Sock Doc 15: Your Immune System, Part 2 – The Exercise ‘Sweet Spot,’ Deep Dive on Immune-Supporting Supplements, Self-Assessing Your Needs, and More

December 31, 2021
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On this episode we have The Sock Doc, Dr. Steve Gangemi, joining us. Steve is a natural health care doctor who founded and practices at Systems Health Care, an integrative wellness center in Chapel Hill, NC. Steve is also a longtime endurance athlete and is a wealth of knowledge for athletes looking to optimize wellness.

In part 2 of this 3-part series we take a deeper dive into immune system function.

If you haven’t yet, listen to part 1 here.

Exercise options for optimal immune function

  • Exercise- some is good, too much has negative effect.
  • Thorne article: How Athletes Can Support Their Immune Function (with links to relevant studies)
  • Equation of fitness isomer than just the exercise itself- so many other variables from sleep to work stress to family stress, diet and so on.
  • Endurance athletes have a greater demand since the amount they mush themselves, and if not careful can be more susceptible.
  • Overtraining runs system down (even if you’re not doing high intensity).
  • Immune cytokines- some are inflammatory and other anti-inflammatory, this impacts immune system function and other systems in the body.
  • Too much HIIT can put us into sympathetic overdrive – symptoms manifest in many ways and could include: skin issues like eczema, fungal infections (including toenail issues), you catch every cold going around, allergies and asthma, and so on.
  • How to find our sweet spot with exercise for robust immune function?
    • Trial and error: See how you respond to different exercise modalities and stimuli. Listen to your body. If you have cravings this could be a sign that things are off.
    • If you had done too much long slow aerobic training and switch to HIIT with low volume helps, you may see better sleep, sharper cognitive function, and so on.
    • If craving sugar, this could be a sign you’re burning too much sugar and not a great fat burner.
    • If craving salt, this could be a sign you’re depleted in electrolytes and/or adrenal glads.
    • Sensitivity to bright lights or sensitivity to sounds are a sign of sympathetic overdrive.
    • Are you peeing during seeing hours? This is not a normal thing.
  • What about people who have a lot of stressors that can’t just change everything, such as shift workers or people traveling to different time zones?
  • Quality diet and training have a bigger positive impact than we may even realize- and those are well within all our control. 
  • Sleep habits as well.

Offseason, training in winter and vitamin D

  • Should we worry about training too much in winter months when we’re not getting an immune boost through the sun?
    • Not necessarily, it depends and shouldn’t negatively affect every single person. Why? You can still supplement with Vitamin D. And also when it comes to illness and things like seasonal affective disorder (SAD), there are typically other issues going on not just a low D thing.
  • The “Vitamin D border” in winter
    • The changing angle of the sun in the winter, and why the latitude in which you live matters.
    • Above the 37th parallel where you won’t get D from the sun in winter months (can get D from the sun above that latitude in summer months).
    • More info: Vitamin D winter by Sock Doc
  • Shadow trick- what is it?
  • D Minder app to monitor your Vitamin D status and more

Self assess & healing

  • Blood markers discussed in detail in part 1.
  • The path to healing and building a stronger immune system.
  • So many speciality labs exist these days. But too much information can be overwhelming. Blood is a great way to start cheaply.
  • Past that, measuring immune markers via blood even just basic Vitamin D.
  • Vit D ideally in 50-80 ng/ml range.
  • Labs are great to point you in the right direction but use caution to not be overwhelmed. 
  • Food sensitivity tests- Steve is not a big fan because of false positives. Not really addressing where the problem actually is.
  • Hormone tests via saliva are more accurate than blood because you can see free levels more accurately for both men and women.
  • In blood- there are a lot of issues that can affect hormone measurements that won’t give you the info you need. Saliva tests may be a better bet especially if symptomatic.
  • If you’re seeing that you’re extra sensitive to minor things even smells of all kinds, chemicals or seasonal things (like pollen in spring), indication that immune system needs work regardless of what the bloodwork may say.
  • Don’t try to just push through it or push harder, it’s ok to go easy and take care of yourself when you need it- listen to how you feel and function.
  • Bloodwork is not going to tell you everything. Listen to your body.
  • LINK And genetic testing? It’s not the be all end all. Our podcast with The Sock Doc on genetic testing here.
  • He’s also not a fan of vitamin and mineral tests in blood because your blood is typically one of the last things to change when there’s an imbalance in the body. You could do a major chemistry analysis and it may not accurately reflect little imbalances, nor does it address why that imbalance is there and supplementing alone may not be the long-term effective answer. Maybe it’s major diet and lifestyle changes.
  • Is it worthless to test those things? Eg B vitamins? No… just don’t rely on single lab tests.
  • Vitamin D is another example that we can’ trust that one marker along- don’t jut test 25-hydroxy Vitamin D, also test the 1,25-dihydroxy vitamin D to measure the balance between the two. But few people do this. If you see levels go up with supplementation then plummet back down after you stop supplementing, then that could be indicative of needing to test both. But then where does the testing end?
  • The bigger issue is that we’re seeing less critical thinking and clinical observations, instead relying too much on labs and numbers not the thorough exam and history. 
  • A case for holistic healthcare and functional medicine.

Nutrition & supplements for immune health and overcoming illness

  • Are there supplements we should take daily? 
    • Stick with the ones that are proven to support and improve T regulatory response: EPA/DHA, grassfed/grass-finished fats, Vitamin A, Vitamin D, zinc.
  • Vitamins A& D
    • Don’t need to fear Vitamin A. Not going to toxic taking it for a short period of time. High doses up to 100,000 IU have been used for certain illnesses.
    • Throughout the winter a normal supplementing routine could include 10,000 IU Vitamin A to 2,000 IU Vitamin D (10:2 ratio), a few times a week. Half that for kids 12 years old and under.
    • Based on your diet or sun exposure, you may not need to supplement that much with these.
    • Warning signs off too much A: headaches, pressure behind the eyes, and others… it takes a while to actually reach toxic levels and poison yourself with Vitamin A.
    • Forms of Vitamin A and what other ingredients are in your supplements?
    • A lot of vitamin A is beta carotene, and just about 30% of that is converted. 
    • Buy Vitamin D in D3 form.
    • Biotics Research is a good brand for these supplements.
  • Ingredients and sources matter!
    • Watch out for seed oils in your supplements and/or a long list of unnecessary ingredients added into supplements.
    • You get what you pay for with supplements, don’t go cheap. Especially things like fish oil that can so easily go rancid, and don’t buy non-triglyceride form.
    • Titanium dioxide was pulled from Europe’s safe ingredient list but has potential side effects, yet is found as an ingredient in MANY supplements.
    • Buy from trusted sources like Wellevate, Fullscript, Thorne, and so on. They stand by their products and have great customer service. 
  • Why is Vitamin C perhaps isn’t as powerful or as necessary as we have been led to believe?
    • Most comes from GMO corn. Over 500mg of ascorbic acid caused some DNA issues. 
    • In regulating your immune system better, Vitamin C is not even in that pathway. 
    • Vitamin C sacrifices itself when other deficiencies are present, i.e. C can make up for other antioxidant deficiencies. 
  • Zinc
    • Huge value in zinc.
  • Astragalus
  • Multivitamins or immune supplements stacks?
    • Biotics Research Immune Support packs to cover a lot of your bases without going crazy picking and choosing a million different bottles. 
  • Elderberry
    • Used with astragalus, works really well.
    • Diminish viral replication.
    • Sambucal syrup loaded with sugar isn’t it. Get a good quality tincture, locally made, used with a natural sweetener. 
    • Only use it when you are actively sick, great for that, won’t help just taking regularly to strengthen immune system (unlike astragalus is good to take regularly for oil support).
    • Can use it pretty heavily when sick, especially in the early phases.
    • Dilute your liquid herbs in water!
  • Glycine
    • Great to improve liver function, break down cytokines in the liver (diminish the cytokine storm and detoxify through the liver).
    • Sweet tasting amino acid, and you can’t really overdose on it. Can take it throughout the day while sick.
  • Quercetin
    • Antioxidant, found in onions, lemon peels.
    • Really good at repairing cell damage and improving IL10- the most important anti-inflammatory interleukin, thus improve immune system.
    • Can also use to negate effects of NSAIDs and detox when NSAIDs were overdone.
    • Safe to take. 
  • Things that get attention but are the worth it and necessary: 
    • Probiotics- ok to take but not something you shouldn’t need to stay on them long-term. You’re taking live cultures that should grow and thrive, to the point where you don’t need it anymore. When using a gut protocol go through the proper phases of cleaning up- kill phase to repopulate and so on. 
    • Oil of oregano- more so used to clean up gut, anti-fungal; good to take but not one that you want to stay on or take long term
    • Digestive enzymes to support gut health – don’t take long term, could lower the bodies own ability to produce these enzymes so don’t keep taking them too much too long. You can become reliant. 
  • More on immune health support for athletes:
    • Nieman D. Moderate exercise improves immunity and decreases illness rates. Am J Lifestyle Med 2011;5(4):338-345. doi:10.1177/1559827610392876
    • Pyne D, Gleeson M. Effects of intensive exercise training on immunity in athletes. Int J Sports Med 1998;19(s 3):s183-s194. doi:10.1055/s-2007-971991

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