Kelsey Marksteiner: I actually don’t do a whole lot of nutrient testing in my practice unless someone really wants it. A lot of times I can kind of tell what they might be low in or what they may need more of based on their symptoms. If they don’t do nutrient testing, honestly I don’t do any sort of baseline supplementation. I base it off of the symptoms that they have. So if they are having some symptoms of leaky gut or something like that, I’m going to add in some zinc, things that I know might be useful for them to improve intestinal permeability. I base it off of the symptoms. I don’t really do a baseline other than a really nutrient-dense diet. I really, really like to see people getting their nutrients from diet anyway, unless they are having really bad gastrointestinal symptoms, where I’m worried about the absorption of nutrients, even if they have a very nutrient-dense diet. In that case, I might recommend a multivitamin, but I will say that I do that pretty rarely.
Honestly, I really do recommend going from the food approach, and unless they’re not willing to eat some of those kinds of “superfoods” that have a lot of vitamins and minerals in them, things like liver, bone broth, those sorts of things, then in that case I would consider supplementing with the nutrients that are found in those foods. But otherwise, if they can get that stuff in and they’re eating fish on a regular basis, all those things that we know have these wonderful nutrients that people need for good health, that’s fine. That’s a great baseline, and it’s just if I’m worried about actual nutrient absorption where I might add in a multivitamin on top of that. Otherwise, yeah, that’s a great place to start.
Then the second question here was, “How often should you test nutrients and make adjustments based on results?” Like I said, I don’t do a whole lot of the nutrient testing, so that actually might be a better question for Chris or Amy. I would recommend asking them in one of their Q&As. That might be a little more helpful for you. But let’s just take vitamin D as an example. If someone comes to me and they have a low vitamin D level and we put them on a vitamin D supplement, I would probably test in a couple of months, so maybe two or three months, see how much things have improved, and then tweak based on that. Same thing for iron. If their ferritin level is low, we add in some iron supplementation or we start adding in foods that are high in iron or adding vitamin C to increase iron absorption. In a couple of months, test again, see how much things have improved, and tweak based on that. If I’m seeing a good improvement, I’m not going to tweak the dosage, but if I’m not seeing as much of an increase as I’d like to, then I may increase the dosage to kind of get that moving a little bit faster, depending on how the person is tolerating the current dose. With vitamin D, tolerating it is not usually an issue, but with something like iron, it can be an issue to do higher dosages, so it sort of depends on how the person does with it, as well.