In my last article, I explained why doing a detox or a cleanse with your friends' multilevel marketing company is likely not the best use of your money. I'm not against cleanses and detoxes, nor am I against multilevel marketing. What I am against is uneducated people dispensing products (and making promises) that they know absolutely nothing about. Multilevel marketing supplement companies thrive on that and blend a dangerous combination of:

     1. Laypeople who typically don't know what they are doing
     2. Who are usually desperate for money or at least looking to recoup their investment
     3. Who have been "educated" aka spoon-fed only one point of view from their company
     4. Have gotten psyched-up at huge mega-conferences every year- extra fun brainwashing!

This usually leads to an army of uneducated people who are sure that everybody needs to take their company's products. The result? A lot of people try an MLM product, don't see results, and go on to swear-off all supplements and natural healthcare entirely. Ohhhh that really grinds my gears- that's how multilevel marketing supplement companies are ruining it for the rest of us.

Don't believe me? Let's look at just a couple of examples of these folk's expertise, shall we?

The person, whom will refer to as "MLMer 1", is sure that their company's products are better than normal multivitamins because of this nifty little at-home experiment. The only problem? Apparently MLMer 1 didn't look at the ingredient lists of each product. Either that, or she doesn't know anything about the ingredients in the products. Of course an enzyme broke down the food and the regular vitamin didn't. Are you kidding me? That's like marveling at how paint thinner dissolves paint but olive oil doesn't do anything. It is also worth noting that MLMer 1 never responded to that last comment, though she was quite eagerly commenting with me before I started pointing out the holes in her rock-solid logic.

If that first example didn't convince you that these people have no idea what they're doing, perhaps my old pal Ashley can help us out. This was an exchange that took place on the website titled "The Truth About Zeal". Now, I will say that I don't agree with everything on this website, but the author does a decent job at outlining some of the problems with Zeal for Life and the MLM supplement world as a whole. I have several beefs with what this Ashley has to say. I will label which of her two responses they came from with a (1) or a (2). 

1. No vitamin or mineral makes you feel worse before you feel better. None. That is simply not how deficiencies work. If you give somebody with a vitamin or mineral deficiency (which are super common, by the way) the nutrients they actually need they should immediately  (within a few days) start to feel better. If they feel nothing or have a bad reaction to the treatment I would consider the following:
               A. Fillers and herbs in the product that can cause numerous reactions (like in Zeal)
               B. The form of the vitamin or mineral you are giving, as some are better absorbed
                    and tolerated than others (Mg Citrate versus Mg Oxide, for example)
               C. Is the patient able to absorb what you are giving them?
               D. Is this (what you are treating) actually the problem? Or is it time to go back to
                   the drawing board and look for other possibly mechanisms? (1)

2. The doctors who designed zeal are human beings, and are thus fully capable of being incorrect, biased, or otherwise imperfect. Using the explanation "these people are really smart and "amazing", therefore must be correct and we should blindly take their word for it" is a fallacy of reasoning called "appeal to authority". (1)

3. "Every vitamin, antioxidant, and nutrient in zeal is great for your body". I wasn't aware that Ashley had conducted a physical exam, history or laboratory testing on Theresa. This is most likely because I'm 100% sure that she hasn't. It's fine to say that something is healthy, but this woman is obviously having a negative reaction to this stuff which makes it NOT healthy for her body. Ashley has been fully brainwashed by the Zeal For Life people and has lost any and all objectivity she may have once had. (1)

4 (Part A). Ashley, like so many others, falsely believe that the minimal training from her company and her own research give her the authority to dispense health advice. Admittedly, I don't know what she means here by "I have researched my nutrition"- she may be very well read. However, judging by our short exchange it is far more likely that Ashley has done a few basic google searches, read information provided by her company, and called it a day. (2)

4 (Part B). Ashley takes this delusion one step further than most by boasting that she has "family that are doctors", which I suppose also entitles her to give people health advice. This one blows me away for a number of reasons:
               A. Most doctors know nothing about nutrition, vitamins, herbs, or supplements. I
                   would have been equally impressed had she said her family are plumbers.
               B. She did not mention if her family of doctors approve of, or even know of, Zeal
                   for Life. Sheer relation to Ashley does not mean that they endorse this product.
               C. See point 2 and the "appeal to authority" fallacy.
               D. It doesn't matter who you're related to or who you know- that doesn't mean that
                   you know what you're doing. My husband is an engineer, and though we talk all
                   day every day, I can assure you that I know nothing about engineering. (2)


Multilevel Marketing supplement companies will almost certainly waste your money, and may be downright dangerous. Do yourself a favor and skip the MLM cleanse or detox this year and entrust your health only to those of us who know what we are doing.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. ​Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

Isagenix, Shakeology, Amway, Herbalife, Shaklee, Zrii, Zeal For Life and countless others

Have you been approached by a friend or family member about doing a detox or weight-loss program for the new year? Do they call themselves a "wellness coach", "wellness advocate", "beach body coach" or something similar even though you know for a fact that they never went to school to obtain a degree in nutrition or a health related field? Then they likely work for a multilevel marketing company like one of the ones above.

I'm not inherently anti-multilevel marketing. However, I am very much against multilevel marketing supplement companies. The reason? These companies thrive- nay, rely on regular, uneducated people to join and perpetuate their business. This isn't especially dangerous if what is being sold is skincare or makeup (like Nerium, for example), but I draw the line when it comes to people's health. Some of the above products are better quality than others, but that doesn't change my biggest problem with MLM supplement companies: the lack of experience and expertise of the people dispensing the products.

Imagine this scenario, if you will-

1. You walk into a store with a friend
2. You walk into the vitamin and supplement section of the store
3. Your pal, whom has no training in anything related to healthcare, nutrition or supplements and no real knowledge of your body or health history, starts telling you that you simply MUST try this protein shake/product/package

Would you take them seriously? Or would you know that they don't know what you need any more than you do?

For that matter, have you ever heard of the saying "when all you have is a hammer everything looks like a nail"? If you have anemia caused by low stomach acid and an H Pylori infection you may complain of fatigue, for instance. Talk to an MLM supplement company rep and they'll likely tell you that you need their company's energy product (or that you need to do a cleanse). Because most of these folks have absolutely NO training in nutrition or healthcare whatsoever, they have no ability to properly diagnose and evaluate what you really need. As a result, they will sell you whatever products their company sells- regardless of if you need it or not.


This year, make a resolution to not do one of these MLM programs. Spend your money going to a doctor who specializes in functional medicine- you'll thank me later.

For Part 2 to this article, click here.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. ​Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

de·tox·i·fy
verb
to remove toxic substances or qualities from

If you've been down the rabbit hole of holistic, natural or alternative medicine for more than ten minutes, chances are you've come across detoxing. But what exactly IS a detox? What do you need to know before you start one? How do you know which type is best for you, or just best in general?

Unfortunately, I think that the term "detox" has become sort of a bastardized term. Even healthcare professionals such as naturopaths and chiropractors can be guilty of this. Most of the time, when people refer to "detoxing" they either prescribe the same exact detox to every single person (MLM companies are super-guilty of this- see part 1 and part 2) or they just have no idea what detoxification actually means. I was once told that a product (an MLM supplement someone was trying to sell me on) would "detox the mitochondria". Come again?

What Detoxification Actually Is:

• Detoxification primarily happens in the liver and intestinal tract.
  
• There are numerous different enzymes and pathways that are in charge of detoxifying different drugs, hormones, toxins, and chemical compounds.
  
• After a compound is detoxified (made less toxic and often water-soluble) it needs to be excreted from the body. This happens in the kidney, intestinal tract and skin via sweat.
  
• Liver detoxification processes happen in two steps: Phase I and Phase II. Phase I actually makes compounds more reactive and harmful, so it's important that all of the phase II pathways are up-to-snuff to clear those intermediates as soon as they are formed.
  
• Some drugs or foods may speed up or slow down phase I detoxification, but not phase II. For example, grapefruit slows down phase I detoxification. This is why it is recommended that you stay away from grapefruit when you take certain medications- the grapefruit will slow down your body's ability to get rid of the drug, increasing it's half-life and the amount of the drug in your bloodstream.
  
• Much of the detoxification that happens in the intestinal tract is done by our gut microbes. This is why a stool test is a necessary part of a good, targeted detox in my opinion.
• Contrary to what my colleagues MLM company tried to sell me, to my knowledge it is not possibly to detoxify individual cells or organelles. The closest thing to a cellular garbage disposal or detoxifier is called the lysosome. Also, the closest thing to being able to "detoxify the mitochondria" is low level laser therapy, but that's a topic for another day.
  

• Some compounds can NOT be detoxified by the human body. Substances like those, as well as leftover detoxifiable compounds that the body couldn't get rid of right away, are stored primarily in bone and fat tissue.
  

In my last blog post I discussed how I use melatonin in my practice as a sleep aid.

There has been a lot of research on melatonin in the last 5-10 years. Among it's impressive credentials, melatonin has now been shown to:

• Decrease oxidative stress (inflammation)
• Reduce pain (like NSAIDs)
• Protect the gastointestinal lining
• Protect the liver
• Help prevent neurodegenerative diseases such as Alzheimer's
• Protect the brain from injury
  
• Protect the heart
  
• Aid in cancer prevention
• Be part of a care/support regime for different types of cancer
  

Now, we can read this list and think "Wow! I had better get some of this stuff right away!" And perhaps we should all be on melatonin. But what if this long (and surely incomplete) list of health benefits has a deeper meaning? Melatonin has quite the impressive resume, as you can see. But to me this signifies the importance of sleep more than melatonin itself. For that matter, sleep's benefits aren't limited to the secretion of melatonin, but go even deeper than this list can portray.

For more in depth reading on the health benefits of melatonin, check out these two articles:
Life Extension (1)
Life Extension (2)

In health,

Urinary neurotransmitter testing is a test that is commonly run by naturopaths and functional medicine doctors. By assessing the amount of different neurotransmitter metabolites in the urine, the doctor hopes to ascertain if the patient has a neurotransmitter deficiency. This is an iffy topic, even in the world of functional medicine. On the one hand, you have doctors who are super gun-ho about it and run these tests frequently. Then there's those in my camp- those of us who don't think this testing is terribly useful or accurate. Alas, I suppose there are disagreements even in the world of functional medicine.

The problems I see with urinary neurotransmitter testing are as follows:

1. Urinary neurotransmitter metabolites don't necessarily correlate with the levels of neurotransmitters in the brain. Since there are tons of neurotransmitters elsewhere in the body and all of the bodily fluids eventually get filtered into the urine by the kidneys, there is no way to know where these metabolites are coming from. For example, the majority of serotinin and dopamine are found in the gastrointestinal tract, not the brain! Acetylcholine is found at each neuromuscular junction in your body as well as the hippocampus in the brain.

2. Many neurotransmitters are recycled (we in the biz call this "re-uptake") on-site, so their metabolites generally don't get excreted in the blood or urine. Serotonin is one such neurotransmitter, while Acetylcholine is broken down after each use.

3. The activity of neurotransmitters is dependent on numerous things- not just the amount of neurotransmitter available. Things like anemia, high blood sugar, inflammation, autoimmune disease, and poor nutrition are much more likely to affect the brain before a blatant neurotransmitter deficiency problem sets in. For that matter, any of those things can cause a neurotransmitter imbalance and must be addressed in treatment.

4. Neurotransmitters do different things in different parts of the brain and body. For example, Dopamine can be excitatory or inhibitory, depending on which receptor is activated and which pathway is stimulated. GABA is found in numerous places in the brain including the frontal lobe, basal ganglia, and cerebellum and is involved in a variety of different pathways. GABA is always inhibitory, but can inhibit excitatory or inhibitory pathways, which may make its' overall effect either excitatory or inhibitory.


All that being said, there is a time and a place for the use of neurotransmitter-specific supplements and treatments... I just think that testing for urinary neurotransmitters is a waste of time and money. Below is my general approach when assessing neurotransmitter function.

1. Patients in my office fill out the Neurotransmitter Assessment Form prior to their first appointment. This form looks at clusters of symptoms that are indicative of neurotransmitter imbalances.

2. I address Overall Brain Health first and foremost in my office. I know this sounds like a really wishy-washy topic, but it's surprisingly important. Neurons (brain cells) need three basic things to survive: Oxygen, fuel (glucose, ketones), and stimulation. This is why ruling out things like anemia, high blood pressure, excessively low blood pressure, blood sugar problems, and hemisphericity needs to be part of the work up for anyone suspecting neurotransmitter imbalance. Many hormones have the ability to globally affect brain function, so thyroid problems and hormonal imbalance should be checked for, too. Even inflammation, digestive problems, food sensitivities, and gut bacteria imbalances can have a tremendous impact on the brain and it's ability to function.

3. Last but not least, if the topics addressed in step two have not resolved the patient's symptoms and they still present with signs of neurotransmitter imbalance I may choose to supplement accordingly. Generally I use combination supplements that include precursor amino acids, vitamins and co-factors needed to make neurotransmitters, and herbs that boost that activity of different receptors.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,

Yes, you should. Thank you for tuning in.

In health,

Okay seriously- Should you be taking antioxidants, and if so which ones? How much? The easier (and funnier) way to answer this question is a simple "yes!" and "the more the merrier!" but let's take a minute to look at this objectively, shall we?

Antioxidants prevent oxidative damage (aka "free radicals" or inflammation). This is becoming increasingly important in today's world where we are exposed to a high amount of stress and inflammatory stimuli. Skeptics argue that people have lived for millennia without supplements, so they must be unnecessary. This sounds like a logical argument until you account for the incredibly different world we live in and the completely different diet our species eats now. Our ancestors ate foods that were rich in vitamins, minerals and antioxidants... meanwhile, we rejoiced as a country at the return of the Twinky.

The tricky thing about antioxidants is that it's hard to really figure out what is the ideal amount to have. You and I could have the same levels of glutathione, for example, but if I am exposed to more inflammation than you are I will have a greater need for antioxidants than you. This is why I generally don't test for antioxidants in my office, but I tend to supplement based off symptoms and apparent need. The exception to this is Omega-3 fatty acids, which I do test for in my office. One lab I run looks at the ratio of omega 6 to omega 3 in the blood, as well as the types of omega-3s present in the blood. This gives us a better idea of how much omega-3 you should be taking (quantity), as well as the type (EPA, DHA, ALA) and dietary modifications we need to make to decrease omega-6s.

Let's look at two different scenarios that can effect one's need for antioxidants.

Scenario 1
Two patients come in with the exact same medical history- the same health as a child, same diet and exercise habits, same stressors and illnesses throughout life. However, Person A has a lesser ability to cope with inflammation than Person B. This means that Person A will experience symptoms and get inflammatory diseases sooner than Person B despite having all the same stressors and inflammatory events. This may be due to genetics, epigenetics, or both.

Scenario 2
Two patients come in with the same health history- they had the same illnesses and inflammatory stimuli at the same points in their life AND they have a similar capacity to handle inflammation. However, Person A started life with less inflammatory load than Person B. This may be due to the health of the parents (or even grandparents!) prior to conception or the mother and baby's health during pregnancy and birth. In this case, Person B is likely to experience symptoms and acquire disease before Person A and it may very well be through no fault of their own!

The reality is that if you are alive today and don't live in a bubble, I'm sure you could benefit from some form of antioxidant support. The awesome thing is that there is relatively little risk that you will cause harm by taking antioxidants (as opposed to herbs, which are a little trickier). Of course, the best way to know if you've got the right dosage and type of antioxidants is to consult with a functional medicine doctor such as myself, but here are some tips for you independent types...

General rules of thumb:

1. For the most part, the dose you need to feel a benefit is related to your symptoms or disease severity. If you have diabetes, fibromyalgia, Crohn's disease or cancer and you take one fish oil pill a day it's likely not going to make a very profound change in your symptoms. For example, it is not uncommon for people with chronic diseases to need up to 10 grams* of omega-3s per day to get their levels to where they need to be. I, on the other hand, tend to do well on just 3 grams per day. You can be the judge of how much antioxidants you need.
*Be careful taking high doses of omega-3s without a physician's supervision. Omega-3s thin the blood, so patients on blood thinners such as coumadin may need to work with their doctor and lower the dose of their medication.

2. Pay close attention to the type of antioxidants you get- many fish oil supplements from drug stores sit on the shelf for a long time and are rancid (and ineffective) before you even get them home. Additionally, supplements may contain things that are not on the label (yikes!). I carefully screen any supplements I carry in my office, but if you must buy supplements elsewhere Consumerlab.com is a great resource.

3.  Finding the most effective type of antioxidant for you is a little trickier of a subject, and is best handled by a supplement-savvy doctor such as myself. However, two antioxidants that I think most people could benefit from are omega-3 fatty acids (EPA and DHA, not ALA) and glutathione.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,

To some of you, the fact that people have said the above to me will be quite shocking. Even more shocking, those exact words have been uttered numerous times by colleagues in chiropractic school.

Saying you "don't believe in supplements" is like saying you "don't believe in surgery"; another thing that is often said by fellow chiropractors. The thing about it is that nothing in life is so black and white. I don't believe in unnecessary surgery, but I'm careful to draw a distinction between necessary and unnecessary and I acknowledge that those definitions change in different situations. If my arm gets lopped off tomorrow please, please get my butt into emergency surgery and sew it back on. Gallbladder removal surgery, many back surgeries, bariatric surgery, and many more? Grossly overused. No question.

I don't believe in unnecessary surgery in the same way I think that most people mean that they don't believe in supplements. I don't believe in unnecessary surgery, nor do I believe in ineffective use of supplements.

So many times people go to a health food store, multilevel marketing supplement distributor,  or website and get random supplement X. Random supplement X might be a vitamin, mineral, herb, or protein powder that has been said to help a symptom or disease- Iodine for the thyroid or alfalfa for gout, perhaps? But without an understanding of the person's whole body and the physiology of the symptom or disease, how do you know that supplement X will help?

My point here is that while all of the above folks are well-intentioned, they often lack the level of understanding needed to appropriately manage people with complex/multiple problems. That's not to say that their products wouldn't help the complex cases I see- it's just that this route tends to be very non-specific. I have just found that many people need their physiology picked apart with a fine-tooth comb- something functional medicine doctors excel at.  

The effectiveness of a supplement is only as good as the understanding and expertise of the person dispensing it. Going to Whole Foods and asking the kid behind the counter what to take for your thyroid might prove to be beneficial, but honestly this model almost never does. These are almost always the beginnings of a "I tried supplement X, Y and Z and didn't feel anything different" stories. Those people often go on to say that they don't "believe in supplements". But of course you wouldn't believe in something that didn't work for you! You'd be a fool to still "believe" in something that has proven to be ineffective.

Finding someone who knows what they're doing is so crucial when considering using supplements. Sadly, even most chiropractors, nutritionists, acupuncturists, doctors, and naturopaths have relatively limited understanding of how to properly dispense supplements. Functional medicine doctors, on the other hand, go to great lengths to understand biochemistry, nutrition, and physiology and are generally very good at using supplements effectively in practice. The key word here is effectively. Functional medicine doctors try to get to the root cause of problems, but often more importantly they prioritize. Figuring out what is causing what is a delicate art and ensures that the patient receives the most effective care (and cost effective supplementation) possible. One such example is being able to recognize when an autoimmune disease (hashimoto's) is causing hypothyroidism, which then in turn causes hormonal imbalance and an irregular period. Oh the tangled webs we weave!

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,

This is the first of a series I'm starting here called "Thoughtful Thursdays", where I give readers my two cents on all things health. I hope you find it both thought provoking and helpful!

I fully admit I love learning about nutrition and supplements. It's one of my nerdier hobbies. I have seen both personally and professionally how supplements can do tremendous things, but over the years I have encountered a number of skeptics. I love people who are skeptical- if nothing else they afford me the opportunity to grow as a teacher, reflect and develop new insights and opinions. Here are a couple of comments I have gotten in the past and my responses to them.

1. What are the best supplements to take?
The long and short answer here is that there is no best supplement, no magic bullet. What might be good for one person may do nothing or harm another. Those of us in the alternative medicine field often forget that and like to think that our natural products can only do good, but that is not necessarily the case.

Granted, a downright negative reaction to a supplement is relatively rare, but it's always something that needs to be discussed prior to treatment. In order to do this and understand the possible side effects the practitioner needs to understand the physiology behind what they are giving you- how does the body absorb the product? How do different tissues use it? Knowing the pathways for how a product is used will give the practitioner insight (and predictive power) if those pathways are pushed a little too far. Sadly, not everybody who prescribes or distributes supplements knows these pathways, and therefore doesn't tell patients about the possible side effects or know how to handle them when they come up. A response I've heard more than once is one of blind faith- "Just keep taking it anyway. I know it's good for you".

The scenario I've heard far more frequently is that where the supplement made no noticeable change. Ask anyone if they've ever taken a vitamin or supplement and I'd bet 80-90% of them will say something akin to "yes, but it didn't do anything so I stopped taking it". This comes down to two issues that really can be rolled into one. If there is no objective measurement (blood, saliva, stool testing) to go off, two things happen. First (and most importantly), the practitioner doesn't necessarily know what your body needs. Yes, there are certain things (like neurotransmitters) that are difficult or impossible to measure, so you have no choice but to go off of the patient's history and exam, but that is not the norm. The second thing that happens is that the patient doesn't know (or understand) how or weather this supplement will actually help them. Without an adequate discussion and explanation the patient may not understand what changes to look for. To add insult to injury, I find that nonchalantly prescribing supplements decreases the value that the patients place on those supplements, and often times people take them sporadically or not at all.

The key with supplements is to
    A. Get lab testing done and an exam to understand what your body needs- don't take something just for the sake of taking it.
    B. Discuss the supplements (and medications) with a physician who is well versed in this topic
    C. Take the supplements as they are prescribed and communicate with your physician as you notice changes, no matter how small

2. I don't believe in taking supplements. Our species has lived for millenia without supplements so we don't need them.

I believe this opinion often stems from people's previous experiences with supplements and vitamins. They, like so many others, have probably tried taking supplements and vitamins before, did not feel a change, and then dismissed that all supplements are worthless. Yes, some supplements are borderline worthless or can do harm, but that is exactly why I do lab work in my practice- so I can better assess what each patient actually needs.

The concept this brings up is an interesting one, though. Do we all need to take supplements every single day? On the one hand, supplements only became available to us as a species in recent years, which may indicate that they are unnecessary for human life. But if you think about it, people are living longer, much different lives than those of our ancestors. It's really not fair to compare the two. Years ago I'm sure people weren't eating PopTarts, sitting all day, taking multiple prescriptions, and being exposed to (the same) toxins we are now. I'm not saying everyone needs to take supplements every day, but I'm sure the relative need for such help has dramatically increased in the last hundred years.

Furthermore, while it's true that most of us can live without such help, that's not always my primary concern. Chronic diseases and poor nutritional status don't kill you immediately (thus, they are chronic) but can dramatically affect your quality of life. Yes, you can live without taking vitamin D if you are deficient... but your quality of life will most certainly be poorer. No, not everybody needs to take MTHF (the metabolically active form of Folate), but if you are one of the many who has an MTHFR SNP and can not convert Folate properly you can bet your bottom dollar I'm going to recommend you take MTHF for the rest of your life.

3. Dr. Oz said this is the most important thing everyone should take.

If you watch these types of shows regularly you'll notice a pattern: whatever they are talking about that day is the most important thing. You never hear The Doctors say "well, as exciting as this episode is, it's not as important as what we told you last month".. That wouldn't do much for ratings and would most certainly confuse the public. I've heard Dr. Oz state no less than 12 times that the supplement he talked about that day was "the most important for everybody to take" or "if I could recommend one thing for everyone to take". The confusion sets in when you realize that he's recommended about a dozen "one thing" products.

Moral of the story, don't take your advice from the TV or internet. Neither of these things can possibly be a substitute for a good physical exam, blood work, and open communication with a practitioner who knows what they are doing.