Protocols

Explore 9 curated protocols with guidance built by Dr. Ilana Goldberg's Dispensary.

NAD+ Supplements
NAD+ Supplements: The Fountain of Youth? NAD+ (nicotinamide adenine dinucleotide) is a molecule found in every cell of your body . It helps turn food into energy, supports DNA repair, improves muscle function, and helps regulate inflammation. Healthy NAD+ status also helps your gut make GLP-1 naturally. NAD+ levels naturally decline with age, dropping roughly 50% between your 20s and 50s. They also fall with obesity, poor sleep, alcohol use, and metabolic dysfunction. Lower NAD+ is associated with fatigue, slower metabolism, and accelerated aging at the cellular level. So it’s no wonder that increasing NAD+ has become a focus of anti-aging clinics and longevity researchers. It’s basically an anti-wrinkle cream for your cells. Cellular aging is the primary risk factor for a host of chronic disorders, including cardiovascular conditions, metabolic diseases (diabetes, hypothyroidism, high cholesterol, hypertension), chronic kidney disease, Alzheimer’s disease, and other dementias, which represent the leading causes of death in developed countries. Much like old bodies, “old” cells are stiffer, more rigid, and less mobile. They don’t divide or reproduce as often or as well. They become larger, rounder, and less efficient at removing waste and repairing DNA damage. Maybe most importantly, “old” mitochondria struggle to produce the same amount of energy as “young” mitochondria. NAD+ decline is a major driver of cellular aging. Low NAD+ impairs DNA repair, sirtuin (metabolic enzyme) activity, and mitochondrial function. Restoring optimal level levels can improve energy, metabolism, physical activity, insulin sensitivity, and reduce inflammation. What is the connection between NAD+ and GLP-1? One area where NAD+ optimization has gained a lot of traction is addressing fatigue related to GLP-1 use. The vast majority of GLP-1 side effects are digestive. But significant fatigue and brain fog are reported by many people taking these medications. This is partially related to nutritional deficiencies. Reduced appetite and caloric intake can impact vitamin and mineral levels. (Vitamin B3 is the direct precursor of NAD+).  Additionally, rapid weight loss and caloric restriction place enormous metabolic demand on cells. Mitochondria are working harder to manage energy, burn more fat, and adjust insulin sensitivity. Ensuring robust NAD+ levels can help support all of these activities.  For many people, GLP-1 weight loss is about 50% lean muscle.  Losing muscle mass reduces the number and efficiency of mitochondria, making additional support essential. This is precisely why many GLP-1 prescribers now also recommend NAD+. But anyone noticing decreased muscle mass with aging could consider increasing NAD+.  The truth is anyone with lower NAD+ may benefit from increasing levels.   So how do you know if you have low NAD+ levels? You can actually test for it. However, this is not available through Labcorp or Quest. There are specialty labs that will do a fingerstick test for NAD+, but it costs around $100. (Let me know if you want to do this test and I can order it for you). Another way is just to look in the mirror. Over 45? Your NAD+ could probably use some support. Dealing with obesity, insulin resistance, high blood pressure, or inflammation? These all lower NAD+. Cognitive issues like memory loss or neurodegeneration (dementia, Parkinson’s, MS, ataxia, etc.)?  Regular alcohol use, chronic stress, sleep deprivation? You would very likely benefit from optimizing NAD+.  SARS-CoV-2 infection appears to deplete NAD+ significantly. NAD+ restoration is also now being studied as a potential treatment for Long COVID. OK, I want to increase my NAD+ levels! How do I do it? Unfortunately, just taking an NAD+ or NADH pill doesn’t work very well. It is largely degraded in the gut and is too big a molecule to pass directly into the cell.  Instead , you can increase NAD+ levels through precursor supplements like NMN (nicotinamide mononucleotide) or NR (nicotinamide riboside), which the body converts into NAD+. Exercise and fasting also raise NAD+ naturally by shifting the cellular energy balance in ways that signal the body to produce more. Many GLP-1 clinics now sell NAD+ injections or infusions.  The benefit of these is that they enter the bloodstream directly and don’t have to go through the digestive system.  However, NAD+ can’t easily cross cell membranes. So the body has to break it down into smaller pieces, absorb it into the cell, and reassemble it from nicotinamide —> NMN —> NAD+. Whether NAD+ injections are actually better than taking oral precursor supplements like NMN or NR (which the body converts to NAD+) is up for debate. And NMN and NR supplements have a great deal more research behind them showing that they do increase NAD+ levels in blood and muscle. NMN or NR supplements are also much less expensive, and don’t require a needle stick or injection. Who should not increase NAD+? Study after study shows that NAD+ supplements are generally safe and well tolerated. However, there are some people who should exercise caution. NAD+ improves cell survival and DNA repair. It can also do this in cancer cells. If you have active cancer or are currently on chemotherapy , this may not be a good supplement for you. Also, producing NAD+ requires well functioning methylation pathways. If you have an MTHFR variant, you may need additional methyl donors (active B vitamins, TMG, etc.) Active liver disease or flaring autoimmune condition? Reach out to me and let’s discuss whether this is a good supplement for you. The Takeaway?   If you are dealing with fatigue related to GLP-1 medication, you should definitely consider optimizing NAD+ levels. Even if you are not taking a GLP-1 but are experiencing fatigue, cognitive dysfunction, insulin resistance, weight gain, hypertension, autoimmune disease, decreased exercise recovery, or are over the age of 45, you may also want to support NAD+ levels.  You can certainly do this through NAD+ injections or infusions. But oral supplements that contain NR (at least 800 mg) or NMN (at least 500 mg) may work just as well for a fraction of the cost. Below are some supplement options to increase NAD+. I recommend picking one and using it consistently for at least 4–6 weeks to see if you notice a change in energy, exercise , or brain function. In Health Dr. G
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CREATINE powders
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Is TikTok telling you to buy creatine? Here’s why… I can always tell when a supplement is having a moment on TikTok because my inbox will fill up with questions from patients. Unfortunately, most of the time the supplement I am being asked to critique is weirdly overpriced or at a much lower dosage than the therapeutic threshold.   One exception to this is creatine. Here’s my take: Creatine is actually pretty great! And it is really well studied. Creatine is a natural molecule made from three different amino acids (protein building blocks). Many of creatine’s benefits affect  muscles . Creatine supplementation (with regular resistance exercise) improves muscle strength, explosive output, and it significantly helps muscle recovery after intense exercise. It also helps improve  energy , because it acts as a phosphate donor to regenerate ATP. The other organ that really benefits from creatine is the  brain .  It helps with memory and reduces mental fatigue.  So creatine makes you ripped and smart? That’s actually what the research says. But, can we just get it from food?  The body actually makes some of its own creatine, but only about 1 g/day. If you are following a carnivorous diet, you may be getting 1-2 g/day on average (less if you are following a plant-based diet). Still nowhere near the 5 g/day recommendation to optimize muscle performance, brain function, and cardiovascular health. Is creatine primarily for gym “bros”? 26 year-old dudes doing plyometric exercises at the gym will definitely benefit from creatine. But you know the other group research says creatine can be very beneficial for? Women! Women in their reproductive years, perimenopausal women, and post menopausal women all benefit from creatine supplementation! Women tend to get less creatine from their diet and we produce less as we age. Also, 95% of it is stored in muscles. If you have less muscle, you store less creatine. Do I need a specific type of creatine? Yes.  Creatine monohydrate.  To get the recommended 5 mg, it usually makes sense to take it as a powder. You can get it as a capsule, but you’d have to take five or six capsules. Look for “ micronized ” creatine powder which dissolves easily in water and has better absorption. I do have one patient who found creatine Gummies with the 5 mg dosage so you can look for those. Will it help me lose weight? Ok, this is where I may lose some of you. No, it will probably not make you lose weight. In fact, you may gain a few pounds but it is usually from muscle cell hydration. However, as you gain muscle your metabolism will increase and your body composition will improve. Can I take it if I am on a GLP-1 like Ozempic? Yes! In fact, this is a great muscle preservation strategy while on these medications. The rapid weight loss people experience is often half fat and half muscle. Creatine can help make sure you retain your muscle.  Should I take it every day? Yes, that seems to be how it works best. Can I take it before my workouts? After my workouts? First thing in the morning? At bedtime? Yes. The benefits of creatine show up no matter when you take it, so experiment to see what works best for you. If you are using it specifically for muscle recovery after workouts, I would take it before your workout. Who should not take creatine? If you have significant kidney disease or liver issues, or are pregnant, talk to your doctor first. It may be that creatine is still a good supplement for you at a modified dosage. Summary: Creatine is one of the most cost-effective, evidence-based supplements you can find. You don’t need a complex protocol — a simple daily scoop of creatine monohydrate works fine. Look for a brand that is NSF certified, or from a reputable nutraceutical company. See my list of favorite creatine products below. Email me any questions at dr.g@holistichealthprovider.com In health Dr. G
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Dr. G’s Optimal Health Starter Pack!
 Dr. G’s Optimal Health Starter pack I first became interested in functional medicine because I love the process of working with individual patients to discover the root cause of their specific health concerns. I still do. However, in the past few weeks I have had several patients reach out to say they want to work with a functional medicine provider but just don’t have the time, finances, or bandwidth to do it right now. So I started thinking about first steps anyone could take to improve their health, even before doing extensive diagnostic testing. Ensuring adequate nutrient levels is foundational in almost all of my treatment plans. Doing so makes it much easier to treat a wide range of health conditions. I came up with a list of nutritional deficiencies that I see over and over again in my patients. Even if people aren’t actually out of range, they are almost always at suboptimal levels for vitamin D, B vitamins, zinc, magnesium, and omega-3 fats . Not having enough of these vital nutrients can contribute to fatigue, brain fog, mood issues, immune dysfunction, restless sleep, hormone imbalance,  inflammation, and increased cardiovascular risk. To address these common deficiencies, there are three types of supplements that I consistently recommend: a high-quality multivitamin, an omega-3 supplement, and magnesium.   I’ve chosen versions of these supplements from companies with high quality assurance protocols, that are well tolerated, and require a minimal number of capsules.  I’ve bundled them together in a convenient “starter pack“ on Full Script. If you are new to nutritional supplements, start with one at a time and take it with food. If you have a serious health condition and need to check about interactions with medicines or other supplements, feel free to email me at dr.g@holistichealthprovider.com. Note: if we have worked together in the past and I have recommended different versions of similar supplements, stick with what I originally recommended. Those were based on your diagnosis and test results and may contain specific nutrients or dosages.   Even if you are not in a place to work with a functional medicine provider, you can start taking constructive steps towards improving your energy, sleep, brain function, and mood by addressing nutritional deficiencies. Start feeling better today! In health Dr. G
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MULTIVITAMINS!
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MULTIVITAMIN s Here is a list of my favorite multivitamins! A good multivitamin should provide a clinically useful amount of vitamin D, bioavailable forms of B vitamins, trace minerals, and antioxidants. These range from 1/day to 4/day capsules, liquids, powders, chewable tablets, and gummy vitamins. Some are high potency for people that need increased levels of nutrients and others are for people who have sensitive stomachs or can’t tolerate higher levels of vitamins. Several children’s vitamins are also included. Want to make sure you are taking the perfect multivitamin to meet your specific nutritional needs? Schedule an appointment with Dr. Goldberg to discuss nutrient and health status testing: Try our online scheduling system: http://truehealthwellness.fullslate.com/
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PREBIOTIC SUPPLEMENTS
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Are Prebiotics the Missing Piece of Your Gut Health Regimen? If you have learned anything about gut health, you have probably heard about the importance of PROBIOTICS. Probiotics are the beneficial bacteria and yeast that are vital parts of a working microbiome. However, you may be less familiar with PREBIOTICS.  Prebiotics are a specialized form of dietary fiber that act as a fuel source for the beneficial bacteria living in the human gut. Unlike other nutrients, prebiotics are not broken down in the digestive tract. Instead, they reach the large intestine relatively unchanged, where beneficial bacteria use them as food. When bacteria ferment these prebiotic fibers, they produce “POSTBIOTICS“ like SCFAs (short chain fatty acids). Oh my gosh you guys, can I just stop for a minute to rave about short chain fatty acids? I know, they need a better name. Instead of SCFAs, they should be called GHWMs - Gut Healing Wonder Molecules! SCFAs like butyrate, acetate, and proprionate work their magic in a number of different ways: SCFAs are a primary fuel source for the cells of the gut lining. This helps maintain a normal intestinal barrier and can reverse leaky gut. They can also slow cancer growth and trigger cancer cell death (autophagy) They support normal immune function - SCFAs can recruit white blood cells and send them where they are needed (areas of injury or inflammation). But maybe even more impressive is that they can down-regulate overactive immune function (as in autoimmune conditions or allergies).   Many SCFAs reduce inflammation - by interrupting inflammatory pathways, SCFAs can decrease inflammation in the gut which is really important for inflammatory bowel disease, celiac, diverticulitis, and IBS. But it turns out they can also decrease inflammation throughout the body (in the nervous system, the respiratory system, etc.) They enhance nutrient absorption - SCFAs change the pH of the gut environment, which can support better absorption of calcium, iron, and magnesium SCFAs promote regular, normal bowel movements - if you don’t realize how important this is, you are probably one of the few humans with naturally fantastic bowel movements. Lucky you. For everyone else, optimizing the bulk and ease of your BMs can promote detoxification, hormone balance, energy, mood, sleep, and reducing the “food baby“ stomach (abdominal distention).   SCFAs can help you lose weight! And lower cholesterol! - I probably should have led with this. The science is fairly new, but emerging research suggests that the metabolism of prebiotics by gut bacteria plays a role in weight management. By influencing the production of satiety hormones such as leptin and ghrelin, prebiotics can decrease appetite and modulate insulin sensitivity. SCFAs also lower cholesterol, which may be one of the main reasons increasing fiber reduces heart disease. Ok, ok, we get it! Short chain fatty acids are gut healing wonder molecules and we should do whatever we can to optimize SCFA production. What next? Increase dietary prebiotic fibers and resistant starches - Great prebiotic food sources include garlic, onion, Jerusalem artichokes, leeks, asparagus, chicory, chickpeas, legumes, green bananas, oat bran, flax seeds, apples, and inulin. These are compounds probiotic bacteria ferment in the gut. However, pathogenic bacteria will also ferment these. If you notice you experience increased bloating, pain, gas, or burping after eating these foods, you may have a bacterial overgrowth infection like SIBO that needs to be addressed first. If you are following a low FODMAP diet for your gut issues, you may not be able to tolerate these.   Consider prebiotic fibers supplements - there are now a wide variety of prebiotic supplements available including inulin, acacia fiber, psyllium husk powder, baobab fiber, apple fiber, green banana starch, xylooligosaccharides (XOS) like PreticX™, Galacto-oligosaccharides, kiwifruit powder, guar gum, Jerusalem artichoke fiber, cellulose, flax seed fiber, and glucomannan (from konjak root). Different bacteria ferment different fibers to produce a variety of SCFAs, so don’t be afraid to mix them up! Best prebiotic supplement to prevent bloating - Can’t take fiber supplements without experiencing gas, bloating, pressure, or burping? You may have SIBO small intestinal bacterial overgrowth (or fungal overgrowth). This will be a whole separate article. Still want the benefits of a prebiotic but can’t tolerate fiber? Consider citrus bioflavonoids and pomegranate non-fiber prebiotics. These can provide essential nutrients to the gut lining without producing bloating as a side effect, helping to reestablish a healthy mucosal barrier and to restore the gut terrain. Consider a “postbiotic” SCFA supplement like Butyrate - if you have the right blend of prebiotic fibers and probiotic bacteria, you can achieve the optimal production of short chain fatty acids like butyrate. However, to maximize gut healing you may want to consider taking butyrate as a supplement.   Unfortunately, several butyrate supplements break down before they get to the colon (where you really need it). A patented form called TRIBUTYRIN bypasses the stomach acid and releases in the small and large intestines so you can experience all of the benefits of butyrate (digestive health, immune health, skin health, brain health, weight management, regularity, etc.) Increase beneficial bacteria by eating fermented foods (yogurt, kefir, sauerkraut, kimchi, kombucha, etc.) or taking a probiotic supplement - strains of probiotic bacteria clinically associated with increased short chain fatty acids include Lactobacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium longum, Lactobacillus plantarum, Faecalibacterium prausnitzii, Roseburia, Clostridium, Akkermansia, etc.   Some of these are easily found in probiotic supplements while others can be more challenging to locate.   Take an omega-3 supplement - omega-3 supplements are one of the few supplements I recommend to almost every one of my patients. They have powerful anti-inflammatory effects which support brain health, mood, and cardiovascular health. In addition, omega-3s can selectively alter the make up of the microbiome, resulting in improved SCFA ratios and positively impacting the gut brain connection. The Takeaway: PREBIOTICs + PROBIOTICs = POSTBIOTICs Fiber + good bacteria = short chain fatty acids Short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate play a crucial role in gut health, influencing everything from inflammation reduction to enhancing nutrient absorption and providing energy to colon cells. Embracing ways to boost these beneficial compounds can significantly impact your gut health and your overall well-being.
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Blood Pressure Support
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Natural Approaches to Lower Blood Pressure High blood pressure is sometimes called a “silent killer,” because it usually has no warning signs, yet it can lead to life-threatening conditions like heart attack or stroke. The high force of blood flow can damage your blood vessels, making them weak, stiff, or narrower. Over time, hypertension can harm several important organs, including your heart, kidneys, brain, and eyes. Getting systolic blood pressure under 120 reduces the risk of heart attack or stroke by 25% and lowers the risk of death from all causes by 27%! Since optimizing blood pressure is so important, it often requires a combination approach. Limit salt, sugar, processed carbohydrates, and saturated fats. Increase fiber (ideally 30 g/day), healthy plant-based fats, and vegetable intake. Increasing physical activity and losing weight will also help substantially. Studies show that supplements like grape seed extract, aged garlic, magnesium, potassium, omega-3 fatty acids, vitamin D, and nitric oxide precursors (like arginine) can also lower blood pressure. Different supplements work better for different individuals, so feel free to try different things and monitor how they affect your blood pressure. Blood pressure changes throughout the day depending on stress level, diet, activity level, salt intake, fluid intake, etc. Take blood pressure frequently throughout the week so you have a clear sense if it is trending up or down. Let me know if you have any questions. Dr. G
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ELECTROLYTE POWDERS
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Electrolyte Powders Electrolytes are compounds that carry a positive or negative charge, also known as ions. These electrolytes are found in your body’s cells, tissues and fluids. Maintaining a proper ratio is necessary for vital body functions like cellular hydration, pH balance, nerve transmission, muscle contraction, circulating blood, and brain function. All electrolytes are minerals , but not all minerals are electrolytes. Minerals are a category of micronutrients that naturally occur in our environment and have a well-defined crystal structure. There are 16 dietary minerals, six of which are also electrolytes: sodium, potassium, chloride, magnesium, calcium, and phosphorus. Your body gets electrolytes from your diet. Unfortunately, our soils are now depleted of key nutrients, including most minerals. Your kidneys filter excess electrolytes out of your body and into your urine. You also lose electrolytes when you sweat. Replenishing important electrolytes is key after exercise, but may be necessary just for normal daily function. Below are several different options for electrolyte powders. They have slightly different levels of sodium, potassium, magnesium and some also include B vitamins and/or amino acids. Taking electrolytes in the morning can help kickstart your day and replenish hydration after fasting through the night. They can also be taken before, during, or after exercise. Taking electrolytes before bed might help restless leg syndrome and deep sleep. Experiment to find what time suits you best.
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Erectile Dysfunction
The Ups and Downs of Erectile Dysfunction  Erectile dysfunction (ED) is the inability to achieve or maintain an erection for sexual performance. If this is something you have experienced, you are not alone. More than 50% of men over the age of 40 will experience this at some point. For most men, erectile dysfunction is caused by physical issues related to the blood supply of the penis. Suboptimal blood flow could result from cardiovascular conditions (high blood pressure, high cholesterol, atherosclerosis), elevated blood sugar, hormone imbalances like low testosterone or hypothyroidism, nerve impairment (Parkinson’s, MS, nerve injury), prescription medications, alcohol intake, cigarette smoking, or stress. The root cause of your individual issue could be any of these, or a combination. The good news is there are many natural ways to support erectile function, libido, and stamina that will also increase overall health! Natural Ways to Get Back in the Saddle Here are some science-backed, natural approaches to motivate your member. Heart healthy equals Penis healthy: Limit processed foods that increase blood sugar and inflammation (bread, pasta, crackers, baked goods, pretzels, etc.). Make vegetables the star of every meal: leafy greens, cruciferous vegetables (broccoli, cauliflower, kale), colorful vegetables like tomatoes, peppers, carrots, purple cabbage, and sulfur rich vegetables like garlic and onion. Make sure you are getting enough clean protein (Start with 0.75-1 grams of protein per pound of body weight). Focus on healthy plant based fats like olive oil, avocado, nuts, and seeds. Exercise: Regular physical activity improves blood flow, boosts testosterone, and reduces stress. Even a brisk walk can be beneficial, but consider adding strength training or high intensity interval training to maximize the effect. Quit Smoking and Limit Alcohol: A few beers might improve your flirting during dinner, but your ultimate performance will be less than stellar. Alcohol can affect hormones, circulation, and nerve function, all of which could contribute to erectile dysfunction. Drink mineral water instead (or you could try beet juice, green tea, grape juice, or pomegranate juice to improve erectile function).  Manage Stress: Stress is the ultimate enemy of penis performance. Elevated cortisol immediately results in lower testosterone. When your body is in “fight or fight”, blood will flow to your arms and legs (your *actual* legs, not your "third" leg). Control external stressors when you can. Manage the stressors you can’t control with journaling, mindfulness, yoga, punching a heavy bag, meditation, exercise, talk therapy, nature walks, or whatever works best for you. Herbs like Ashwagandha can simultaneously lower cortisol and increase testosterone. Check Your Meds: Several prescription and over-the-counter medications can affect erectile function: antidepressants, antihistamines, blood pressure medication, diuretics, appetite suppressants, NSAIDS like ibuprofen or aspirin, sedatives, ulcer medication, etc.  If you suspect your prescription is the problem, talk to your prescribing doctor—don’t just stop cold turkey. Supplements: The best supplements for each individual will depend on the underlying root causes. Is your testosterone low because you are deficient in vitamin D, zinc, or boron? Consider adding a high-quality multivitamin. Is stress taking a toll on your testosterone levels? Consider herbs like Ashwagandha, eurycoma, tribulus, or fenugreek. From a blood flow perspective, the supplements I think are the most effective are those that work on nitric oxide.  Nitric oxide (NO), a natural component of the human body, plays a vital role in blood vessel dilation, hormone release, and nerve function. When a man is sexually aroused, his body releases nitric oxide to relax the muscles in his penis and increase blood flow, leading to an erection. Prescription medications like Viagra and Cialis help this process by blocking an enzyme (PDE5) that would normally stop the erection from happening. However, they may also cause side effects like headaches, flushing, digestive issues, muscle pain, dizziness, or visual disturbances. Studies show that increasing NO naturally by supplementing the amino acids arginine and citrulline can also help improve erectile function with fewer side effects. The amount of the amino acids used is important. Low doses of arginine and citrulline do not work nearly as as well as higher doses ( 1000–5000 MG). You should not take arginine/citrulline if you have had a recent heart attack, have low blood pressure, kidney disease, are about to have surgery, or are dealing with a current viral infection. Below are some supplements to consider for increasing nitric oxide and blood flow. Questions if these supplements are appropriate for you specifically? Reach out to Dr. Goldberg at dr.g@holistichealthprovider.com
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Multivitamins
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MULTIVITAMINS; The Good, The Bad, and the Ugly One of my favorite books growing up was Charlie and the Chocolate Factory by Roald Dahl. If you have read the book or seen the movie, you may recall that one of the golden ticket winners was a little girl named Violet Beauregard. In addition to being selfish and arrogant, Violet is also obsessed with chewing gum. She snatches a piece of Willy Wonka's chewing gum in the Inventing Room because it advertises that each small piece of gum contains an entire three course meal. At first she is delighted by the tomato soup, roast beef, baked potato, and blueberry pie. However, something goes horribly wrong once she is at the dessert course and she swells up until she has turned into a large blueberry. Not only that, but she has to be rolled down to the juicing room so she doesn't explode! This is how I usually feel about multivitamins. The promise of a whole day's worth of nutrition in one small pill often ends up being an empty promise. Or even worse, it has a negative effect (although usually not exploding thank goodness). I love the idea of the multivitamin. Our food today is not nearly as nutritious as it was 50 years ago. Over-farming has depleted our soil so that the same vegetable your grandmother ate now has 30 to 50% less calcium, magnesium, copper, zinc, phosphorus, vitamin C, riboflavin, etc. Americans eat way more processed grains, industrial seed oils, and refined sugar than we used to. 1/3 of Americans have at least one significant vitamin deficiency or anemia. But truthfully, there is at least one thing I really dislike about almost every multivitamin I pick up. Most of them are derived from coal tar and contain synthetic versions of nutrients that are cheap to make in a lab but may not even exist in nature (Centrum, NatureMade). Others, like Ritual Multivitamin, contain therapeutic forms/amounts of some vitamins and are completely missing most of the B vitamins and trace minerals. That being said, a high-quality multivitamin made by companies with strict quality assurance protocols and based on well-designed research studies can be a great investment in your health. A good multivitamin should have a therapeutic amount of vitamin D (1000 to 2000 IU of D3), activated bioavailable B vitamins, antioxidants, vitamin K2 (not K1) and trace minerals like zinc and manganese. A quick way to tell the quality of a multivitamin is to look at the form of B12 included. The B12 molecule, cobalamin, is always attached to another molecule. Methylcobalamin is B12 attached to a methyl group. This is the most active form of B12. Hydroxocobalamin and Adenosylcobalamin are other forms of B12 found in nature. Cyanocobalamin is the synthetic form of B12 that is bound to a molecule of cyanide. Genetically, a third of the population may be unable to fully absorb this synthetic version. A more natural form of B12 is most likely a better option for you. So here is my list of multivitamins that I actually like a lot. Ideally, your functional medicine provider would test you for nutritional deficiencies and help determine exactly which multivitamin would be best for you. But these are multivitamins that I trust the quality of, and routinely recommend to patients. Want to talk about testing for a specific nutritional markers? Feel free to make an appointment here to discuss: http://truehealthwellness.fullslate.com/ Best Dr. G
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