Webinar Replay

Welcoming Dr. Alon Sitzer! | Q&A | Ways to deal with fatigue



In this Q&A, our Plant based Telehealth doctors introduce Dr. Alon Sitzer and discuss ways to overcome fatigue.

Questions Answered

Complete Transcript

Dr. Laurie Marbas

(00:04)
Welcome everyone and we want to welcome a very special guest today and then Dr. Miller, excuse me will go ahead and teach us about fatigue which is really helpful because that's one of the most common complaints in family medicine for decades I've heard. We want to welcome Dr. Alon Sitzer and he's our newest doc. He's practicing in Massachusetts in New Hampshire right now. Dr. Sitzer you want to share with us a little bit about yourself?

Dr. Alon Sitzer

(00:37)
Sure. Hi everybody, nice to meet you. Honored to be here. I live in Massachusetts. Married, have two little kiddos, four and six, actually they're six and eight. I am a board certified family medicine physician. In a past life I was a massage therapist and studied nutrition for many years and that was along the lines of focused on plant based nutrition. It was once called raw foodism or veganism and now the term is whole food plant based nutrition. And I just joined Plant Based TeleHealth. I also have my own medical practice in the state of Massachusetts which is also geared towards lifestyle medicine and whole food plant based nutrition. And I am happy to be part of this family, this team and I'm happy to be here yeah.

Dr. Laurie Marbas

(01:42)
Excellent. Thank you. That was wonderful. So we're going to be really mean to, I'm just kidding, today we're going to throw all the questions at Dr. Sitzer. But no, no, it's all good. It's like baptism by fire over here.

“Dr. Alon Sitzer

(01:57)
I thought I have a week until I'm allowed to…

Dr. Laurie Marbas

(02:00)
That's right. That's a good point. You're going to actually be starting to see patients on March 16th. So all of you Massachusetts, New Hampshire folks check out Dr. Sitzer. And if you want to see someone in person check out his website, it's really cool. So he's got a really neat way of practicing, kind of old style family medicine. And if you have questions please put them in the Q&A box if you're in the webinar sphere. If you're over in the Facebook side of things, please go to Plant Based TeleHealth the page and ask your question under the live video because that's where I'm going to be monitoring, if I'm looking up and down that's why. And please share this, if you're on Facebook, please share this to your regular timeline, to any group that you feel might be helpful. And then that way we're spreading the news, these valuable resources and these amazing doctors who are sharing their knowledge with you. And with that I will turn it over to Dr. Miller.

Dr. Chris Miller

(02:54)
Awesome. Thank you. So thank you everyone for being here and I'm so excited to have Alon and Elisabeth with us. Kim, you too. It's nice to see some different faces so it's awesome to have this group here. So anyway, I had an opportunity to talk today and I was trying to think what I would talk about. And it's like so many of the patients that I see come in and either they're complaining of fatigue or people are experiencing it, or I just ask them, how's your energy level? And maybe it's not where they want it to be. It's a little bit lower and it's extremely a common complaint. For some people it's the main thing that they're concerned about and other people it's just, I don't have the energy I used to have, I feel like I should have more energy. And you hear about people going whole food plant based and having this amazing energy. And maybe you don't feel it yet or something suddenly zapped it and we're trying to get you there.

Dr. Chris Miller

(03:45)
So I wanted to break it down a little bit into different reasons that people have fatigue and then I'm going to give you 12 tips to improve your energy today, no matter what the cause is. So stick around for this. So I put that together for you guys. So first of all, the causes of fatigue the way I'm going to think of it today as we're talking is first of all, lifestyle factors. So the number one that comes to my mind is not sleeping. If you don't get a good night of sleep you're going to be tired. And so sometimes I'm talking to people and they're just not a good sleeper and they're just like, oh, I don't have energy. Well of course you don't have energy, we need to sleep to get energy. So that's a very common cause.

Dr. Chris Miller

(04:25)
Lack of physical activity. You might think I'm too tired to move or to exercise but sitting all day will zap your energy. So if you're indoors all the time, keep that in mind that that could be why you're feeling so tired now. And still in the lifestyle factor diet of course plays a role. We're plant based physicians, we have to talk about the diet. So if you're getting inadequate nutrients, if you're nutrient deficient in anything you're going to feel tired. Your body needs zinc, your body needs magnesium, your body needs B vitamins in order to function. These are necessary vitamins and minerals and they're for a reason. And so if you're deficient in anything you may feel a little sluggish.

Dr. Chris Miller

(05:08)
And then if you're eating pro-inflammatory foods, so I'm going to talk about this under medical issues, but inflammation causes fatigue. So for everyone feeling, with any inflammatory condition. So those of us with autoimmune disease we know when our autoimmune disease flares, one of the first things we'll present with is fatigue, extreme fatigue. But even if you have asthma or gingivitis or plantar fasciitis, anything with an itis, any sort of inflammation, GERD, APAD, inflammation, actually the inflammatory markers suppress the mitochondria which produce energy and you're going to feel fatigue. So it's a common thing that if you work on inflammation, eating an anti-inflammatory diet, removing pro-inflammatory factors your energy will start to increase. And again, I'm going to give you tips on how to do all this so stick around.

Dr. Chris Miller

(06:03)
Back to lifestyle factors, a few more that come to mind. So alcohol and tobacco. Hopefully not too many of you are smoking anymore, if you are we have all sorts of great things to help you with that. Apps that we were just talking about this morning. And so if you need help you can see one of us doctors and we're happy to help you with that. And excessive alcohol will also zap your energy. Excess caffeine, so it seems like if you drink caffeine that you're going to have more energy but it actually robs you of energy that you'd have later on. So especially if you're drinking coffee or caffeine all day long to stay awake. Maybe what you should be doing is working on a better night of sleep or getting more rest or moving your body instead of just having caffeine which is actually robbing you of long term energy.

Dr. Chris Miller

(06:52)
Excess stress is a big one. I talk about stress a lot with my patients and in my own life but stress will rob you of energy as well. So these are some common lifestyle factors that you can think of right now like mm-hmm what's going on in my life? Are any of these zapping me of the optimal energy that I'm searching for everyday? Then there's medical issues. This is the second category and I have to talk about this as a physician. So there are real medical reasons, it's not always just lifestyle that you have fatigue. And so that's where we want you to work with a doctor. One of us absolutely, or one of your own doctors or someone knowledgeable to help you.

Dr. Chris Miller

(07:27)
So I already talked about inflammation. Chronic inflammation will absolutely, the inflammatory markers will inhibit your mitochondria from producing energy. So you'll feel fatigue when you have chronic inflammation, that's every autoimmune disease you can think of from hypothyroid, to lupus, to rheumatoid arthritis, to Sjögren's whatever, any autoimmune, psoriasis, when it's flaring you're going to probably feel some fatigue at that point. But it's also inflammatory conditions like heart disease, asthma, anything that you may experience, GERD, things like that.

Dr. Chris Miller

(08:01)
Then hormonal imbalance will cause fatigue. So I already mentioned hypothyroid. So if you are hypothyroid your hormones are out of balance you need thyroid hormone for energy. So that's a cause that can certainly be a reason, that's a medical reason. Insulin resistance, so those of you who working hard with your diet and your lifestyle to reverse your insulin resistance. When you're extremely insulin resistant you'll probably feel pretty sluggish so that's something to look forward to as you work on improving that. And excess cortisol is another hormone, that's a stress hormone. And again, we talked about stress in the lifestyle factors. So if you're really stressed out you're going to have high cortisol which is going to suppress your mitochondria again and your energy production you're going to feel more fatigue.

Dr. Chris Miller

(08:45)
Another medical issue that's very common and we see quite a bit is anemia. So you may have low red blood cells carrying less oxygen and feel fatigue. And along with that, if you're iron deficient. So it can be iron deficiency anemia or you're just maybe low iron. And these are reasons that you may not have a lot of energy. And that's a simple blood test to check for that. I already mentioned nutrient deficiency. So people who are deficient in B12 or vitamin D or zinc, any of the nutrient deficiencies. Any of the B vitamins, vitamin C, vitamin A, any deficiency will lead to a feeling of fatigue because these nutrients are necessary and at a cellular level you're going to be deficient and they're eventually going to run to a standstill.

Dr. Chris Miller

(09:29)
This is one that sometimes people don't think of but I think of a lot with my patients. If people are telling me that they're feeling fatigue is your gut function. So if you don't have optimal gut function, if you're not properly digesting your food, absorbing your nutrients and eliminating toxins and waste, it's an extremely common reason that people will feel fatigued. And along with that your microbiome may be out of balance a little bit. So if your microbiome is out of balance, your microbiome produces energy for us, we know so much about this microbiome. And so if you're feeling gassy, excessively gassy I should say because a lot of people are a little bit gassy, but excessively gassy and bloated, having loose stools, diarrhea, constipation, any of this imbalances of your gut you're likely not getting optimal digestion, absorption and elimination of waste. And when you improve that and improve the microbiome, energy significantly improves. So that's something that you can work on with your doctor, anyone of us, of course.

Dr. Chris Miller

(10:30)
Medications can cause fatigue. So if you're on something for blood pressure, or diabetes or autoimmune diseases. I certainly know, I had a lot of fatigue with some of the medications I used to have to take. So that can be a cause and that's something you can work with your physician. Hopefully you're working to get off the medication maybe but if not, maybe you can switch a medicine if you need it or something so if it's causing you severe fatigue. And then of course anything medical, liver disease, kidney disease, heart disease, pulmonary disease. So if you have a medical condition hopefully you're working with a doctor. We can help check labs if something's going on, make sure nothing medical's going on.

Dr. Chris Miller

(11:05)
And then the third major category is mental health issues and they absolutely cause fatigue. And sometimes we forget or it's overlooked but keep that in mind. So if you're feeling depressed or anxious you may have no energy. Loneliness, fear, anxiety. Hello COVID-19 for the past two years, I think we all felt a little bit of that and maybe our energy kind of tanked down. So hopefully as we're kind of coming out of it now a little bit maybe knock on wood we can feel more energy. And then along with that in mental health issues is medications and substance abuse. So any of those will also zap your energy. So that is a summary. There are bajillions of reasons for having low energy, but I kind of summed it up into big categories for you guys so you can kind of start thinking if you're feeling not like you're having the most optimal energy ever then you can start thinking of that and you can talk about it with your doctor.

Dr. Chris Miller

(12:01)
So here it is, 12 steps that you can do today to begin to reduce your fatigue. So I had to talk about them. So number one, the big one is improve your sleep. So if you're not sleeping well, take a good look at your sleep. We talk about it a lot on this webinar, people asked so many wonderful questions about sleep, a lot of people are having a hard time. So we were just talking about apps for sleeping, apps for relaxation to reduce your anxiety. Some of my favorites are Calm, Headspace. We're now working with Dr. Jud Brewer, we're pretty psyched and we're going to be able to give discounts to our patients for reduced anxiety, it's an app. So you can talk to one of us and we'll help get you hooked up if you're interested in that and these relaxation things can help you fall asleep better.

Dr. Chris Miller

(12:48)
We talk a lot about sleep hygiene and I'm not going to go into it today but we've talked quite a bit about sleep hygiene. Getting out in the sunlight, not eating before bed, keeping your room dark, dark, dark, not using blue light for an hour before bed, all of that stuff, all of that matters. So sleep hygiene and being on a circadian rhythm. So going to bed the same time and eating around the same time, not too late at night and waking up the same time. Those are basic things. So number one is if you're not sleeping well and you're feeling tired, work hard, work with a doctor. There's so many different things right now to help you improve your sleep.

Dr. Chris Miller

(13:19)
Number two is regular exercise. And along with that is to move throughout the day. If you're sitting all day and I know when I turn to this job I sit all day, I feel tired. So I'm trying to sit and stand and work out in between patients and at a lunch break. The more you move, the more energy you get. Remember, our bodies are designed to move and not be stationary and if you become stationary you're going to feel sluggish. Your blood gets kind of sluggish. So do your best to move as much as you can, even if you're working from home like me and try to stay active. And definitely regular exercise. So regular cardio, regular resistance training, build some muscles, it will give you more energy.

Dr. Chris Miller

(14:00)
And along with that number three is get outdoors. This is one of my favorite. I feel so energized when I'm outside, especially if it's sunny out, if I can get in nature. But even if I can't, even if it's not sunny, it's not sunny today and I can't see nature from my house but just looking at the sky, looking at the trees, breathing the air, feeling the wind. Get outside. Watch you guys, if you're not used to doing this regularly it will totally energize you pretty quickly. If you start doing it regularly, getting outside, the more time outside. I feel like we're like plants and we need our sunlight in order to thrive and grow and be energized. Photosynthesis and we need some of this sunlight in our body, so get outdoors. So that was number three. We're getting there, we got nine more to go. I hope you guys are feeling more energized already.

Dr. Chris Miller

(14:49)
Number four, from plant based doctors is a whole food plant based diet. And I emphasize whole food because just being plant based is not going to give you energy so it really does have to be whole food. It's brown rice, not brown rice crackers, it's bananas, not banana chips. So eat whole foods and eat the real plants the way they're intended to and you will see a huge difference. And if you're not there already or you're working towards it, keep working towards it because it's an enormous thing to give people energy just going whole food plant based. Oh and along with that, I wanted to say avoid sugar. So sugar will zap your energy. And I've talked to so many people who are eating pretty clean but just a little bit of sugar and they're still feeling drained. And so when we take the sugar out it makes a dramatic difference. So get that sugar out and you'll see that you start to have more energy as well.

Dr. Chris Miller

(15:39)
Number five, it goes along with the whole food plant based diet. But if you're already doing that and you're still not having energy, I say eat more greens. Green leafy vegetables have the phytonutrients, the living enzymes, they're the life for us I think. They got the chlorophyll to absorb that sun and photosynthesize, it's the raw green leafy vegetables that give people energy. So when people are really feeling fatigued when they see me I increase their greens throughout the day and it makes a dramatic difference. And I would say in as soon as three days people have more energy when they start eating more greens. So it's my secret weapon to improve people's energy pretty quickly.

Dr. Chris Miller

(16:15)
Number six is to drink water. Being dehydrated will zap your energy. And if you eat a whole food plant based diet, lots of fresh vegetables and fruit you may not need to drink too much water because you're getting the water through your fruits and vegetables. But depending on what your diet is or how active you are or what altitude you live at, or time of year, how sunny it is or hot it is, things like that, you may need more water. So make sure you're not dehydrated.

Dr. Chris Miller

(16:40)
Number seven is to evaluate your mental health and you can kind of all do this yourself. Do you feel anxious? I know during COVID I was super anxious. Are you depressed? Are you isolated? These are things that are going to zap your energy. So I would say, seek help, rediscover your joy, reconnect with others. And you can talk to people to help you figure out how to do that because sometimes we need help for that. I know I did. So reach out and get help with that if you have to. Whatever it takes to get you back, engaged and connected with others and to help your anxiety or your depression.

Dr. Chris Miller

(17:18)
Stress management, I talked about the importance of stress. We want to lower that cortisol. So whatever you can do, do it daily, do it regularly. So that may look like outdoor time, gentle meandering walks. That may be your meditation, your yoga, your deep breathing, I'm such a fan of deep breathing, it's really powerful to help lower stress. But lowering stress actually gives you energy. So get that cortisol down, get those stress hormones down, become more parasympathetic and you will improve your energy right there. We're getting close, four left.

Dr. Chris Miller

(17:50)
Number nine, and we talked about this is your gut health. So optimize your gut health. So make sure you're having regular daily bowel movements and not too gassy and bloated. And so you know you're getting the maximum digestion of your food, absorption of your nutrients and elimination of waste. So extra waste in your body is going to cause you to feel fatigued, not absorbing all your nutrients, you're eating in these wonderful foods. So we want to optimize your gut health. And you can work with one of us if you're having ongoing problems that you can't figure out on your own.

Dr. Chris Miller

(18:22)
Number 10 is to reduce your chronic inflammation. So I'm an expert on that, living with it my whole life it seems like. And so that can be from a highly anti-inflammatory diet, removing pro-inflammatory foods, removing pro-inflammatory thoughts, optimizing sleep, weight loss, extra weight increases inflammatory markers. So there's a lot we can do to reduce your inflammation and create an anti-inflammatory state in your body which will help improve your energy pretty quickly actually too. So that's exciting when you get the inflammation down, good energy follows with that.

Dr. Chris Miller

(19:00)
Last two, number 11 is to improve hormonal balance. So I like to think of the hormones in terms of your thyroid, make sure your thyroid's in perfect function. You can sometimes do a lot with diet to improve it. Or if you're on medications you make sure you're on the right amount that we're optimizing it. Improve your blood sugar. So if you're hyperglycemic or having insulin resistance, work with one of us and we can help you improve that. Stress manage and get that cortisol down. So being in good hormonal balance will improve your energy.

Dr. Chris Miller

(19:29)
And the last one, number 12 is what I mentioned before, is rule out medical conditions. So see a doctor if you're having ongoing fatigue and make sure someone does a good history, maybe an exam, looks at blood counts, nutritional status, inflammatory markers, gut health, thyroid, blood sugar, liver, kidneys, heart. And those are things that we do pretty quickly, we can help people with as well. So if you have ongoing things, make sure we're not missing anything in you. So those are my top tips and I would love to hear from the other docs and you guys out there with your thoughts on that.

Dr. Laurie Marbas

(20:01)
So I just want to say, thanks Chris, that was really helpful and very thorough. And I think you had some major, major points. And does any of the other docs have any thoughts before we open up to questions?

“Dr. Alon Sitzer

(20:09)
I think that was a wonderful extensive summary of a subject that in my old practice when I used to have people and the chief complaint was fatigue and I had 15 minutes, 20 minutes. And I'd think how in the world can you go over such a symptom that seems so, oh it's just fatigue, but it is so multifactorial and there can be so many underlying causes and [inaudible 00:20:22] and reasons for it. And so I think that was a great summary.

Dr. Laurie Marbas

(20:24)
Thank you. Very helpful. Anybody else, Dr. Fontaine?

Dr. Elisabeth Fontaine

(20:27)
Well just to show you how I'm impressed. This is very good to show how many point you can touch. And maybe when you talk about hormones since my specialty is more women and I know you may not have had time. But when women reach the age of menopause this imbalance in their hormone will often produce the typical hot flashes and then there'll be an impact, significant in their sleep pattern and then on the fatigue. So that's another important one that we can substantially improve with a whole plant based diet. And so just to understand it because sometimes we just say, ah, I'm having hot flashes, this is terrible, this is menopause and they accept it as something that we can't do anything about it. But we can, we can by improving the diet and can substantially improve the sleep. So I just wanted to add that but it was a very fantastic review of everything on the fatigue. I see that there's a few question in the chat. I did not answer so I don't know if people want to kind of look at them and-

Dr. Laurie Marbas

(21:01)
Yeah, I'll bring them up here. So I think there's some also over here on the plant-based diet that are kind of related to blood sugar, disruption to sleep. So does anyone want to speak to maybe diabetes or the up and down part of the blood sugars related to fatigue? Dr. Scheuer?

Dr. Kim Scheuer

(21:12)
Sure. So I think by the way, Dr. Miller, Chris that was an amazing presentation. So thank you very much for that. And as you said, when your hormones are off and you're not in balance, whether it's psychological balance, physical balance, emotional balance, you can have a lot of fatigue and that's true with the hormones and with sugars. So if your sugars are going way up and down, you're not going to be stable and you'll have maybe a buzz then you'll be really fatigued. And that just weighs on your body. So eating a healthy diet, improving your insulin resistance and getting as insulin sensitive as possible. And we can help you at Plant Based TeleHealth, lots of our doctors know about that.

Dr. Kim Scheuer

(21:35)
Working on blood sugars that are dropping too much, I saw somebody who was commenting whether they should be seen. Yes, absolutely. There's a lot that our doctors can do. The variable blood sugars, especially if you're on a CGM and know that the numbers are correct, you should be seen ASAP. Especially if you're going as low as you are and feeling these issues I would suggest going to our website and putting in the state you're in, finding out which doctor you can see and get on onboard ASAP. So yeah, just stabilizing everything will make a difference, including your sugars and we can help you with that.

Dr. Laurie Marbas

(22:00)
Very good points. Good.

“Dr. Alon Sitzer

(22:02)
Maybe something to add about the blood sugar is looking that they're dropping. Obviously I don't know if your medical history and all, but one of the things with whole food plant-based nutrition is if you're used to a certain lifestyle that's not plant-based and you're consuming a lot of calories through it and you certainly switched to a whole food plant-based nutrition there, these foods they're dense in nutrients but they're low calories. So we still need calorie. We still need food to also create energy. And with blood sugars that are kind of that low I think it's important to get a consultant and be seen and just talk about it more. But if you don't eat much, your sugars are eventually going to go down. So you do need food and calories and nutrition to kind of also kind of maintain and also kind of get energy. So just another point.

Dr. Laurie Marbas

(22:27)
I think that's exactly right because that's a very common lesson I learned early on when I switched to plant-based diet, working with patients like I'm just eating fruits and vegetables, I'm so tired. I'm like oh, you need more food. And the older women, tiny women tend to eat a little bit less and they struggle with that. So maybe focusing on your beans, your whole grains, some nuts and seeds, healthy fats, avocados, things like that. But yeah, absolutely we would recommend to be seeing that's at plantbasedhealth.com. And as Dr. Scheuer mentioned, you can click on meet the docs or find a doc and it will help you filter out who is available to see you in your state. And those are very good, very good answers. I guess another question that we're seeing a little bit about maybe a little bit off topic is intermittent fasting and any thoughts about intermittent fasting and helping with weight losses to someone who's still starting to eat on a plant based diet. Any thoughts there?

Dr. Chris Miller

(22:56)
So I'll start with that one and then the others can jump in and add. But I'm a huge fan of intermittent fasting. And actually there's quite a bit of data on it and that having a little more restricted of a window, like you shouldn't be eating 24 hours a day. So having a period of eating a period of not eating so. And the data shows that starting with a 12 hour eating window and 12 hour fasting window is actually beneficial. And then if you can shorten little bit like an 11 hour eating window and a 13 hour fasting window. What it does, and you can even shorten it more, 10 hour and 14, or people are doing eight hours and 16 hours, kind of depending on what works for you. You can intermittent fast by doing one day of eating or one day of lower calorie eating one day of not eating or eating regular calories.

Dr. Chris Miller

(23:20)
So there's different ways that you can do it and find what works for you. But one of the reasons I find it helpful is for some people who eat a lot at night, like you get home at the end of the day, your willpower's run out at this point. And that's when you sit down on the couch and you're eating a lot. Well if you put a window on yourself where you don't eat past seven o'clock, let's say past dinner time then it takes out the willpower of eating in the evening. And it can significantly help with weight loss actually for several reasons. One, because you're not overeating in the evening anymore by putting this window on. And it's a habit, once you become used to eating breakfast at eight and lunch at noon and dinner at six and then you're done and then you don't eat that evening.

Dr. Chris Miller

(23:41)
So it's really been proven to be helpful. It also helps lower inflammatory markers, blood pressure, blood sugar, it improves blood sugar control and insulin resistance. So it has been helpful for weight loss for people. There are some caveats and some certain people that struggle with. Elisabeth can probably tell us about pregnant women, why they shouldn't be doing that or breastfeeding women, why maybe they shouldn't be doing that. But in general it's very helpful. And especially if you eat earlier in the day than later in the day, it helps even more with weight loss because we actually don't metabolize our food at night as well as we do in the morning. And we're not as insulin sensitive in the evening as we have in the morning. And so yeah, so I'm a fan of it and I encourage it as long as you don't do too short of the window and you get enough nutrition in. I've seen people do really short windows and eating fruit and then not getting the nutrients that they need. So yeah, so that would be my thought on it.

Dr. Elisabeth Fontaine

(24:08)
It's interesting. Thank you. It's kind the new kid on the block, the intermittent fasting but in itself t's a little bit what we used to say to people, don't eat at night. This is not the best time. And in itself it was kind of 12 hours. So if you say intermittent fasting people like it more than just saying don't eat at night. It's as simple as that when you think about it. But the other thing is that when you are trying to lose weight, your body goes into this kind of change.

Dr. Elisabeth Fontaine

(24:23)
And eventually it tends to want to be in some sort of a status quo, it doesn't want to change anymore. It wants to be back to where it was. So by introducing a little bit of a change, if you had to try with a little bit more movement, a whole plant based diet and then you are at a plateau then introducing a little bit of intermittent fasting you're kind of playing a little bit with your system and then you sometimes will be able to jump and go over that plateau. So it is pretty helpful in that sense as well.

Dr. Laurie Marbas

(24:41)
Good point. Anybody else? Maybe time for one more question? Yes Dr. Scheuer please.

Dr. Kim Scheuer

(24:44)
I was going to say there's different ways intermittent fast. I personally like exactly what you guys have mentioned the limited time. But I also like there's some people do better with a one day a week fast, intermittent fast. And again, fasting is when we, our bodies, our cells recover. And it helps everything from mitochondria to your sleep, to everything. So it's a good way and your weight, it's a really good way to help accelerate a little bit.

“Dr. Alon Sitzer

(24:59)
[crosstalk 00:24:59] One more point. There's a standard American lifestyle and we sometimes take for granted that we have a grocery store that's open, literally you can buy whatever you want to eat, whatever you want to drink at any time and hour of the day. And the pendulum swung to such an extreme and it does come back to simply it's nighttime. It's time to rest. It's time to take a break from food. It's time to rejuvenate. And rather than eat, eat, eat and get late at night and all the kind of physiological and emotional mental consequences that can just come from constantly doing something rather than just there's a time for this. And there's a time for that and finding that healthy place of balance and moderation just giving your body rest. So just another yeah.

Dr. Laurie Marbas

(25:25)
The nods are coming. So yes, absolutely. Maybe one last question. We try to keep these because I've discovered the human attention span has shrunk dramatically. So we'll do one more question. But a few people have asked about supplementation for sleep or leg spasms or anything. Is there anything, food specific or supplements that you guys would recommend for either of those?

“Dr. Alon Sitzer

(25:40)
In my experience some of these supplements are kind of trial and error. And honestly my always approach whether it's been a medication to pharmaceutical or nutraceutical or supplement or a herb it's always kind of trial and error. And ultimately it starts with trying to adjust kind of the lifestyle, the day to day habits and trying to find that part that's missing, that hasn't received enough love and attention from me or it's neglected. That said, in my experience some people have taken kind of the B vitamins, it have held some. Magnesium is kind of a known one. Sometimes we talk about potassium. And it's important to also remember that sometimes you can find the foods that are rich in these nutrients as well.

“Dr. Alon Sitzer

(26:04)
It's always stuck in my head that someone once told me pumpkins are really good for insomnia and for sleep. And it has to do also with kind their nutrient density and the richness of the vitamins and minerals. So yeah, that's just been my experience with supplements. For some it's helped, for others it just didn't help when they tried this. But again, just approaching kind of any illness or disease with kind of trying to find a cure treatment without addressing kind of your day to day life, the stress, the thoughts, the job, the nutrition, the exercise, the sunshine, et cetera is kind of it's just part of the whole package, let's put it that way.

Dr. Laurie Marbas

(26:26)
Fabulous, anyone else?

Dr. Kim Scheuer

(26:29)
I agree also with the package deal. If you were thinking about magnesium or things like that, taking it out, taking out specific nutrients and putting them separately doesn't work as well as having the foods that have it. And so I think that's why a lot of us push the whole food parts of this and having the package together. Yes, sometimes supplements help. And that's when you come and see us individually for that. But do the whole package, that's a really important thing.

Dr. Chris Miller

(26:44)
I would add to what those guys have just said that for the person who was talking about leg cramps at night. So one thing that I do is I check electrolytes in people and make sure that they're okay because some people we're not eating any much or any salt. If you drink a lot of fluids you can have low salt levels. If you're exercising a lot or sweating a lot you could need little extra calcium or little extra magnesium, things like that. So checking electrolytes can be helpful, making sure you're well hydrated is helpful because being dehydrated one of the main cause of leg cramps at night time. Looking for their medical conditions like restless legs, there's a couple things that can be keeping you awake at night as well that we can help with if we find something like that. And then of course working in the lifestyle like everybody else talked about and possibly playing with some different supplements or herbs to help you. So I agree with everyone else.

Dr. Laurie Marbas

(27:10)
Anybody else? I think that's it. All right guys, we're going to call to wrap but we want to welcome again, Dr. Sitzer. You're going to be an amazing… Today was great too. So I'm like, oh yes, you're going to be wonderful. So you guys check him out at Plant Based TeleHealth. Our docs are available in all 50 states in DC and please spread the word about us. We're always here to help and we'll be back next, today's Friday, next Thursday, 12:30 Mountain Time. I'll let y'all figure out wherever you are and what that means. And we'll go from there. But thanks again. And please check us out again, Plant Based TeleHealth and thank you doctors for joining us today. And again, it was a great one. Y'all have a great weekend.

Dr. Chris Miller

(27:35)
Bye, thank you.

“Dr. Alon Sitzer

(27:35)
Bye, take care y'all.

*Recorded on 3.4.22

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