Read the Episode Transcript
I'm Dr.
Alexa Neynaber with Virasoap Natural Medicine.
I'm a naturopathic medical doctor and certified functional physician, and our clinic specializes
in natural health, wellness, and aesthetics for the whole human here in Meridian, Idaho.
Earlier this week, I had the wonderful opportunity to get to connect with one of my favorite
nutritionists in the valley, Dani, and she owns and operates a practice called Riverwood Wellness.
And I'm very excited for you to listen in a little bit more on the
conversations we had, and we cover a lot of ground so I hope you enjoy.
If you could share a little bit about your really unique backstory and kind of how
you ended up in nutrition, because you have a very unique set of previous jobs.
Okay.
I do.
I do.
Thank you so much for asking.
So I'm Dani and I am, , the founder and creator of my company called Riverwood Wellness.
I've always been a health, lover.
Uh, I just, people are born that way.
I think some people are, I definitely was.
But I did, you know, suffer quite significantly in my childhood
because now autoimmune disease is pretty, you know, common.
It's very easy to catch right away, or at least we have a lot of ways of recognizing it.
But, um, back in the eighties, which when that's when I was
growing up, there was just not a lot of understanding around it.
And I had really significant asthma and this was like before there were inhalers.
So I really suffered a lot as a child, um, often with
like this feeling of, you know, not being able to breathe.
Um, and thankfully through.
Um, naturopathic means and Chinese medicine, um, which we found kind
of through the back door because my parents really tried to take me
to, you know, medical doctors and nobody was able to do anything.
But, uh, eventually through Chinese medicine, I was able to
come to homeostasis and I don't suffer in that way anymore.
Um, that really kind of opened the door for me in terms of what was possible with herbs.
And, uh, we didn't really have supplements at that time, but with herbs, and food.
Uh, but then uh, life goes on and you kind of forget all of those
things my life I wanted to be a pastor, that's what I wanted to do.
So I was off running to graduate school to become a pastor in the presbyterian
church and lived that life, still do because I haven't given up my ordination.
Then 2020 happened I kind of wanted to take another look at my life and through you
know this course of events I just jumped in with two feet and it was wild because I
was a liberal arts and I was studying literarytheory in graduate school and now all
of a sudden I had to go back to school and learn about cells and, um, it, it was wild.
It was a really humbling experience but it was really beautiful in so many
ways I'm really glad that happened now that I'm on the other end of it.
it just feels like I'm so grateful that I have a
chance to bring these two things together together.
and that's what brought me into this path in 2020 is that
I realized was just like, I had this crystallization.
I had known all these things for a really long time, but all of a sudden I was like.
the whole person actually means like the health of the body.
And I kind of committed myself from that point on to learning how to support the health of the body.
And I couldn't become a doctor because I had a family.
I mean, that's still a lot of work that you've put into the degrees that
you've come to, and you're still doing education too in the nutritional space.
I mean, gosh, you've been in school a very long time.
I mean, I don't blame you for not being like, I'm not going to go the full doctor track
I know.
I looked into it, but, um, I couldn't ask my family to put up with that.
Um, so I had to say no.
with something that's so unique too about, the way that we met and the journey
is you and I met in Boise and Meridian, but we discovered that we technically
were , Neighbors back in the Seattle area where we lived in Ballard and
the church that you worked in, I'm pretty sure was down the street from me
It
it's just such a wild, weird connection to have made.
And like, how did we never meet there?
yeah, it was like 10 blocks away from where you lived, but I was rarely in the health space.
So just would not have intersected, you know, but it's just so crazy.
And then Another thing is that before we lived in Ballard,
we lived a few blocks away from Bastyr, which is where
So weird.
know.
And so I just, then that, that's what I mean.
I feel like, you know, I was steeped in this world, um, but just didn't know where the door was.
You know, it was like, how do you get in?
Um, it just takes time to kind of figure that out.
I love on the clear days, like seeing the mountains, but when you're
a student, you don't really realize how much the clouds get to you.
And by the time I was in residency and like biking all the time and like kind of having a
little bit more of a life outside of work, I was like, Ooh, you know, I do kind of miss the sun.
I don't know how you did it for so long.
I think it really started to get to me after a few years.
you know, You can't kick yourself for not knowing the things that, you know, later, earlier
on in your life, but I go back to looking at pictures of myself during my childbearing years.
Right.
And I, every picture I'm like vitamin D deficient.
Vitamin D deficient, like it's just so obvious, um, my face, in the
tone of my skin, in the, like, sort of the darkness under my eyes.
Um, I just know that that was a significant player in
a lot of the issues that I had around my pregnancy.
And of course I had no clue whatsoever.
So.
I mean, it's not something that's really talked about it even there.
It should be because it's so prevalent there with how many days of cloud cover versus sunshine.
You know, I always used to joke when you would go to PCC or Trader Joe's or the grocery store there.
On the days, the sun would come out at the checkout stand, everyone was so nice to each other.
It was like palatably different.
And people were like, what are you doing this weekend?
And actually making conversation versus the normal, maybe like six other days of the
week, when I would go check out, everyone's just like, did you find everything you needed?
Great.
Like, it was a lot more cold.
And so I really don't think people realize there, exactly as you said, when you're in it, you
can't really have the perspective outwards of how much that affects even just your daily mood.
Yes.
And I never even checked my vitamin D level.
I mean, that's the wildness.
Um,
It's still not standard of care on an annual panel.
I had no clue.
And here's the thing.
gave birth, this is just a shout out to moms who are going through very significant
like nutrient deficient seasons, which I would say is when you're in your childbearing
years, like, like it or not, it doesn't matter how well you took care of yourself
before, like you are going to need huge amounts of nutrients during that time.
Dr.
Alexa, I didn't know what I was doing.
Like, I was trying to eat food.
I was hungry all the time, but I was not strategic with any of that.
Um, I don't think I got nearly enough vitamin D.
I don't think I got enough iron.
I don't think I got enough B 12.
Like there's so many things that are so needed at that stage in life
Yeah,
to mood and that helped to mitigate against postpartum depression and all of that sort of thing.
And I, know any of that.
And I was living in a state where there's no sun.
right.
I mean, looking back at it, was your OBGYN care team even looking at these types of things?
It was not even something that came up, but I'll also say that neither did the midwife.
Um, I just wonder, and again, my oldest son is 19 now.
So we would back up like 20 years.
I just wonder.
if there was significant research going on at that time that was helping folks to know.
And I think that one thing that I celebrate now is that we've had so much research among
nutrients and supplements, often unutilized, but really significant research that helps us
to say, no, like we're saying now, If your vitamin D level is less than 20, that is alarming.
But if it's in the 20 to 30 range, like we need to get that up because you're running the risk of
some mood issues, potentially, you know, postpartum or even currently, um, but then the longterm
health, you know, um, in terms of bone health and all of that sort of thing that it contributes to.
you know, especially what you're saying in childbearing
eras, , it really takes a lot of nutrients to grow a person.
And why aren't we talking about that?
You have to be your own advocate.
You almost have to be your own doctor to be able to, Try to find all this information
of what the heck you're supposed to eat, you know, preconception during pregnancy,
postpartum, and we've come a long way, but there's still a lot of lacking information
out there for people who just don't understand and they're stuck under that cloud of,
well, I'm in postpartum depression, I need to go and I need to get an antidepressant.
And maybe that's true, but maybe also nutrient status hasn't really been
evaluated or, That treatment hasn't even been something you were looking for.
Yeah.
so, , I love having those conversations with people now about
like, I'm starting to think about family planning, you know?
Oh, great.
Have you ran an iron panel?
Have you run like your B vitamin status?
Those things are really important.
, And I could chat literally for hours about the disservice of the world of
iron towards women because so often it's not looked at during pregnancy or
they just run a CBC and it's like, you okay, so you know that you have an
increased blood count that's going to hide a lot of these types of deficiencies.
Has anyone actually looked at an iron panel?
What is your storage like?
Because a pregnant mom, yeah.
with a ferritin of nine does not feel well.
And having someone tell you like, oh, that's normal
or worse, not even checking it is such a disservice.
I'm so curious to hear, because I, love to hear the
different opinions, between other clinical providers.
What is your ideal vitamin D in the summertime versus the winter time in your patients here?
Oh, that's such a great question.
Um, when somebody is up around 40 to 60, I'm usually like, things are looking pretty good for you.
Like that's a good place.
And I think it looks a little bit different in every person.
Like if somebody has got some lipid dysregulation, then I'm
looking for a little bit higher vitamin D in that person.
Totally.
if somebody's feeling really good, um, and they're on like
a 40, then I'm kind of like, okay, let's just keep an eye.
We don't want to.
You know, we want to keep those fat soluble vitamins in balance.
Um, so I usually go between 40 and 60.
I will tell a funny story.
Um, well, it's funny to me.
Uh, so during the summer I don't take vitamin D, uh, that's just me personally.
Um, but I spend a lot of time outside.
So I went to go do a blood panel.
I don't know, maybe three years ago, my vitamin D was 60.
Um, no, uh, exogenous nutrients taken.
It was just from the sun and the provider that I was working with at
that time told me it was way too high and I needed to get it down.
And I was like, what?
Did you know at the time any better?
Like, were you like, are you sure?
Or?
This individual was operating under, um, a, an assumption that vitamin D and vitamin A have to work
in a certain proportion to each other, or they can be sort of harmful to longterm mineral depletion.
Um, So I understand that, uh, and what this person was saying was that my
vitamin A was too low, um, and so the vitamin D and the vitamin A were not in a
correct proportion, according to her, but I've since kind of thought about it.
Let that go.
Um, and I don't operate under that assumption at all, particularly because
I was feeling pretty good and my body was doing what it needed to do.
And I just kind of felt like if my body is going to make
that amount of vitamin D, like I'm not going to fight it.
So yeah, 40 to 60.
you know, I like the answer though of , you know, it isn't just a set number for every single person
because we are going to have a variance between ages and genders, you know, and maybe the season.
And so, I would agree with you, if someone can be out
in the sun and they can get it that way, that's awesome.
I'm obviously always cautious about sunburning and, you
know, skin health because I work in the aesthetics world as well.
And I do believe there's, A little bit of a Goldilocks situation where you can have just enough.
You can have too much, you can have too little.
, and so I really think that that middle ground of like the 15 minutes of the unprotected, you know,
without sunscreen is like that perfect middle ground, but past that, especially if you are a light,
Fitzpatrick type in your skin tone, you do really need to be cautious about sun damage, especially.
But I'll tell the story about my mother.
, she was living in California and so she was sunbathing all the time.
She was not a very good person about sunscreen, which I've gotten on her case about.
But, , she was at least getting 20 to 30 minutes of midday sun.
And based on.
Research, that should be plenty, especially if you're doing that every single day.
We ran her vitamin D status and it was 15, even still with sunbathing.
And so that is where I started to research and realize that there are genetic predispositions
that people have, especially with the VDR taq mutation, that not everyone converts from the sun.
So this idea that , Oh, you can just get everything from the sun, you don't
need a supplement, I really push back on, you really don't know until you test.
I totally agree.
And I could not agree more.
And, um, personally, I, you know, I've always loved the sun.
And so it didn't surprise me that I and I don't know what my phenotype
is in that regard, because I haven't done that scope of testing.
But, um, what I will say is that I have a redhead.
My son is a redhead, and we are very cautious with his sun exposure.
And keep a close eye on his vitamin D because of that,
because of all of these things that you're talking about.
So it is essential to test and yeah, you can't just
assume that, you know, just cause you're getting the sun.
No, definitely not.
And I do think that, you know, it's such an important thing, we keep finding
out more and more information; it's not just a vitamin, it's a hormone.
And it has all of these other anti inflammatory
implications that it should be on the standard panel.
It should be part of what we're looking at preventative medicine wise in terms of storage.
If COVID taught us nothing else, I mean, there were so many studies that came out , your mortality
risk and your risk of contracting an upper respiratory virus was worse in low vitamin D status.
And I like to remind my patients about this is like, let's say
they had a really good vitamin D score at the end of summer.
You know, like you said, it was 60.
Perfect.
You've been out in the sun playing.
Awesome.
We get into winter.
You get hit with a bug.
You get hit with RSV or you get hit with COVID or you get hit with the flu.
I expect someone's vitamin D to drop at least 10 to 20 points.
And so that's why in those stages, you should bump it up significantly more
than what you're supplementing on a regular basis because we expect it to fall.
I completely agree.
And the other thing that, um, that I love vitamin D for, and that it
sometimes gets forgotten about is when it comes to lipid modulation.
For folks that are dealing with high triglycerides or that are really trying
to work on their cholesterol levels And again cholesterol is a completely
different conversation, but just in terms of people who are inflamed.
Let's put it that way.
They're also showing signs of lipid inflammation.
These are folks who are likely very vitamin D deficient, and that's what I found clinically.
And so with those folks in particular, you know, really bumping up their
vitamin D to just start to get those lipids working the way that they need to.
I mean, to think of it as a vitamin, I know that, you know, I'm always
sort of amazed that we've only discovered vitamins really in the last
100 years in terms of Being able to identify what the actual molecule is.
It wasn't that long ago.
I mean, it is important in historical context to remember that this is
kind of a new area of medicine we haven't been focusing on for a long time.
We just kind of knew generalizations and we knew the types of foods that were good.
I really think it will continue to emerge and we will find out , lo and behold, food
matters, the way that you give your body nutrients really matters, and I wish, I mean,
probably like you, I wish there were easier ways for people who especially don't convert
from the sun that they could get vitamin D from the diet, but it's pretty darn hard.
There's not a whole lot.
It's really hard.
And, You know, we look at traditional sources, which would be like cod liver oil,
and then we look at, you know, cultures that were isolated from the sun, like the
North Alaskan culture where they were eating significant amounts of Marine fat,
and in that Marine fat, so it wasn't just limited to cod liver oil, obviously.
And in that Marine fat, they were able to recoup that vitamin D.
But I don't see people in our day and age, like eating seal fat
on a regular basis, you know, I just, it's just not happening.
And even if we do get it, we're not getting the lipids and we're not getting
the organs of those animals, which is where the vitamin D would be accessible.
Right.
Yeah, a deep dive into finding food sources of vitamin D would kind of mean
a radical culture shift that I don't think anybody is ready to take on.
So I do think that, you know, we either need to get it from the sun or
we need to get it from these exogenous processes, but, we definitely
need it and I think we're getting to a point where we can't contest that.
Right.
I mean, when people say , well, I eat some mushrooms and I drink milk.
I'm like, well, in the milk everything's been added back in after it's been super vat pasteurized.
I really don't think that this is a super, Highly absorbable form that's actually going to
accumulate to being a level that is going to serve your needs in terms of cold and flu season and
milk in general has its other problems, but that's one of the biggest pet peeves I have about it.
When they're like putting vitamins back into a food, whether it's milk,
whether it's cereals, whether it's flour, um, what else do they do it with?
I think those are kind of the main things.
Yes, the fortified foods, they're using the lowest
quality vitamin that they can possibly come up with.
And I think it's important to know that these vitamins, um, they do come in various types.
you know, amounts of quality, like there are sort of categorical qualities that they exist in.
And for example, like the way in which you receive B12 can actually cause your body to process
a little bit of cyanide, or it can cause your body not to process a little bit of cyanide.
Can your body do it?
Absolutely.
It can.
Would we want a high level of that?
Maybe not on an everyday basis.
Um, especially when we consider our whole toxin load.
So This is where that discussion around vitamins gets really interesting.
interesting and also complicated, right?
Because we know that a low quality one can create actually negative results.
But when we're receiving it in an absorbable way and we're getting
high quality vitamins, we see significant shifts in health.
And
It's really hard for people to understand that.
And I think the other mistake that we make is that we think if we pay
more money, Then we're getting a higher quality vitamin because we're
looking for
how do you tell us what's higher quality?
And unfortunately the supplement market is just so saturated right now.
It's a nightmare, especially.
a nightmare.
I want to encourage people to do their research and I want to
encourage people to look into supplements that can benefit their health.
But when they're buying something from Costco or Walmart that
hasn't had any sort of third party verification testing, there is no
guarantee that it actually contains the amount it says on the label.
And to your point, it could be a super low quality.
Type of formulation that does not even allow the body to absorb it.
And so it's such a waste of money.
And in the worst type of scenario, like you brought up certain types
of vitamins can actually become harmful because of the way they're
formulated or the way that the chemical backbone is in that specific form.
And so I always used to joke that cyanocobalamin was
kind of like junk B12 and it's the least favorable form.
And it tends to be the one that I see in a lot of really crappy multivitamins.
Almost everything.
That's a big deal in our, injection supplies.
You know, when we do infusions or when we're doing intramuscular shots, we're very, very picky
about the form that we're going to purchase because it's going straight into someone's bloodstream.
And obviously, that's not right for everyone.
Really, when I use things , for example, the vitamin D shots, I'm really using those in
patients who they have failed oral absorption of really good quality daily supplements.
And we're always going to try that first.
You know, I try the trick of like, okay, have you taken it with a source of fat in your day?
You know, alongside maybe an avocado, maybe that's going to help with your absorption.
Are you taking a form with K2?
That might help with your absorption.
And if someone truly is still failing that and
genetically they're just not absorbing that or the sun.
I might make a recommendation to build up their levels with the injections and
then with the hope that they can maintain with diet lifestyle supplementation.
Um, I don't want people to be reliant on the shots forever, but it can be a
nice way if someone is totally tanked that we can get their levels back up.
Yes.
And I, you know, received B12 shots during my childbearing years for that reason.
And that was just the result of not knowing very much about nutrition, spending years on
a vegetarian diet, and then having three children in very quick succession to one another.
Um, And yeah, it was, it was really, and so yes, I think there are significant times and
important times where having that kind of intervention can really change, quality of life.
Were you doing the B12 shots during your pregnancy or postpartum?
It was postpartum.
Okay.
Yeah.
And at that time, did you know like what the form was or anything like that?
I knew nothing.
And not only that.
I didn't know that B12 needed to be taken in combination with other B vitamins
like folate and riboflavin in order to even do what it was needing to do.
So likely I was getting B12 and nothing else
Yeah.
and really expensive urine?
Was like, anyway, it was just a wild season in my own health of, but
I think what it alludes to is that we do think like, oh, I'm tired.
I must need B12 in the naturopathic world or in the natural world, right?
Instead of recognizing that maybe it's not just one thing that's
needed, but the whole spectrum of nutrients that work within that, those
pathways that can kind of help you get on the road to health again.
And that's kind of the same in medicine too, right?
It's not usually just one thing.
not usually one root cause that's a singular.
I mean, if it is for someone, I love that for them and that's great.
Great.
But it's not typical.
It is going to be an accumulation of multiple different factors and
variables, which is why we look at multiple different types of nutrient
status at once, when we're doing someone's overall health evaluation.
We aren't just going based on the labs either.
We're mirroring that at the same time with someone's symptoms, because as you alluded
to earlier, someone might have rockstar energy and their vitamin D is only 50.
And that level might be sufficient for them.
You can't take labs as everything.
Okay.
Because they have flaws.
They have errors.
There is a degree of variability.
I always kind of say that it should be this marriage between the labs and the symptoms.
One tells half the story.
The other one tells the other half of the story.
And, there are problems with labs.
The biggest problem I have with evaluating someone's B vitamin status is
they'll come in and say, well, my primary tested my B12 and it was fine.
Okay, well that's a serum B vitamin value, so it's only
showing what's carrying around in your bloodstream.
That has nothing to do with what is actually stored in your
body, or what is actually available for functional use.
So, serum based lab values have problems, and they're not perfect.
Yeah,
And this is why I don't typically test vitamins.
Um, I look at, you know, full labs.
CBC metabolic panel from those and a lipid panel from those I can pretty, I
can get a pretty decent picture of some of the things that might be going on.
I agree.
It's only 50 percent of the story.
When I look at somebody's labs, I'm thinking, I might see this.
I might see this.
I might see this.
And then when I'm listening to them, I'm in my head thinking, okay, that makes sense.
That makes sense.
Let me hear a little bit more about this and that always 100%.
But I think people I have this idea that if I can just test my
RBC level of specific vitamins, I'll know what I'm deficient in.
I wish that was the case.
And sometimes I think that gives us a picture, but you're sure.
I don't think that it's an all in all.
Um, and the, the sad thing is that those tests are expensive and
they're kind of like you're digging up rocks in every corner.
You're like, Oh, now I know maybe 12, but what's my riboflavin?
Oh, now I know my riboflavin.
Well, what's my zinc?
Oh, what's my now what's my selenium like you're looking for all of these different things
not realizing that they work in kind of this massive orchestrated pattern and the body starts
to kind of give you signs when one of thing is out of balance and you maybe have to do a
little bit of digging into nutrient supplementation or into diet or into that kind of thing.
Um, but yeah, I totally agree.
I, and I really wish that, you know, vitamins had better testing, you know, because there are
some and you have to take each one with the grain of salt, you know, especially those RBC tests.
They are really expensive.
They're like never covered by insurance and, they really only give you that
snapshot, you know, it's something that's constantly being shuttled inside and
outside of red blood cells, white blood cells, other types of cells in your body.
You're only seeing that one snapshot of time.
You are not seeing the functional use of it.
So that's why I love, like you do, pairing the whole picture of someone's complete
annual labs to kind of get a better idea of what's the utilization of those vitamins
looking like because that tells us a lot more of their vitamin or nutrition status.
One of the examples is like magnesium, right?
Your magnesium RBC level might look just fine, but I
can guarantee most Americans are deficient in magnesium.
The soils are very depleted in it, and most of the time, we just do not get enough from food.
We just don't consume the amount of food, even if those food values were perfect, of leafy
greens and other different types of magnesium containing foods that would give us those levels.
And so You know, when people ask me that question, well, should I take a magnesium supplement?
I'm like, well, maybe there's other different ways you could get magnesium into your body.
Let's look at what you're eating food wise first, but yeah, you might benefit from this.
Let's do a therapeutic trial and see if, you know, does
your sleep improve, does your muscle tension improve?
Do your headaches improve?
You know, based on the different type of, there's like
a million types of magnesiums now that you can utilize.
. And so there is not one perfect lab test that's going to give us all the
answers, which is why you really do need someone clinically trained, you know,
to have seen the experience of these patterns of what you're describing with
your symptoms, really tell the story of a potential magnesium deficiency.
You can't get that from a lab test, right?
Mm hmm.
one of the things about magnesium and you know, this is that it really
depends on this absorption because it's used so much inside the cell.
It's not really helpful, um, sort of in the extracellular space.
And so you.
You can have somebody who's deficient in magnesium, but they're not able to get it in the cell.
And so sometimes taking magnesium ends up providing symptoms for that particular person.
And they're like, well, I can't take magnesium because it does this or that.
And with those people, I'm always really cautious.
Uh, and I'm not thinking let's test your magnesium, you know, because it's
usually something that's kind of outside of testing that we're trying to
figure out, but we're trying to figure out what are the issues with absorption.
Um, sometimes it's not even gut.
Sometimes it's hydration issues.
You know, sometimes it's issues, honestly, around B
vitamins and sort of challenges with B vitamin absorption.
So you're not quite able to utilize the magnesium
that's there because the systems aren't running right.
So, um, I do agree that we are totally magnesium deficient.
I, you know, this is one thing that has kind of stumped me for a while because I've thought like,
how did people like, yes, we can get it through leafy greens, almonds, chocolate, all of those.
There are food sources, but the amount that we need to thrive, um, is really.
kind of more than those food sources allow for.
Yeah.
I have come to the conclusion, not scientifically, but just through my own sort of
experience that magnesium really means it also should be in the water supply to some degree.
And I think you see that in spring water and in mineral water you see some
small level of magnesium present balance with calcium in those water sources.
And that's why when somebody is magnesium deficient or
you know sort of sharing symptoms that are around that.
that are around that, I'm thinking, what are your sources of hydration?
Not just in terms of You know, plastic water bottles are any of that kind of stuff,
but I'm thinking, how is your body able to absorb the water that you're getting?
Is there a form of magnesium that's in that water?
No, it's not going to supply the complete nutrients that you need here.
But let's try to hit it from all angles.
Let's think about your water.
Let's think about your diet.
think about your nutrient supplementation and let's think about those
other cofactors that magnesium needs in order to function adequately.
So it really is this giant picture.
It's not just a matter of taking magnesium.
Right, and you bring up a really good point that I always like to ask opinions about
because everyone has their favorite product or has their favorite solution for this.
Um, we live in a very dry place, you know, we're at high desert and it's very
different to what we are used to in the Seattle area where it was a very high humidity.
And so, with hydration.
What do you typically like your clients to use, in terms of water filtration and mineral
repletion as they are hydrating to have really true water that they are holding onto?
Yeah.
Okay.
I'm going to be really unpopular here.
I'm going to say just do not use reverse osmosis systems.
Um,
think there's validity to this.
Yeah.
I'd love to hear your opinion on that.
so this is an anecdotal experience, but I used reverse
osmosis for, you know, 15 years I did not have symptoms.
symptoms until year 15, um, that were directly related, uh, which we can
talk about, you know, in depth, but it's complicated, I have realized that
most people can handle reverse osmosis water, but here's what it does.
It takes a tiny little bit of a toll on your kidneys on a regular basis because they are
receiving water that has no mineral substrates in it and therefore they are repleting
needing to replete those minerals through the filtration system of the kidneys, right?
So the proponents of the RO water will say well your kidneys
are designed to do that and if you just
to do that.
And if you just eat enough fruits and vegetables, everything will be fine.
Nobody has done enough research to actually know the answer to this question.
So the science is truly undecided,
personally, my opinion is that I don't recommend it because over time I think it
adds too much stress to the kidneys and therefore runs the risk of depleting bone.
So especially in older patients, I would say never use reverse osmosis water.
And, um, if you're dealing with any form of osteoarthritis, osteoporosis issues, or use it very
limitedly, I shouldn't put a scare factor out there because Kidney, your kidneys are amazing and
they can do a ton of stuff and we don't need to be afraid, they're actually very amazing organs.
I'm wrestling with what's a realistic solution for people, um,
because it is an area that, um, that I think is really significant.
Well, it's important, right?
I mean, if we look at like foundational pieces of health, hydration and water is huge.
We would die without water fast.
Before, you know, we would die without food.
, It's one of those things that I think we've just been pushed
in terms of dosage and frequency, dosage and frequency.
How much water do you need?
But we don't really very often talk about the quality and what does it mean to actually be hydrated?
So , yes, I have kind of, here's approximately the amount of water you should be drinking
for your activity level and your, sweat level and your diuretic use and everything like that.
But what does it actually mean for the water you're choosing, right?
You've brought up plastics we want to try to avoid.
We want to try to be out of glass or metal.
You know, we want to try to be having as clean of a source as possible.
But looking at the water quality here of what we actually get accessible in
terms of Meridian City water, Boise City water, Eagle City water, it's not great.
There's a lot of really bad, significant heavy metal contaminants.
There's a lot of really bad issues with things we don't fully
understand in terms of their amounts in the water supply.
And so I also have this wrestling in my brain of, you know, minerals, but also toxins.
And I want to make sure that I'm not poisoning myself and my family with what's in the water supply.
So I've come to this middle ground where also I was raised in a household
with RO and I had a lot of kind of suspicions that maybe it wasn't right.
But when you truly look at what can take some of these contaminants out?
It's one of the only things now.
There's some filters out.
So what I've thought and kind of what I encourage people to do is if you are going to
use an RO or reverse osmosis water system, you need a way to replace the minerals back.
And I would agree with you.
Not all of us are going to be diligent enough to consume the amount of
vegetables and produce that we would need to get those minerals back.
So if someone is having an RO system, they now have filters that you can do another
remineralization pass, and I think that that's really important if you are going to use RO.
And then I've had the question from patients, well, do I
really need to install this whole other filter in my house?
Well, maybe not, but then you need to find another source of them.
And so then I will encourage people to do significant amount
of trace mineral repletion, either in the form of drops.
I don't know if the capsules are significant enough to replace the amount
of minerals some people would be losing for the amount of hydration,
like some of our pro hydrators that get like 80 plus ounces a day.
I don't know that one trace mineral capsule is enough.
So my rule of thumb is every, 40 to 60 ounces of water you consume, you should be doing some sort
of electrolyte replacement or trace mineral replacement in order to hold on to that water better.
I'm curious if you have any of your favorite go to electrolytes
or trace minerals that you like to recommend to people.
Yeah, I usually go with what, and I completely agree.
I usually go with what people, um, sort of, they find works for them.
So I do a lot of the pickleball cocktail with, um, Jigsaw
What's that?
I think they, they put that one out.
out.
Um, that seems to work with a lot of people.
Whoa, whoa, wait.
The brand is Pickleball?
it's called pickleball cocktail.
Yeah, that's actually what it's called.
I'm not making it
adorable.
It's just a little higher in potassium.
Um, so I'll recommend that one.
People will want to do the.
super high sodium ones, to be honest I've found that those do
work for some people the one gram of sodium, which is just crazy.
Um, but with some people they can tolerate it.
And this is again why I think it's such a challenging thing.
Even when people ask me how much water should I drink or I get the flip side, which
is I asked them if how much water they're drinking just to get a sense of hydration.
And they're almost like they're almost like angry.
They're like, I drink so much water.
Like I am totally hydrated.
And And I'm like, okay, you know, like, let me just get a picture of what's going on.
So I think a few things here, I've started talking
with people about, um, honestly their urine color.
Like I'm like, tell me what it looks like.
Like, are you peeing clear all day long?
Because if you are, you might not be holding the water that you drinking.
You might be thinking that you're drinking a lot of water, but it's just going straight through you.
Um, You know, is it like heavy yellow all the time?
And again, we talk about like how vitamins can show up in that.
Like even this is a complicated conversation, right?
But it just, feel like we need a little bit more than just
a little bit more information than just water going in.
Yes.
we also need a sense of like how much water is coming out.
Are they having significant urgency?
Like, can they go a long time without urinating?
All of those things I think matter a lot in terms of how it is that we're holding the water.
And I've tried to explain to people like, look, I'm
not necessarily just looking at what you're drinking.
I'm also really interested in how you're holding that water.
And that to me is the most important thing.
And likewise, you can get people that overhold the water, right?
And they are swelling after they have, you know, um,
a cocktail that has a little bit more sodium in it.
So you can get a wide range going on there.
And that response that you get people that like, gut check of like, I am working so hard on this.
I'm hitting my water goal.
It's because, you know, we got drilled over the last
kind of 10 years about, people weren't drinking enough.
And I do agree with that.
I mean, sometimes on people's intakes, I see responses of , I'm
getting 12 ounces, 15 ounces, 20 ounces of water a day.
And just from a, you know, strictly volume speaking, that's not enough.
Um, just, you know, You're deficient in the amount of water you're
putting into your body, especially in a very dry high desert place.
But when you get into now the trend of the emotional support water bottle
and constantly sipping on water throughout whole day, which I'm loving
that trend because people are getting better about their hydration goals.
Then we start having to talk about the fact, are you holding onto it?
Because you don't want that effort to be completely going to waste.
I agree with you.
And it's not something we often are asking people, well, what was your pee color today?
Right.
Exactly.
Exactly.
And that's where I think that telehealth is kind of helpful because, you
know, they're not in, um, know, we're not like looking at their urine, right?
They're just, I'm just asking for a recall there and they're talking to their computer.
Yeah, to their computer in a safe space.
And I'm, it's not like we're going to talk about that
afterwards, but yeah, it is, it is a helpful piece of the puzzle.
This is such a good, like, random pieces of the things
that we get to talk with people about every single day.
And I feel like these conversations should be had more often, especially when we're considering,
preventative health and how to follow and design a healthy lifestyle for you and your family.
I don't think these things are being talked about in the primary care space, and they should be.
They really, really should be.
And I love that you are advocating and bringing in these conversations in your practice
because I really think that they are very underutilized pieces of a healthy lifestyle.
I love what you are doing as well.
And I think people don't realize that, it's not just about not being sick.
It's about being everything you want to be.
You know, it.
Avoiding sickness is one tiny piece of the story, you know, the rest of the
story is, do you have the energy to live the life that you're here to live?
And I think that that's really what kind of continues to, kind of light my fire.
And I know it light yours too.
As I'm having my diuretic, I'm like, Ooh, maybe I do need to increase my hydration today.
Oh my gosh.
It's always really nice catching up with you.
I definitely look forward to.
hearing about you helping more people that are looking to take that
deeper dive in terms of their nutrition, people who have those questions
about how they better follow a diet that fits them and their families.
And I think you just are a natural at it because of your
background and the heart for wanting to help people.
And I'm so, so grateful for other people who have this mindset
to try to better people's lives beyond just that line of fine.
I'm not sick, but I want to feel better.