Podcast Episode #335: Testing Nutritional Status: The Ultimate Cheat Sheet with Dr. Chris Masterjohn, PhD

Topics

1. News and updates from Diane & Liz [1:54]
2. Introducing our guest, Dr. Chris Masterjohn, PhD [6:14]
3. Something new Chris is into [7:50]
4. Chris's educational background [9:10]
5. Testing Nutritional Status Ultimate Cheat Sheet [19:54]
6. Ordering lab tests [28:02]
7. Knowledge in testing [32:27]
8. Who can benefit from the Ultimate Cheat Sheet [44:36]

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You’re listening to the Balanced Bites podcast episode 335.

Liz Wolfe: Welcome to the Balanced Bites podcast. I'm Liz; a nutritional therapy practitioner, and author of the Wall Street Journal best-seller Eat the Yolks; The Purely Primal Skincare Guide; and the online program Baby Making and Beyond. I live on a farm in the mystical land of the Midwest, outside of Kansas City.

I'm the co-creators of the Balanced Bites Master Class, with my podcast partner in crime, Diane. And we've been bringing you this award-winning podcast for more than 6 years. We're here to share our take on modern paleo living, answer your questions, and chat with leading health and wellness experts. Enjoy this week's episode, and submit your questions at http://blog.balancedbites.com or watch the Balanced Bites podcast Instagram account. You can ask us anything in the comments.

Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment. Before we get started, let's hear from one of our sponsors.

Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants (including me; I'm an NTP), emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body's ability to heal. The NTA‘s NTP and NTC programs empower graduates with the education and skills needed to launch a successful, fulfilling career in holistic nutrition. To learn lots more about the NTA's nutritional therapy programs, go to http://www.NutritionalTherapy.com. There are workshop venues in the US, Canada, and Australia, and a brand new NTC venue in Vancouver, Washington. So chances are you'll be able to find a venue that works for you.

1. News and updates from Diane & Liz [1:54]

Liz Wolfe: Hey everybody! I'm really excited about our interview today. But first, a couple of details about what's going on and what's coming up. First of all, the NTA preconference business success workshop. Diane and I are doing this on March 1st, before the NTA conference starts on that Friday. We're going to talk about what it takes to establish and to run a successful wellness business. Both in person and online. And we're going to talk about balancing those two things.

We're going to talk about how to choose what you're doing, and where you're spending your time. We're going to talk about finding your voice, and connecting with people, and social media strategies. Basically everything that we've learned and we've done and we've leveraged to be successful. To build sustainable business that pay the bills using the knowledge that we gained from our nutrition programs.

As you guys know, Diane and I went through different nutrition programs, both of them holistically oriented. But we've used a lot of the same tools to get to where we are. Diane and I do a lot of the same things; we do this podcast together. We work in the holistic wellness community. But we both have careers that look a little bit different. Our priorities are slightly different from one to another where we spend our time.

But what's the same about us is we've both created businesses that fulfill our financial needs and that are sustainable. And we are producing content at a rate and in a way that is authentic to us. So we really want to share what works and maybe pass along a ball of clay. And you can mold that clay in a way that works for you.

There's so much information out there on the nuts and bolts of nutrition and physiology. And I think our talents are not necessarily in teaching you everything you need to know about; I don't know, different types of estrogen. Or how the liver detoxes hormones. We're not necessarily here to teach you everything you need to know about one organ, or one aspect of nutrition. We cover things in a much broader way. And we cover a lot of lifestyle stuff. But what we want to teach people is how to leverage what you know and communicate it in a way that's going to help you build your business.

You don't have to be a member of the Nutritional Therapy Association or a student to go to the conference or to come to our session. So if you can make it to Vancouver, you can come to our session, or you can come to the conference. You don't have to be a member or a student. So if it's within your realm to come and join us, please do. You can navigate to the ticket purchasing portal super easily. And I'll give you a link here. You can go to http://realfoodliz.com/NTAworkshop to look at the preworkshop offerings, what Diane and I are doing. And you can also buy your ticket to the conference via the Nutritional Therapy website. So I really hope to see folks there.

We will also be, Diane and I will be recording a podcast live at the NTA conference on that Friday. And we're really excited about it. So I hope to see everybody there.

Liz Wolfe: Today's podcast is sponsored by Vital Choice wild seafood and organics. The leading source of superior, sustainably sourced wild seafood and a certified B corporation. February is heart month, when it's smart to remember that diets rich in seafood and its superior omega-3 fatty acids can reduce your risk of heart disease and high blood pressure. Wild fish and shellfish are the riches sources of the healthiest kinds of omega-3 fatty acids, and Vital Choice offers a wide range. You'll find the very best, paleo friendly, wild salmon, fish, and shellfish; plus salmon burgers, dogs, and bacon. Mouth-watering grass-fed meats and organic bone broths. Check it all out at www.vitalchoice.com.

2. Introducing our guest, Dr. Chris Masterjohn [6:14]

Liz Wolfe: I'm so thrilled to welcome Chris Masterjohn to the show today. Dr. Chris Masterjohn. A lot of you know exactly who he is, and follow his work. But before we get to the interview, I will go ahead and give a quick background on Chris for those who are not familiar. Or for those who need a refresher.

Chris Masterjohn earned his PhD in nutritional sciences in 2012 from the University of Connecticut at Storrs. Served as a post-doctoral research associate at the University of Illinois at Urbana Champaign from 2012-2014, and served as assistant professor of health and nutrition sciences at Brooklyn college from 2014-2016. He now works independently in health and nutrition research, education, and consulting.

Chris has authored or co-authored 10 peer-reviewed publications. His podcast, Mastering Nutrition, and his two-video series; Chris Masterjohn light, and Master Class with Masterjohn, and his blog can all be found on the website, www.ChrisMasterjohnPHD.com. You can also find him on Facebook, Instagram, Twitter, YouTube, and Snapchat, where his user name is @ChrisMasterjohn. Chris, thank you so much for being here.

Dr. Chris Masterjohn: Thank you for having me, Liz. It's great to be here.

Liz Wolfe: You've been on a couple of times. You know the drill. But we've added a couple of fun little segments. And because it's no fun to just talk about nutrition, we need to get a little bit personal before we jump into that.

Dr. Chris Masterjohn: That sounds really boring.

3. Something new Chris is into [7:50]

Liz Wolfe: {laughs} It does, doesn't it? Maybe not for you. Maybe not for me. Ok, maybe a little bit for me. So, I want to ask you; what are you into right now? It can be anything.

Dr. Chris Masterjohn: I'm into rediscovering all of my childhood video games. Because I just purchased a set of retro power USB controllers that has emulations of the Nintendo, the Super Nintendo, the Nintendo 64, the PlayStation 2, and Sega Genesis controllers that plug into my laptop and I can run all the old video games on it. So that's what I'm doing right now.

Liz Wolfe: Wow. That is not; that was no where near in my real of expectation for what you might say. {laughs}

Dr. Chris Masterjohn: {laughing} What did you think I was going to say?

Liz Wolfe: I have idea. I thought maybe it'd be a treat, or you know, I don't know man. I was never one of the; my parents didn't let me have a Nintendo. I didn't have any cool stuff. But my husband's all about.

Dr. Chris Masterjohn: Well that's sad.

Liz Wolfe: I know. It's a sad little childhood Liz. But I always was jealous of the kids that did. So that's really {laughs} that's so fun that they're having a resurgence.

Dr. Chris Masterjohn: Well at least you're on Facebook now. {laughs}

4. Chris's educational background [9:10]

Liz Wolfe: Oh lord. That's a time vacuum if anything. Well very cool. Alright, so let's nerd out a little bit. And I just have to ask; this is less a personal question and more just personal curiosity. But can we just talk about your education for a second?

Dr. Chris Masterjohn: Sure.

Liz Wolfe: Like, what got you interested in nutrition to this degree? And what prompted you to use your proclivities and your talents in this way?

Dr. Chris Masterjohn: Well, my interest in nutrition goes back to my teenage years. I saw my mom recover from a lot of her health problems. She was suffering from fibromyalgia. She was in chronic pain. She went through the whole macrobiotic diet, alternative medicine, yoga, herbs. Explored through all of that territory, and I got a really early appreciation for how those things can really impact your health just by watching her.

And it wasn't all upside from there. I got so into nutrition that I decided to become a vegan. I was idealistic at the time. I was extreme about everything at the time. That was just another way to put my extreme idealism into play. I expected to protect myself from a lifelong risk of disease, and I quickly got ill much faster than I would have expected it to ever take.

I wound up with a lot of tooth decay, a lot of anxiety problems. And then I kind of surreptitiously discovered the work of Weston Price. Because my boss at the time, and now friend Wayne, gave me some information on it. I was suffering from a lot of tooth decay. I heard of Weston Price; this guy who figured out the cause of tooth decay and the impact of nutrition on it back in the 1930s. So I read all about that. Wound up changing my diet to incorporate a lot of nutrient-dense animal foods. I was mainly focused on my teeth, but it made a huge improvement in my mental health. So that just reinforced even more my belief in the power of nutrition. But also convinced me that most of what I had read up to that point had been wrong.

So that motivated me to move from what I had been doing, which was finishing up my bachelor's degree in history, to pay it forward in some way by entering the health field. I expected the best way to do that would be to become a doctor. That required studying a lot of premed, science prerequisites. Because I didn't have chemistry, I didn't have biology, I didn't have physics, I didn't have this and that. So I pursued that as soon as I graduated. And while I was doing that, a few things happened that made me go into a PhD program instead of medicine.

One was, I just fell in love with the microscopic stuff. The stuff that you can't see. The abstract part of my brain went nuts figuring the nuts and bolts of chemicals and molecules. But I think more importantly than that, I was writing about nutrition a lot at that point. And I was developing my own hypotheses, and I really wanted answers to these questions that I was generating. And it was pretty obvious that no one would ever answer them unless I went into research to answer them.

And on top of that, the icing on the cake was just many people in my life, including several of my professors, were telling me that I should go into research. Because I really had the brain for research. So I just decided that I would be better off developing new knowledge, and figuring out new things that people could apply rather than just taking the existing treatment protocols and applying them in practice. Which is what I feel like I would have been doing had I gone into medicine. And that led me to do a PhD program in nutrition.

I went the traditional route of getting a PhD, doing a post-doc, becoming a professor. And I realized a couple of things; one is just on a very personal level, I have a very strong need for autonomy. Being a university professor is one of the jobs that you could have that's closest to being self employed in the sense of the amount of control you have over your day to day life and how you arrange your priorities, but it wasn't anywhere near enough autonomy for me. So, I just jumped ship and went into my own business.

On top of that, as I've rethought all of my priorities, one of the things that I've realized is that although I felt that I needed to generate new knowledge, there's this even bigger problem where there's an enormous mass of science that has been done and is just left in this big pile where it has no practical utility because no one is doing anything with it. And very few people can cross the boundary to know what people need on a practical level. And also be able to sift through the technical detail of all of that science to actually translate it from one to the other. So I actually feel right now that my most important niche is to dig into that scientific research and that massive pile of information to really translate it into practical stuff that people can use.

Liz Wolfe: So; I had in my notes here written down; communicator. And you're such a phenomenal communicator. And what's so amazing, and what really makes you a go-to for so many folks is the fact that you have that research brain. You have the intelligence, and the drive, and the curiosity. And the ability to figure out and understand things that I certainly cannot. But you also have the ability to package them in a way that people can understand. People like me and people that are just trying to help themselves. And I think that's amazing.

I imagine, being the go-to for so many people could be a little bit stressful. Would that be accurate?

Dr. Chris Masterjohn: Yeah. I mean, it can be stressful. But my goal is not to be the go-to for many individuals. My goal is really to try to leverage the time that I spend to help the most people that I can. And I think that the way that I do that is not to spend most of my time being the go-to on a personal level for a large number of people. That's just impractical to scale.

So I think that; I guess there's, I don't know, a sense of responsibility, or weight, or something like that that might come with mass communication. But I think that I'm really focused on; I spend a lot of time focusing on how to actually take care of myself. Because I think that's something that I've neglected for the better portion of my adult life, and I really see; I think that anyone who has people who depend on them really has to maybe put a lot of attention into taking care of yourself. Because I think those of us who are really out to help other people kind of have the personality that allows us to neglect that. But you really can't help anyone if you burn out.

So, I think I'm getting; I'm not done fixing that part of myself. But I have a really good handle on it now. So; I don't know, my stress could be lower. But I think I'm at a very good point compared to most of the rest of my life in figuring out how to get that balance right and taking care of myself and giving my mind a rest so that I can find ways to help people at scale.

Liz Wolfe: You really articulated one of the lessons of parenthood {laughs} that I've learned.

Dr. Chris Masterjohn: Oh. I haven't done that one yet.

Liz Wolfe: As far as when you've got somebody. Well, and I have this conversation with Diane sometimes. Because she is an entrepreneur, and just like you just said. When you have people that depend on you, the weight of that responsibility is large. But it also can lead you to neglect the important thing, which is to take care of yourself. So, I have always very much respected some of these parallels between entrepreneurship and parenthood. And I think you just articulated that nicely.

Dr. Chris Masterjohn: Thank you.

Liz Wolfe: Alright. So, one of the things that we were just talking about is how you communicate things in a scalable way. So we're going to talk about one of your digital products during this episode called The Testing Nutrition Status Ultimate Cheat Sheet. And I'm very excited to talk about that. But I just have to take a quick detour, and ask you; what the heck were you going to do with a history degree?

Dr. Chris Masterjohn: {laughs} I was going to be a social studies teacher.

Liz Wolfe: Wow.

Dr. Chris Masterjohn: High school.

Liz Wolfe: I mean, you would have been the greatest social studies teacher ever. But I'm so glad that you took this detour and decided to become a health communicator in the way that you have. I think that's amazing.

Dr. Chris Masterjohn: Yeah. I almost became a biology teacher instead, before I got into a graduate program.

Liz Wolfe: You ever look back and just think; wow. {laughs}

Dr. Chris Masterjohn: But yeah. It's so stressful going through grad school. I remember when I was towards the end, there were people who finished everything, and just had to write their dissertation. And were talking about quitting. {laughs}

Liz Wolfe: Wow.

Dr. Chris Masterjohn: Not seriously, but that's how they felt. And I remember telling my mom in the year leading up to my graduation. I was like; I'm going to pump gas for a living when I get out of this. {laughs} Because you're just; you feel like you've exhausted every fiber in your body that can do whatever you were studying, and you just want to do something; anything else. But then you give your mind a rest, and you recover, and you realize why you went into this in the first place. Because you really do have something to offer in that area.

Liz Wolfe: Many parallels to parenthood here, Chris. I don't know if you know that. But. 100% true.

Dr. Chris Masterjohn: Well, I'm glad I'm well prepared in case that ever happens.

5. Testing Nutritional Status Ultimate Cheat Sheet [19:54]

Liz Wolfe: You are. You're good to go. Don't worry about it. It will be easy. It's easy. Do it. Alright. {laughs} Let's talk about the Testing Nutritional Status Ultimate Cheat Sheet. Tell me; first of all give us a little window into what this is and why you decided to create it.

Dr. Chris Masterjohn: So this is a guide that is meant to empower people, whether they're in a position to help other people with their health or they want to help themselves with their health, to optimize their nutritional status for vitamins, minerals, and essential fatty acids to make sure they're getting enough of things, that they're not getting too much of anything, and that everything is in balance to optimally support their health.

And the reason that I put this out, honestly, is popular demand. And it goes back to my core audience who was following me on my podcast last year. I put out a series on managing nutritional status. Because people wanted it. There's a lot of people out there who are trying to figure out whether they have all these things right. And there are a lot of people who are getting testing done. And there's conflicting opinions about what test they should be running. Should they be running nutritional profiles? Should they be running the cutting edge ones? Should they be running the traditional ones? How should they be interpreting it? Is the range correct? And things like that.

So I wound up producing these podcasts that would take me two whole weeks of doing nothing else to put together. And then just geek out for two hours on an individual nutrient with all the scientific detail and leading into all the practical conclusions around how to know if you don't have enough, or if you have too much, or what to do about any of those things.

And they were very popular; but they were not very digestible or scalable, for a number of reasons. First of all, it was taking me so long to put them out, that it was like; there must have been a lot of people who just loved them with no complaints. But were thinking; Jeeze, I know how to manage my selenium status, but am I going to wait until October 2018 for you to tell me how to manage my magnesium status?

Liz Wolfe: {laughs}

Dr. Chris Masterjohn: Then there were other people who knew that they loved them, but if they have people they're trying to help, they're not going to convince them they need more vitamin A by having them listen to me geek out on vitamin A for two hours.

And then there were other people who were asking me to publish something that they could pay for that would just put everything in one place. Because you listen to a podcast; and even though I have transcripts and you can keyword search the transcripts, it's still a lot of work to go back and find all that information.

So people were asking me to simplify something, put something all in one place, make something really easy to navigate as a one-page cheat sheet. Now, this thing ended up being a 78-page cheat sheet. And the back story of that is, the reason I call it a cheat sheet is I designed it so that you could start off only reading a couple of pages. And you would be told in an algorithmic manner exactly what else you would have to read. And you would not have to do any extra work to sift through anything. So you might get full value out of this 78-page cheat sheet, and only ever read 6 pages of it because it's directed to you to exactly what you need to do.

But it was just fundamentally a fact that you cannot make a one-page cheat sheet in a way that does justice to this topic. What you can do, what you absolutely can do, is list all the important tests that someone should get. List the ranges. List the optimal value, or whatever. But you can't, in one page, tell someone what to do about any of that.

But even more importantly; you can't integrate the information that is just as critical as any lab test. Which is; what is your experience like? What are your health challenges? What are your signs and symptoms? Do any of them actually fit a nutrient deficiency or toxicity? And what is your diet and lifestyle like? What does that tell you about the likelihood that anything is out of balance?

Those are critically important, because when we define optimal ranges on a blood test or a urine test, we're talking about the average person, and not everyone is the average. When we talk about the RDA for a nutrient, we're talking about the range of intakes that will cover most people based on what we think the average needs are and the spread of variation. But they don't cover everyone, because your needs could be higher or lower.

So you need to be able to integrate those three pieces of evidence; your signs and symptoms, your diet and lifestyle analysis, and your laboratory work, in a way that covers the possibility that one of those indicators isn't telling you what you need to know. And you're able to fall back on the other two to direct you to the highest probability of what you should be doing to fix your health challenges. Or to take you to the next level. And then, also fit in there an action protocol in a way to evaluate whether that action protocol is actually working.

And so, I call it a cheat sheet because if you're going to do comprehensive lab testing, you have all of the lab tests in one single page that you would need. And in only a handful of pages, about 5 pages, you have an algorithmic set of instructions on what to read if any of those values are gone off.

But there are also ways to not do all that comprehensive lab testing for people who don't have the money for it. Because your insurance might not pay for it. You might be paying out of pocket. And if that's the case, most people can't afford to run all of the tests that would be ideal. So I give strategies to instead rely on the signs and symptoms. Or instead put more emphasis on the dietary analysis. Some people don't have time for the dietary analysis.

So I give people basically a three-pronged approach. Or a set of three approaches. One is; do you not want to miss a thing? You do the comprehensive approach. One is; do you need to save time? You put more emphasis on the lab data and the signs and symptoms, less on the dietary analysis. Or do you need to save money? You put less analysis on the lab testing and you put more emphasis on the things you can do for free at home, like review your signs and symptoms and run a dietary analysis.

All tailored to the available resources that you have at your disposal, and guiding you through how to arrive at the action protocol that you should have in the quickest possible way with the least amount of stress on your resources. And then figure out what you're doing is working, and how to get to the next step after that.

6. Ordering lab tests [28:08]

Liz Wolfe: So, part of the reason I personally am so excited about this is because; and I'm sure many people have had this same experience. I have been to the doctor and said; hey, I'd like to find out about XYZ. And the answer is; alright, let's test your vitamin D and your thyroid. And the end. And I'm thinking; I don't think that's the long and short of what I need to know. The information that I need to have about my nutritional status. It's a fight to get them to check magnesium.

So, just to kind of crystalize exactly why this is such a valuable resource for self-knowledge and potentially to have more informed conversations with your health care practitioner. And also, I'll throw this out there. You have resources for ordering some of these tests yourself. You don't necessarily have to go through your doctor to order a lot of these tests. Right?

Dr. Chris Masterjohn: So, that depends on where you live.

Liz Wolfe: Right.

Dr. Chris Masterjohn: If you go to something like DirectLabs.com. and there are several direct to consumer sites. But I think directlabs.com appears to be the one that has the most comprehensive access to the most number of tests. They operate in most states. But there are some states where they don't. And if you live in those states, you either need to go out of state to get those tests, or you need to work directly with your doctor.

And that has less to do with the laws and really more to do with the tradition of how the laws are enforced. So almost any of these states; probably all of them, there were laws that restrict who can order lab tests. And the way that these direct to consumer companies work is usually they have someone who is licensed in whatever state is necessary to order those labs, and they're on the other end at that company. They sign the requisition form.

They have a contract with something like LabCorp or Quest. They just give you the requisition form signed by their doctor as if it's your doctor, and you go into LabCorp or Quest and bring it in. You don't even need an appointment. You just give them the paper, pay out of pocket. They give you the results. If your insurance might cover that, it's up to you to seek the reimbursement. And so on.

So that's maximal convenience. But there are some states; New York is one of them, which is where I live. Where the enforcement agencies have basically said; that doesn't count as that doctor ordering the test. It has to be that person's personal doctor. They don't actually have a doctor-patient relationship. So, we're going to come after you. And the direct to consumer labs have basically said; we're not going to deal with that legal dispute. We're just going to not operate in that state.

So, regardless, I think it's important for everyone to realize that even if you have this Cheat Sheet where I've done my absolute best to empower you with knowledge. And this is absolutely meant not for; most of the people who buy this are not health care practitioners. They're people who are seeking things for their own health. I think it's really for both. If you're a health care practitioner, you can use this to better serve your patients. And if you're a patient, you can use this to better discuss things with your doctor.

Or, if you live in the right state and that's the approach you want to use, order these labs yourself. But when you do that, I think it's important to realize that there is no substitute for a comprehensive medical training that allows you to see all of the potential nuances of what those tests could reveal. So I'm teaching people the nutritional implications of some of those tests. But I think it is always wise, if you do run your own tests, to submit them to your doctor so they are aware of what those tests say. Because there's always a chance that those tests could reveal something that only a doctor would recognize could be something important to your health. And you don't want all those things to fall under the radar if you can help it.

Liz Wolfe: Yeah. I feel like one of the things; of many things that this Ultimate Cheat Sheet can do is to lead to more robust, more mutual understanding between doctor and patient. Which is; I mean, just sorely lacking in a lot of interactions with physicians nowadays. We just don't; the layman, me, my family. We don't have the expertise. We don't know what conversation to have. And I think one of the side benefits of having the Ultimate Cheat Sheet at your disposal is to have more informed conversations and be more confident in the approach that you agree upon with your physician.

7. Knowledge in testing [32:27]

Liz Wolfe: Can you give me an idea; just an example, of the kind of knowledge that this guide is going to impart with regard to how nutritional status is generally tested. Are you differentiating between, say, red blood cell magnesium and serum magnesium testing? Things that as a patient, without this kind of information, you might not know has a critical difference.

Dr. Chris Masterjohn: Yeah. That's exactly the kind of reason that this was produced in the first place. Because I was producing that level of detail for my audience, and that's exactly the kind of detail thing that has practical value. So if you're going to order a test, you really need to know if you should order the test in plasma, or serum, or red blood cell, or urine, or whatever.

And I think magnesium is a great example. But before I get to my approach on that, I just want to dismiss what I think is a very, very common misperception. Where there are a lot of people who think that there is some particular compartment that everything should be measured in to be reliable. And that's very wrong.

So there are people out there who advocate the view that you shouldn't be measuring anything in plasma. You should be measuring it in your red blood cells. And there is no such rule that applies to anything. If you want to know what the right marker of nutritional status is for something, what you need to have is scientific studies that look at what happens when you become deficient in that nutrient, how do your signs and symptoms emerge? What are they? When do they occur? How can we use blood, urine, or any other markers to identify where you are in that stage of deficiency? And what happens when you replete that nutrient?

You really have to understand why those things are changing from a mechanistic perspective to really understand how to interpret them. And what we find is that when we do those studies, everything has to be addressed on a case by case basis. Like, zinc for example, really has to be measured in plasma. You really shouldn't be measuring it in red blood cells. Or in serum, even.

And that's because there are peculiarities of how zinc is handled in the way it's transported and the biochemistry and physiology of zinc that we have enormous research on. Where we understand what that means for zinc. And it's just not true for something else like copper, that's better measured in serum. Or magnesium, where you really should be measuring it in multiple compartments.

So, to directly answer your question about magnesium; there are some studies that indicate that red blood cell magnesium might enable you to detect deficiency earlier than serum magnesium. But, if you look at why is that the case; first of all. We don't really know whether it's the case. Because you can have someone who is just not getting magnesium into their red blood cells. And if they have body-wide deficiency in the transport of magnesium into their cells, they're probably going to benefit from more magnesium.

But the real problem might be some deficiency in getting magnesium into their cells. And if you just say; I'm going to measure magnesium in red blood cells, and you're not going to measure it in serum or urine. You probably will benefit people. But you might not, because if there's a slight loss of the ability to transport magnesium into your cells, you can probably compensate for that by throwing more magnesium at the problem. Even though you're not actually addressing the underlying issue.

In that case, the person might not have enough sodium. The person might have problems with insulin. Insulin is important to get magnesium into cells. ATP is important to get magnesium into cells, which is your basic energy production. So if you have any kind of metabolic disorder. If you have hypothyroidism, where you have a deficiency in any of the energy metabolism nutrients. Any of these things might be compromising your ability to get magnesium into your cells.

I'm in a Facebook group where I saw; and actually, this is a person who highly values my work and I hadn't written anything on magnesium. So until I made this Cheat Sheet; this is pre-Cheat Sheet. And I see this guy posting. And he had been battering himself with over a gram of magnesium a day, because he had these repeated red blood cell measures of magnesium that were on the low end of normal. Or maybe just floating at the bottom of the range. And no matter how much magnesium he threw at the problem, he could not get his red blood cell magnesium up.

And all he interpreted from that was that he still wasn't getting enough magnesium. Meanwhile, he was giving himself problems that are clearly associated with magnesium overdose. Such as a low heart rate. And not having any idea that magnesium overdose can cause those problems. And he didn't have any serum measurements.

The problem with magnesium overdose, which generally is not; magnesium is pretty safe to take. But if you have poor kidney function where you're not excreting it. Or you're using really high doses and just battering yourself with it. And in his case, maybe as a transport issues that's exacerbating the inability; if you can't take magnesium into your cells, any given dose is probably going to raise your serum levels even high. The problems of magnesium toxicity are mainly due to high serum levels. So for all we know, his serum levels were twice the upper limit of the normal range, because he never measured it. Because everyone else was saying; “You're supposed to measure magnesium in red blood cells.”

So he is suffering; perhaps he's twice as sensitive to the toxic consequences of having high serum magnesium. Because he's not able to get it into his cells. Right? So what you should be doing with magnesium, ideally, you measure it red blood cells, you measure it in serum, and you measure it in urine.

Why would you measure it in urine? Well, if you imagine the case where someone is just frankly deficient in the diet, everything should be low. Right? Because it's going to get into their blood, and then from there, it's going to get into their urine. Or it's going to get into their cells. And if the magnesium input is the problem, the serum level is going to be low, the red blood cell is going to be low, and the urine is going to be low.

But you can have a totally different problem where the primary problem is you're wasting magnesium in the urine. This could have a number of causes. Diuretics can cause this. Really, anything that causes excessive urination can cause this. Some people pee too much when they're really stressed. And that can be one of the things that can cause that. Someone with diabetes who may not know they have diabetes; they may not be diagnosed. They might be peeing too much from that. That's a major cause of magnesium loss.

Any of these things, and others, can cause you to lose too much magnesium in the urine. In that case, your serum is going to be low, and your urine is going to be high. It's really valuable to know that. Because even though there might be a place for magnesium supplementation in both of those cases; there are probably other things that you need to fix.

If everything is indicating that the input of magnesium is wrong, is not enough. It's not high enough. Then you either are eating a magnesium deficient diet; or you have a malabsorption problem. If you're eating a magnesium deficient diet, what you should be doing is fixing your diet. Sure, there may be a place for bridging the gap with supplementation. But you really should be rethinking your entire diet, and eating more magnesium rich foods.

If the problem is malabsorption, then yes there may be a place for compensating for the malabsorption by taking more magnesium, but there may also be a case for trying other methods. And in an extreme case, maybe you need to work with a health care practitioner for IV magnesium. Maybe you can try a transdermal route and see if it's adequately absorbed. You need to test to make sure of that.

But regardless, if you're not absorbing it, there's got to be other things you need to know about to fix the malabsorption issue. Maybe it's a digestive disorder. Maybe you; salt can be important for magnesium absorption and many other nutrients. Maybe you're on a low-salt diet, you are hypothyroid, so those are combining in a way that's preventing you from absorbing magnesium. Any of those things should be the thing that you're fixing, not just throwing more magnesium at the problem.

And if the problem is urinary loss, then that might alert you to; why are you losing magnesium in the urine? That could be a whole different set of problems that you need to address with your doctor. So if you're just looking at low red blood cell magnesium, or in the case we talked before; red blood cell might be low and serum high. Then you know that no matter how much magnesium you throw at that problem, it's not working and it could be dangerous. So you really need to; if you don't measure the different compartments, you never get a good picture of what's actually going on. And if you don't understand what's actually going on, you're probably going to be fixing a problem that's not really there. Or not fixing a problem that really needs your attention, and you don't know about it.

Liz Wolfe: And I think both of those things happen a lot. More than folks think. Where we're either not fixing something that needs to be fixed, or we're hammering at something that's perfectly fine on its own.

Dr. Chris Masterjohn: Yeah.

Liz Wolfe: So this is why we need a Cheat Sheet, people!

Dr. Chris Masterjohn: That's true. That's very true.

Liz Wolfe: Yeah. So, I'm pretty sure we have not had the word urine in the podcast that many times in at least two years. So thank you for bringing us back up to snuff on that. So what's on my mind now is; this is maybe the new before and after. Folks that post their bikini pictures; before my diet, and then after. But now maybe it's; I'm going to post my before magnesium status, and then I'm going to get tested, I'm going to use the Ultimate Cheat Sheet, and I'm going to post my after magnesium status. That type of thing. That could be fun.

Dr. Chris Masterjohn: Yeah.

Liz Wolfe: We could develop a hashtag for that.

Dr. Chris Masterjohn: This is the new bikini.

Liz Wolfe: {laughs} Magnesium status is the new bikini.

Dr. Chris Masterjohn: Is the new bikini! {laughs}

Liz Wolfe: I like it.

Dr. Chris Masterjohn: And thus the meme is born.

8. Who can benefit from the Ultimate Cheat Sheet [44:36]

Liz Wolfe: Yeah, exactly! Oh man. Well, I know I only have you for a few more minutes. So if you could give me a quick idea. Maybe you can draw from your experienced with the folks that have used the Cheat Sheet, or the folks that you've consulted with. Who should do this? Who needs the Ultimate Cheat Sheet? Who can benefit from it?

Dr. Chris Masterjohn: So, the person who doesn't need the Cheat Sheet, and that's easier to pinpoint. The person who doesn't need the Cheat Sheet is the person who has perfect health, doesn't have any problems or any challenges that they're trying to work on. And doesn't really care about preventing deficiencies or any nutritional imbalances in the future. Gets everything they need from food. Doesn't take any supplements. Doesn't need any. That person probably doesn't need the Cheat Sheet.

But I think who this Cheat Sheet is for is very broad. And when it gets to the kind of audiences that are on your show, or mine, we're all here discussing this as nutrition oriented people who care about our health. And then it becomes most people. And that's because the two primary utilities of this are; if you are in charge of helping other people with their health as some kind of practitioner or consultant, then you can better help your clients and patients by ordering the right tests or interpreting the signs and symptoms correctly.

And if you want to be on top of your own nutrition; either because, the people who really need this, are the people who are having difficulty making the progress that they want. But even if you don't know how difficult it is. Let's imagine that you just came here, and you're trying to figure out some health challenges. And you don't know how much trouble you're going to have going forward. You're going to have less trouble if you can very quickly get a bird's eye view of what the probability is that you need to work on your vitamins, minerals, and essential fatty acids. And get to the right action protocol faster.

So, I think any of those people; that's who the Cheat Sheet is for. This is really; it's designed so that, as I was saying before, your resources might be that you have a lot of money, or that you have awesome insurance that covers everything that you can imagine. Or your resources might be that you have some time to spend with this and you don't have great insurance, you don't have money. And the Cheat Sheet is designed to find the approach that works for you, given your resources, to optimally use them to make sure you manage your nutritional status correctly. So if you feel like you fall into any of these camps, then I think that the Cheat Sheet is really for you.

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Liz Wolfe: Well, I think this Cheat Sheet is really for anyone and everyone. We have a lot of women who listen to this show; particularly women who are dealing with health challenges. And the universe of Google is very intimidating. But if you have just it all distilled into a 70-some page Cheat Sheet, you can go search for your keyword in there instead of searching for your keyword in Google and being overwhelmed with a million different ideas and approaches and being completely unable to sort through it all.

So, I just think. And not only that, but it is priced really, really fairly. And we also have a deal for Balanced Bites listeners who purchase between February 15th and February 21st, 2018, I believe. Is that correct, Chris?

Dr. Chris Masterjohn: That is correct. So if you go to www.ChrisMasterjohnPhD.com/balancedbites, that will bring you directly to a page that will welcome you as a Balanced Bites listener and reiterate everything that I'm telling you right now. Which is that when you order the Cheat Sheet, if at checkout you will enter BALANCEDBITES, all in caps. Or just copy and paste it from the page, and you hit the apply button, you'll watch the price fall from $30 to $20, which is a huge discount. And that expires February 21st at midnight Eastern time. So if you're on the Pacific Coast, that's 9 p.m. So adjust that for wherever you are. But that is; yeah, very fairly priced to begin with and a huge discount just for your listeners.

Liz Wolfe: Absolutely. To have this much knowledge at your fingertips for $30; and if you buy within the window, for $20. The peace of mind, I think, is just immeasurable. So folks know this about me, but I follow your work very, very closely. You are one of my go-to's. I try not to bother you in person too much. Try not to ping you on Facebook too often. But you have been such a wealth of knowledge and information for me, for which I am so grateful. And folks, if you had to pick one health related book, document, purchase for this new year; start with this. I am so, so excited about.

Dr. Chris Masterjohn: Thanks Liz; I appreciate it.

Liz Wolfe: Thank you, Chris. I really appreciate you coming on the show.

So, that's it guys, for this week. You can find me, Liz, at http://realfoodliz.com/ and Chris at www.ChrisMasterjohnPhD.com. Balanced Bites listeners, get his Testing Nutritional Status Ultimate Cheat Sheet for $10 off between today, February 15th, and February 21st, 2018, midnight Eastern time when you click through the link from our episode show notes, or just go to www.ChrisMasterjohnPhD.com/balancedbites. Remember guys; Join our email lists for free goodies and updates that you don't find anywhere else on our website. And while you're on the internet, leave us an iTunes review. See you next week.