help for a week or two and then they tend to stop working. And so, you know, I think the most important thing for sleep is, you know, a lot of the medications actually can help and then they can actually make the quality of your sleep worse over time. And so I think one of the most important things for sleep is that you determine, are you doing all the lifestyle things to actually improve your sleep instead of adding more supplements.

So back to the original question, I don't think that there's been a study on the safety interaction between CBD and melatonin. I don't know. However, I know a lot of patients who do overlap the two and as long as you're sticking within a pretty safe therapeutic dose instead of a pharmacologic dose, then you should be fine. And then coming back to the magnesium and sleep magnesium can also help with sleep. Absolutely. magnesium, it's very calming, so it helps with, it helps with sleep a lot. Again, you know, you don't want to take a bunch of magnesium and then be up at night having to use the restroom. So that's why I usually recommend that people take it earlier in the day. If you want to take some for sleep, it's usually best taken about half an hour before you go to bed.

Okay. And for that women's vitality formula that's one of the ingredients is we do use magnesium in the citrate form. But I think the other thing to consider too, you know, just sort of circling back to the coven, menopause and supplements sort of general umbrella question is that if you look at the main health conditions that tend to be more prevalent at menopause, a lot of them are overlapping with the things that are risk factors for getting covered. And so as we hit menopause, we have a substantial increase in cardiovascular risk. And so the vitality supplement does have some of that magnesium in it to support heart health. And it also has Coke U 10 in it, which is basically it's like the fuel for the mitochondria and a lot of medications that are specific for cardiovascular disease, whether it's a statin medication or blood pressure medication can deplete our body's production of CoQ-10, which is why that was put in there.

And so if we can support our heart health going into menopause, not only will that help our overall health, but it will help reduce our risk to other health conditions like a virus. And the same for magnesium and diabetes. We know that magnesium is really important in blood sugar regulation. And we know that as women approach menopause, one of the biggest complaints is weight gain around the middle. Yep. And that is due to estrogen decline. And then our body actually shifts estrogen or shifts that fat up into the middle and takes it away generally from arms and legs in some circumstances. And that is an increased risk factor for diabetes and also heart disease, but also, you know, it increases our risk of getting viruses. So there's a lot of overlap between the risk factors for many health conditions including this virus.

Stasi Kasianchuk

That's such a good point. And again, where we can have a multipronged approach to support overall health, that in turn makes us healthier overall. And that immune system is that much stronger. Exactly. Excellent. Well, a couple other questions that came in. One is can you address fish oil for cholesterol and any specific supplements to combat menopause symptoms? So we've talked a lot about that. And the fish oil piece and cholesterol and obviously that ties into heart health as well.

Dr. Wendy Ellis

Yeah.Fortunately, I just had I just attended a cardiovascular CME event earlier this week and that conversation came up about fish oil because some studies show that fish oil can actually increase cholesterol. And so there's been a little bit of backlash on fish oil and how it benefits us but we do know that fish oil can actually increase HDL cholesterol. But we also know that fish oil is so important for things outside of cardiovascular health too. So it's really good for the joints. It's really good for the eyes. It's very good for cognitive function. And so I think the problem with a lot of these studies is that we're looking at single issues. We're not considering the global effect. Of course, there's no study that could actually do that. But I think fish oil is we, we, the, we, Stasi, I, we worked with a company that did a lot of testing of Omega three fatty acids and patients and most people were low and there are negative health consequences with low levels of Omega three and we are eating less fish. And that's where we get most of our Omega three. And so that is why most people do have the supplement fish oil and specifically for cardiovascular health, there's more research for high potency EPA products. And so if you're looking at fish oil, we have Omega-three fatty acids and then we have the EPA and the DHA, which are other components. When you look on a label, you'll see total Omega three EPA, DHA. And so if you shoot for the higher EPA value that is associated with better cardiovascular health in the long run.

Stasi Kasianchuk

Awesome. That's great to know cause there's a lot of those numbers and letters on these fish oils up a bit, so that's helpful to

Dr. Wendy Ellis

Exactly, exactly. There's actually one FDA approved EPA formula. I cannot remember the name of it. But I just recommend fish oil with a higher EPA content.

Stasi Kasianchuk

Okay, excellent. And then a question back on the weight gain during menopause, do you think that there's a threshold for weight gain and menopause? This individual feels that 10 pounds is in a normal range or they're asking if 10 pounds is a normal range?

Dr. Wendy Ellis

Yeah, I would say that's pretty common. Ten pounds is pretty common for many people. And you know, I'd say the weight gain is probably the biggest complaint behind hot flashes. Yeah, I would agree. And you know, as Stasi knows, being an exercise physiologist it's one of those things that, you know, our metabolism slows down. So we burn about 200 to 400 less calories per day. We're also not sleeping very well. And so we tend to grab food to sustain our energy. I also know that as estrogen levels fall, our body's estrogen and serotonin have sort of this relationship where we know that giving SSRI antidepressants can improve hot flashes and we don't know exactly the mechanism for hot flashes, but we do know that serotonin helps that. And we also know that when estrogen falls, we tend to have more depression.

So we may have, there is a correlation with lower serotonin as compared to estrogen as well. And again, I don't know exactly the mechanism. But at the, at the end of the day when it comes to weight gain, we really have to reduce our caloric intake a bit to overcome that. And then we also have to really work on weight training. And I, I feel like a lot of patients that I see are like, I'm eating the same, I'm doing the same type of exercise and I'm gaining weight. And so I really have stress doing specific weight training because cardiovascular disease obviously, or cardiovascular exercise is really important. But I do feel like the weight and resistance training makes the biggest difference, not necessarily in the number on the scale. I feel like it's good to weigh yourself because if we don't, all of a sudden you get on the scale and you're like, Oh my gosh, I've gained 20 pounds.

But body mass index is important. And knowing that you can actually improve muscle tone and muscles going to burn at a higher metabolic rate than fat. So the scale can be deceiving. But there are also other things like thyroid disease. There's also, you know, just being depressed and craving carbohydrates. And so it's, it's a convoluted question. And I, and I also struggle with having to have these conversations with women that, because our physiology is changing, our body shapes are going to change and there has to be some degree of acceptance with the changes that go along with aging. And that's a hard one to swallow.

Stasi Kasianchuk

No, it does. And we could probably do a whole another webinar on the topic of body composition changes. And this individual, they've put in some additional comments about how bodyweight seems like it appears overnight and what worked before just doesn't work anymore. And there is some truth to that as you explained. There's different physiology during perimenopause and menopause then pre-menopause and then certainly, you know, even twenties and thirties. You know, I'm premenopausal, but I know I noticed a difference between my thirties and my twenties. Like there are changes happening there. It does happen.

Dr. Wendy Ellis

Yeah. Yeah, it does. And I will say, I have some women who are post-menopausal who have six-packs and they look amazing, but there's a trade-off. So those are the women who are in my Orange Theory class who go like five or six days a week. And so, and then they don't eat the cupcakes and they're, you know, they're, they're making a lot of sacrifices to have that. And so I feel like the conversation I have with people is how much are you willing to do? And so, you know, for me, I actually consulted with Stasi a while back because I'm like, I know what I need to do. I just need someone to hold me accountable. And so oftentimes it's having an accountability partner, whatever that looks like.

Stasi Kasianchuk

Yeah. And I liked that you brought that up and that's what our HealthFix program is all about, is really providing that accountability and that support and helping you find a plan that's gonna work best for you so you can feel good in your body, have the benefits of health and wellness and still have your life. If you don't want to be working out five, six, seven, eight days a week, you don't have to. But it's figuring out what's gonna work for you and help you that way. Right. Excellent. Thanks for that point.

Dr. Wendy Ellis

I will say that exercise, like you have to exercise every day and that doesn't mean that you have to go to some rigorous class, but part of, part of improving your immune system and part of helping your menopause symptoms movement have to be a part of that. But it also has to be something that you enjoy. Right. And so, you know, it's like for me, I like going to classes because I put it on my calendar to actually show up. Yes. So that, and so that should lead to the next question, Stasi, about what lifestyle things?

Stasi Kasianchuk

Yeah, let's actually, let's dive right into those lifestyle factors. And before we do that though, let's remind people, cause we've been talking a lot about that vitality pack. A couple of questions came in on that. So one is if someone starts taking the vitality should they also take magnesium? Especially cause there's magnesium in it and this person is that they're taking a lot of supplements because they also have celiac disease. So what's your recommendation?

Dr. Wendy Ellis

So the vitality pack has 200 milligrams of magnesium in it. And so I'd say two to 400 milligrams is a pretty standard daily dose. And so the vitality pack may have enough. And then the vitamin a, there's actually 10,000 units of vitamin a and the vitality pack for the immune support vitamin D, there's 2000 I use. So you may need to supplement 2000 more on top of what's in here or 2000, maybe enough. Again, you wouldn't know until you did your blood test to determine. And I like a level of at least 50. I prefer 50. I don't like high levels. I have people who are taking 20,000 units and that can actually cause calcium issues. And so that's one of the issues that you can have with taking too much vitamin D. Okay. The B vitamins, again, they're water-soluble and this doesn't have all the BS that has a, B6, B12, and foliate.

These are the most important nutrients when it comes to mental health and also stress support. This is assuming, and I think one of the most important things is that taking this vitality pack doesn't mean that you don't have to eat well for you don't exercise, right? It's meant to be an adjunct to a good diet and good health. The other thing that's in here is biotin. And biotin is really important because it's important in your nails and your skin and your hair. And I think that even though we try not to be vain, there's a lot of changes in those things that occur secondary to aging and biotin is in there. Another thing that's in here is selenium. And when we talk about antivirals, actually selenium is a really important antiviral. But selenium is also really important in thyroid health.

Stasi Kasianchuk

Okay. Another big one in there, especially during menopause, some of those changes in thyroid function that happened. Exactly.

Dr. Wendy Ellis

And so I would say, you know, and then we talked about the CoQ-10. And then the other thing that's in here is turmeric. So if we think about an anti-inflammatory, so joint pain is a common complaint for people who are approaching or in or post-menopause. And a lot of the anti-inflammatories I think as this virus thing began and everyone was like, "Oh, you shouldn't take ibuprofen." And, and it was found that, "Oh, that actually may have negative side effects because it's a fever reducer." That curcumin is an herb, but it's a very potent anti-inflammatory. So this is something that, and it's also been associated with improving cognitive function and so it's one of those things that you can take without side effects.

Stasi Kasianchuk

Awesome. Yeah, that's great. And a couple of other questions there. Is the pack vegetarian? Yes, it is a vegetarian packer. And when can people start getting a hold of this?

Dr. Wendy Ellis

It should be available at the end of May. Awesome. May, mid-May, May 15th maybe.

Stasi Kasianchuk

Okay, great. Well, we'll keep people that will be updated on our shop, on our website. So keep an eye out for that and we'll be sure to send out an email. So make sure you're on our lists to get that release once that's out and ready.

Dr. Wendy Ellis

Yeah, I'm super excited to take it again. I feel like I recommend the assault piecemeal and it was really great to have the opportunity to put it all together into (daily packs of ) five. I wish it was less, but to that point, there are a lot of supplements that are sold as women's supplements and if you look at the ingredients list, it's like everything under the sun. And the point of this supplement is not to give you everything under the sun. The point is to look at the most important nutrients for this phase in life and give you a therapeutic dose of the specific nutrients in there. So I had to cut some of the things out that were my dream list, like fish oil. I would have loved to put fish oil in here, but then contaminates the whole capsule and it wouldn't be vegetarian. We had to sort of, you know, make a little bit of adjustment for those two reasons.

Stasi Kasianchuk

Excellent. All right, well thank you for doing the work. On the supplement, we're excited to offer it. May 15th is the date that it will be released, but again we'll definitely launch it via email as well. So let's finish up with talking about some of those lifestyle factors, Wendy, that you are mentioning also supports immune health and have benefits during this phase of life of supporting women and managing their menopause symptoms.

Dr. Wendy Ellis

Yeah. and this is the most important thing. So if we don't have a good foundational lifestyle, you can't supplement your way out of that. And so diet is really important and if you think about it, you know, I always talk about eating the rainbow. So if you look at your foods, the things that are bright, bright and colorful, like, you know, red, orange, yellow, green, blue, like berries, these have high accidents and they're also very anti-inflammatory. And actually, by eating those foods, those will actually reduce your hot flashes as well. There's definitely evidence of that. And so dietary wise there's a lot of research on the Mediterranean diet across the board as being a healthy diet to follow. And what I usually recommend to people as I hate the word “diet,” I agree, but I usually recommend that people just print out the list of foods that are on the Mediterranean diet and just try to stick to those most of the time.

Dr. Wendy Ellis:

I mean there are times where you're going to eat a piece of pie, or you're going to have some birthday cake, or you're going to do that. But I usually recommend that people, if you can stick to a whole foods diet the majority of the time, like 80 to 90% of the time, that allows you to eat other things without feeling the guilt. Cause I feel like people who take those, if you completely eliminate a food group other than having celiac disease and not being able to eat gluten for a medical reason, I feel like your mind sort of tricks you into thinking you only want that and then you end up being Bingy. And so diet is probably the most important thing. Exercise, we touched upon exercise... Exercise is so important for making more of those anti-inflammatory cytokines versus proinflammatory cytokines. So it's improving your immune system by exercising.

Dr. Wendy Ellis

And you also need to exercise because your joints need movement. Like, movement is the lubrication for your joints. And then it's good for our mental health. It's good for our sleep. And so I know when I don't exercise, I crave weird things, and my diet goes off the rails and I also don't sleep well and I'm crabby. And so it makes a big difference if I'm exercising. 

And then sleep. Yeah, sleep. Our bodies do so much work while we're sleeping to help us. And so we learned about the lymphatic system, which is almost like a self-cleaning oven for our brains that happens only while we're sleeping, but our bodies basically heal and restore while we're sleeping and we should be sleeping at least seven hours per night. I'd say seven to nine hours is the window of sleeping enough but not too much because too much sleep can actually be detrimental as well. Back to that balance factor. Right. I know. And then the last, but probably the most important thing is having a good digestive function because the microbiome, which basically describes all the colonic bacteria in our large intestine. If we, if we think about most of our immune systems in the GI tract, you have to have good, good GI function to have good immune, good immunity.

Stasi Kasianchuk

Excellent. Great recommendations there. It sounds like a bunch of topics for future webinars, so we might have to think of some future collaborations here.

Dr. Wendy Ellis

And then stress managing your stress. If you look at some of the most common health conditions that are in the population, stress is a huge contributing factor. And so, you know, whether you're using an app to help you with your stress, whether exercise helps meditation, prayer, anything that can help reduce your stress, this is a really important part of health that often gets sort of, you know, it's like, well reduce your stress. It's like, how do you do that?

Stasi Kasianchuk

Right? So that's an important piece and figuring out what's going to work. But again, it goes back to what's gonna work best for that individual.

Dr. Wendy Ellis

Yep. Exactly.

Stasi Kasianchuk

Awesome. Well, we had one question about gut health. How do you start to address that and find out how yours is a, I'm going to table that question for right now. We did do a webinar a few weeks back on gut health, so we'll link that. We can possibly link that into this email or it's also on the YouTube channel with all of these and that has some more information there on the gut health piece. But with time, we're a little bit over the hour, but when did you have anything else to recommend? How can people get in touch with you if they want to work with you? How do they go about doing that?

Dr. Wendy Ellis:

So I have a website that's just my name is drwendyellis.com. There's more information about me there. In the coming weeks, you'll be able to find me on the generic website in the practitioner section. So in the meantime, I would just contact Gennev and patients can be put in touch with me as needed. One more thing. Oh, just you know, about GI health. I listened to that. It was wonderful. It was a great lecture. The one thing, if, if, cause I know a lot of people aren't going to go back and listen to that. Some may, but you know, it's, we're all busy. I'd say the more variety in your diet, the better. And so obviously now we're sort of limited with groceries, but if you can eat with the seasons and eat what's in season, that will give you variety, which gives you diversity in your, in your bacterial flora. And that's one of the best things you can do to improve your immune system in the GI tract.

Stasi Kasianchuk

Excellent. That's a great recommendation. And then also that plays into the color that you recommended from eating the rainbow.

Dr. Wendy Ellis

Yeah, and I'm not a fan of juicing because we need the fiber. I'm not against juice a hundred percent. However, you need to be eating the fiber within those juices to actually have the beneficial benefit to your short-chain fatty acids producing short, short-chain acids for those good microbes.

Stasi Kasianchuk

Thanks for that reminder as well. It's been awesome talking with you. I'm so thank you so much for taking this time and just a reminder, you know, a lot of these things with immune function and finding the right supplements it's a multifactorial approach and there's not one approach for one person. So if you have questions on what's best for you, our health fix program matches you with a registered dietician, nutritionist for a coaching accountability program. And then we also have our telemedicine practitioners, if you're looking more for that medical advice or more on the gynecological side of things. So both of those options are available on our website. So please take advantage of that. And our next webinar is actually going to be off our Thursday schedule or coming back on Monday evening at 5:00 PM Pacific time. And I'm going to be talking with Dr. Rebecca, our Chief Medical Officer, about how what are we going to be doing now when it comes to personal protective equipment or that PPE? A lot of places we see, I got a notification from Costco yesterday that told me as of May 4th in Oregon, at least everyone will be required to wear a mask when you go to Costco. So what does that look like? How can you make your own mask? What is PPE and why should I be thinking about that? So that's coming to you on Monday. So registered through the link and tune-in then. All right. Thanks again, Wendy. Bye.

 
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