Episode 47: Dr. Joel Evans, MD on COVID-19: Functional Medicine, Variants, and Vaccines

Show Summary:

Three years ago, a virus changed our entire world. Since then, we have had on our minds, what can we do to protect ourselves? How can we optimize our immune system using lifestyle medicine?

That is what we are discussing with today’s guest, Dr. Joel Evans.

Joel Evans is a board certified OB/GYN and international lecturer, is the director of The Center for Functional Medicine in Stamford, CT. He is also senior advisor to Amy Mack, the CEO of IFM, and the co-director of the IFM Resistance, Resilience, and Recovery: Patient Care in a Pandemic course on COVID-19. He now leads the IFM response to post-acute COVID-19 and has co-authored two recently published papers on the pandemic, with a third recently submitted for publication.

Join us as we discuss how functional medicine approaches COVID-19 and how lifestyle medicine can help to optimize your immune system.

0:00 - Introduction

3:45 - What is the IFM?

9:56 - Sleep and vaccine efficacy

12:16 - How does our terrain impact our immune system?

14:09 - Dealing with new variants

16:48 - Metabolic health and COVID

18:11 - Future variants of COVID

21:13 - What can you do if you get COVID?

25:52 - Microbiome and COVID

30:22 - Long COVID

34:05 - Nitric Oxide and Anticoagulation

35:59 - Protein intake and nutrition

38:08 - Ideal vitamin D levels

39:26 - Where are we headed with vaccines?

43:36 - Dr. Evan’s morning routine

48:34 - Taking supplements onto a desert island

50:37 - How to learn more about Dr. Evans

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Full Episode Transcript:

SPEAKERS: Dr. Andrew Wong, Dr. Joel Evans

Dr. Evans:

We've done the prevention stuff with, you know, with everything that everyone knows about. That hasn't worked. We've got COVID now. What do we do? Well, what we try to do is cocoon, so you need to, you know, isolate so you don't give it to anyone that you're in close contact with but cocooning means as best you can, decreasing the stress in your life. Now, of course, it's stressful to be ill and have COVID but if you're stressed and have COVID, you have to let go of work-related stressors, you have to let go of any other things as much as possible that you can do,and then you want to eat well, so this is a time where you're not overeating and, you know, this whole adage about chicken soup is a good thing, right?

Dr. Wong:

Yeah, yeah.

Dr. Evans:

You know, so.

Dr. Wong:

Yes, yeah.

Dr. Evans:

Yeah, so, you know, that kind of thing works well but don't binge on sugar and doughnuts and all that sort of stuff. That's, you know, something you don't want to do. And then there's the role of supplements and there's a lot of supplements that IFM has discussed. They're on our website, ifm.org. People can dig into that, however much they like but some of the biggies, you know, would be vitamin D, quercetin, glutathione or NAC, zinc. Those are the biggies and melatonin.

Dr. Wong:

Three years ago, a virus changed our entire world. Since then, we have had on our minds, “What can we do to protect ourselves and how can we optimize our immune system using Lifestyle Medicine?”. That is what we are discussing with today's guest, Dr. Joel Evans. Joel is a board-certified OB GYN and international lecturer and is director of the Center for Functional Medicine in Stamford, Connecticut. Dr. Evans is also senior advisor to Amy Mack, the CEO of The Institute for Functional Medicine and the co-director of the IFM ‘Resistance, Resilience, and Recovery: Patient Care in a Pandemic’ course on COVID-19. He now leads the Functional Medicine response at the IFM to acute COVID 19 and has co-authored two recently published papers on the pandemic with a third recently submitted for publication. I am Dr. Andrew Wong, co-founder of Capital Integrative Health. This is a podcast dedicated to transforming the consciousness around what it means to be healthy and understanding the root causes of disease and wellness. And today, we're going to be focusing on COVID. Join us please for how we discuss how Functional Medicine approaches COVID-19 and how Lifestyle Medicine can help to optimize your immune system. Well, thank you so much Dr. Evans for coming on and we are really honored to have you her on our podcast. Joel or Dr. Evans, he is the chief of medical affairs of The Institute for Functional Medicine among many other honors and accolades and I think first, let's just talk about that for a sec. You’re chief of medical affairs for IFM. Let's talk about what that means and maybe for those listening, and then we have a lot of practitioners out there listening but for the audience, what is The Institute for Functional Medicine kind of, and then what do you do with the organization?

Dr. Evans:

So that's a great question to start off with Andy and, you know, Functional Medicine as I'm sure your listeners know is something that is really taking quite a hold in the interest of the general public and The Institute for Functional Medicine is the foremost educational institution for health care practitioners in Functional Medicine and we are teaching not only physicians but nurse practitioners, acupuncturists, nurses, chiropractors, and many other different types of healthcare practitioners, and so what I do as chief of medical affairs is really look at what we're doing medically in terms of what's happening in the world, so what are the health issues confronting the world and it's COVID, and so I've been in charge of the COVID initiative initially. I was co-directing a course and now, pretty much have been put in charge of our COVID initiative and Functional medicine as your listeners know, really is about how the body functions and we talk about how the body functions in relation to all sorts of chronic disease and I'm sure you remember as you were coming up through the ranks and just learning, we would talk about diabetes, heart disease, migraines, neurological disease, all the diseases that are becoming more common in the United States. And then we would show you the way the body functions determines whether a person even gets an issue, has symptoms, the symptoms develop to be a diagnosed disease.It's sort of a spectrum, right? Then along came COVID and this was a brand new illness and we're all aware how Allopathic physicians or Conventional Medicine really struggled with treating people, right? The death rate, it was it was really something that was horrendous and at the same time it was the perfect opportunity for us to demonstrate the role of Functional Medicine both in helping people to prevent getting COVID and we do that by strengthening immune health, etc., so we don't say, “Oh. This will prevent it.”, but we use the term ‘help mitigator’ to help reduce the risk or help reduce the likelihood. And then we talk about how you can reduce the likelihood of a severe infection, and then we talk about how we can reduce the likelihood of getting long COVID, and then if you have long COVID, we talk about how we can reduce the symptomatology, so what's nice about this overlap of COVID with Functional Medicine is that it gives us an opportunity almost as an example or exemplar case of how Functional Medicine can have real utility in the face of the pandemic.

Dr. Wong:

Thank you Joel for that great intro here. I know that for the listeners too just like you said in the

beginning when you look at the page of educators at the ifm it's really spans all disciplines medical doctor

naturopathic doctor mp pa rns

nutritionists you know dc's right you know just just everyone

Really and when you look at when you look at that really it's because of the the lens

through which we view the body the physiology the root causes

and then like you said to connect the dots between Functional Medicine and COVID 19

really it's not only about the bugs but it's about the terrain meaning the the you know health of the organism the

resiliency and you know Functional Medicine does such a great job of that I think

you know we can really work with our conventional colleagues to ideally sit synergistically

or you know certainly there's there's some role of course for all different types of Medicine but it really sounds like you know the

functional approach for you know for COVID is is so relevant and I mean it has been

last few years but it's really become I think much more clear

in the fa in the past year especially that we really need to work on the terrain

to really get you know to really get past this I think

yeah that's that's so true and what's interesting

is we know this intuitively because pre-COVID

if you were talking to a patient about let's say influenza

you would say you know whether you get a vaccine or not is a separate conversation

but with or without the vaccine because we know the vaccines aren't perfect in preventing influenza

but we would say the best thing you could do to prevent influenza or to reduce the severity should you get

it is to be as healthy as you can be and

exactly and even even on the data for influenza right there's studies that show that if you get more sleep then the

vaccine's going to take better and then you know that's why even there's there's recommendations now

that you know people with more immunocompromised maybe they need a higher dose of the

vaccine you know for the future I gotta tell you that little snippet about sleep before

flu vaccine that is such an interesting

body of medical research you know vaccine efficacy and modifying vaccine

efficacy so when the COVID vaccines first came out that's

something that I you know really dug into that that literature and a lot of it comes out of

ohio state actually interesting and we almost had um

one of their lead researchers as as a guest that it just didn't work

out for one of our webinars dr key called glazer and

what we found is in the literature there is so much information on vaccine

efficacy with hepatitis vaccine with flu vaccine and it's sleep it's stress

and most people don't even know about that but it's

but it is really well documented in the literature and so we then use that

in our message to say if you choose to get a COVID vaccine these are the things we think you should

do not that it's been proven to be helpful or of any benefit with COVID vaccine but

it's been shown to be effective with other vaccines so why not how can it hurt you

yeah sleep right more sleep less stress yeah yeah there's a great study on stress

that if you're stressed when you get a get a vaccine

it doesn't take as well yeah so

so got to do some meditation it sounds like before the before the vaccine yeah yeah

so so let's kind of go into that a little deeper now in terms of how the return brain affects the of the immune

system rather affects our ability to be resilient against this virus which now we're I think working on omicron

ba four and five five yeah you know so so like when is it going to end I think

we're all kind of getting I know i'm kind of getting tired of you know reading about it even and then obviously

we're living that too so there's a there's a couple of things and

we can talk about you know four and five

now we can talk about four and five at the end because there's some

important things about four and five and actually they're so important I want to mention them now because they're up

front yeah sounds good yeah it's so important we need to put it up front and that is um

it's very very very transmissible so as we

are getting variations or mutations

we're getting increased transmissibility luckily with that we're also getting decreased severity of illness or

decreased virulence however one of the things that we're losing

is we're losing natural immunity that may have occurred from previous

infection so if you've had an omicron infection

or even a COVID infection from a non-omicron variant sort of a pre-omicron variant

you are not going to be protected and so that's very important because

what I hear from my patients is I've had covid I don't need to worry anymore

that is not true it does not yeah well there's there's an

immune evasion that's happening right with all the different speculations

not protected so so what is the ifm or what is what is you know Dr. Evans here

what do you what do you recommend for how to deal with ba four and five which is the current ones as we're

taping this right now you're really you nothing changes it's the same thing

which is number one try to be as healthy as possible

because we know that the chronic illnesses that are so prevalent

really affect not only immune function but also affect the likelihood of

getting COVID and the likelihood of getting severe COVID so

I don't know about you and your practice but I've got a lot of whether we call them pre-diabetic

metabolic syndrome a lot of patients running around with insulins that are higher than they

should be that are higher than they should be you talk about national numbers between

you know 30 percent of the population something you know so it's a significant number of people

and if they could just put the pedal to the metal and be motivated to

do things and you know what you tell your patients they're the same things I tell your patients but getting that

blood sugar as close to normal as possible is so important

it not only will make them healthier and less likely to develop diabetes but

it'll also help them with this protection against COVID so it's a it's a win-win

but that's the most important thing normalizing blood sugar and it's not a

covid specific intervention but it's something that helps kovid

significantly and so when we look at the risk factors for

severe covid it's body weight and blood sugar

and these things make a a tremendous difference right if your normal weight

you have a 63 percent reduced risk of severe coved

you know and and the same is true with normalizing blood sugar

you know where it's 35 to a of a severe disease but 70 percent

protection insane

no no pill can do that that I know of yeah correct is there is there any data on

optimizing blood sugar path like lower than 100 so let's say blood sugar is like 95 or something and then

you know patients like well i'm I don't have a high blood sugar you know but but then they're still like kind of

metabolically off well you know that's a great question and that's where I would say Functional Medicine would would answer this in this way

no there's no data because the data is those with abnormal versus you know

elevated primarily but there's what we call biologic plausibility and what biologic

plausibility means in normal language is it makes sense

so it makes sense to have as healthy a blood sugar level as possible even

though I can't give you a statistic about how much better you'll do it makes sense because having an

elevated blood sugar makes all the COVID parameters worse

and also decreases immune function so I kind of want to cover this at some

point so I kind of want to talk about it now just because it's in my head right now and hard to get out of my head it almost

sound it almost feels like a virus you know sometimes ideas are like viruses you know you can't get them out of your head

where do you see the pandemic going and and we can also touch on that at the end

because this is a very broad type of question you know with the different variants and is this going to still kind

of spin off kind of like flu flu variants every year or what are your thoughts about about omicron and future

variants of covid yeah so what's interesting is

and i'm not just saying this but the truth is we just don't know

right and what that means what that means

is that it depends on what we can't quantify

which is the variance what's going to happen with the variance

because variants are random events right so this virus just keeps

replicating in people and unfortunately one of the reasons we keep

getting more new variants is because this virus becomes more and more transmissible

as it's more and more transmissible it's in more people as it's in more people it

keeps replicating more as it keeps replicating more you're increased risk for these random

events these random mutations that change it so we just don't know what we do know

is viral infections like the flu can increase in the fall and the winter months so we're sort of

expecting that and that's just because of the behavior

where colder weather people are indoors etc so

what I suspect is that there will be an increase

in the fall because the pattern of mutations

so far has declared itself as something that continues to happen

because these mutations continue to happen i expect them to continue to happen

and we'll see you know in the fall the

concern of course is with these variations or these

these mutations what if we get one that's both more transmissible and more

severe yeah that's my fear but thankfully

conventional medicine has stepped up to the plate and paxlavid

is something that seems to work with minimal

severe side effects yeah yeah and it seems to be now much more widely available than yes initially

you know right different pharmacies and all that let's say someone gets COVID or you

know it's certainly something that even dr falchi was like we're all gonna get covered you know at some point what

would you as a Functional Medicine doctor function as the leader here chief of medical affairs of ifm what

would you say joel for a person that you know has some COVID and you know obviously we

we don't think this is this podcast is not a medical treatment podcast so talk to your practitioner about these

things but if someone has kovac kind of run-of-the-mill they're not their oxygen's okay and you know things like

that so that that's an important part andy and we have to stress that that you as as a patient can't know

whether you fall in this category of high risk or not and so that's where

a medical appointment is is important because needed yeah yeah yeah we have to figure that out

and if you're like most people

it's a low-risk situation where you're not going to need to go to the hospital

you're not going to be on a ventilator you're not going to be in an icu and in those cases

that's where outpatient pax levit is a great treatment and

that's done in addition to the Functional Medicine nutraceutical

approach so we really look at our approaches as foundational

so we've done the prevention stuff with you know with everything that everyone

knows about that hasn't worked we've got covid now what do we do

well what we try to do is cocoon so you need to

you know isolate so you don't give it to anyone that you're in close contact

with but cocooning means as best you can decreasing the stress in your life now

of course it's stressful to be ill and have COVID but if you're stressed and have covid

you have to let go of work related stressors you have to let go of any other things

as much as possible that that you can do um

and then you want to eat well so this is a time

where you're not overeating and

you know the this whole adage about chicken soup is a good thing right yeah yeah yeah you know

yeah so you know that kind of thing works well but you're not don't binge on sugar and doughnuts and

all that sort of stuff that's you know something you don't want to do and

then there's the role of supplements and there's a lot of supplements

that ifm has discussed they're on our website ifm.org covent people can dig into that

however much they like but some of the biggies you know would be vitamin d

quercetin glutathione or nac

zinc those are those are the biggies and melatonin

what about vitamin c anything there for vitamin c vitamin c is great too

yeah yeah yeah that's a good starting point for for supplements and obviously the same things trend like you said

getting enough sleep avoiding sugar trying to decrease stress

or increase resilience what about what about um

what about cooked foods versus raw foods you know I know in traditional chinese medicine it's it's usually about trying

to do warming foods and and these type of things and not so much raw so i'm just curious

about your thoughts on so you know I am one of the

I am never too proud to admit when I don't know something and so

that's an area in which I would say I am not an expert so

if you are or if you're not a practitioner and you go to a practitioner that is an expert in

this area I would follow the advice of that expert there's no literature that i'm aware of

on that but I am aware of the traditional chinese medicine

you know philosophies of you know of cooling and warming and

I will tell you that in my own personal life with the practitioner I work with that's real and and

it it's valid to me I just don't have the knowledge base of that yeah got it got it well I love the

humility there I know you've been researching this up the wazoo but I think any good practitioners kind of

gonna say what they know and say what they don't know right that's that's really a good thing thank you thank you Dr. Evans how does the gut no now

we're going to get into the the big topics like how did the gut impact the immune system

and at risk of COVID what do you think about microbiome balance and COVID is there anything there in the research

so yes there is a lot there so um

what I would say is there's a basic principle in Functional Medicine predating covid

that the gut is the biggest immune organ of the body and therefore gut health is intimately

tied to immune health so we've known about that for many many

years then comes covid and we find out that covid actually infects the gut

and before there was widespread COVID testing

what they did is they would do testing in sewage treatment plants for covid

and they were able to tell weeks in advance the areas where there would be COVID

peaks so here you have the fact that the gut is the biggest

immune organ of the body and covid infects that organ of the body

and yes digestive symptoms are part of it but not always

but there's COVID in the gut within her with or without digestive symptoms

it sounds like a carrier organ I know we were talking about this functional stool micro you know stool

test that I think you you and I know what we're talking about on this but and

they do that that pcr for for sars kobe 2 you know

I haven't used that too much I don't know if you've you have or a game because I haven't been helpful you

haven't been yeah so it's like I guess we have to assume that because i'm always wondering too with

people is that you know are they really clear you know the cdc says you can stop quarantining after

five days wear a mask for another five days but i wonder how many people have

COVID kind of lately in there and this is where the bridge might come at some point in this conversation the long

covid but you know or past you know like like you're talking about in other words I wonder if some of these other

organs end up being reservoirs for COVID and then that can lead to to some

sort of long COVID situation well actually it is you know they've done some biopsies actually um

in infants and found actual replicating SARS- CoV-2 virus in the GI tract

okay a little disturbing but yeah yeah so it's a carrier

and it's still actively multiplying and and the challenge there is when we look

at long covid we don't know what the relationship is

to infection meaning is the infection gone and these are just

post-infectious sequelae or there's just damage in different organ systems from the infection

or is there [Music] sort of a latent

long-term infection that's actually happening and the reason we say that that's a

possibility is because when the

mrna vaccines first came out there was this phenomenon of seeing

people recover from long COVIDafter mrna vaccine

and the reason for that was it was postulated that the vast antibody response generated

by the vaccine killed off yeah the small amount of virus that was still replicating in the person

yeah so that's so interesting um

and I know there's a lot of information on on the ifm website about pasc or or long

covid if we can get into that a bit I know that a lot of people are interested in that even with a

reduced severity of the virus like with omicron now it's spreading more it's more transmissible but then less

severe acutely but then I think people are still concerned about long cove but the

possibility of getting cove but I think I just read something that you know there's studies that done that you know

up to I think even a third of people have symptoms even after three months or something a crazy number like that so

what are your thoughts on yeah actually even more the good news is the latest study which

came out I think a week or seven or ten days ago is that in these newer variants

it appears that long coven is less frequent

so that's some good news so not only is severity less but

long COVID is less but that's one paper it's preliminary data we're not really

ready to say that's the way it is but at least it's some good news yeah yeah I wonder if they

if the researchers might start to separate out sort of conventionally you know

Labeling COVID as different variants versus functionally how that's

doing like someone that's hospitalized with delta or omicron let's say

you know and so it's really not about the variant but about what happened to them and how severe it was

the more severe the illness the more likely for long code that makes sense that makes sense so

what is the ifc approach without you know going through the whole website of the debate

it's the basics it's nothing that would surprise anybody that went to our

training which is reduce inflammation help the mitochondria work

reduce free radicals or reduce oxidative stress

gut health which is our way of looking at immune health and

microvascular health and cell membrane health yeah it pretty pretty much covers it um

one other question about that would you consider more like treating

latent viruses with antimicrobials either I guess maybe botanicals and things like

that I do so this is one of those cases where I might use

that stool test for example to see if there's still sars covey in um

in the stool that would then make me believe there's still some active infection so that's a

a sweet spot for that test I believe mm-hmm yeah I do believe

you know so we're doing a study with a major medical center on the Functional Medicine approach to long COVID

and so we are not able to personalize we have to give the same regimen

to all comers and so we have to give

anti-inflammatories mitochondrial support free radical support gut support

microvascular support and then immune support and we're using

mushroom extract because that will help the immune system

right so we're yeah all the different possibilities about

what's going on and giving an intervention in that area

would I want or ever give a patient one of those and everything no

I talk to them and find out what's bothering them and then try to figure out how to intervene

I want to get a little deeper into one of those topics you mentioned which is microvascular support we know that

there's decreased glutathione and then there's also decreased probably nitric oxide

there's different you know I think enos goes down and things like that so what does what is your thought

about you know or I know some of the protocols out there indicate not only nitric oxide

boosting support but also even anticoagulation i'm curious your thoughts about about that for

for long coved let's say yeah so I don't actively anticoagulate

unless someone has a positive d dimer or has had a positive b dimer

or has a history of a thrombotic event um

in the past so I don't do anticoagulation but I do push hard on

nitric oxide yeah yeah yeah I think there's really no downside to that and I mean it's sort of

like the cells need more circulation the tissues need more circulation what do you think about about the idea

of something I’ve heard recently just wanted to see what your thoughts are

also on on like biofilms and like this idea of fibrin biofilms I don't

know if you've got come across that at all and whether or not that has a role in long COVID or

COVID in general I think I think theoretically it could um

I don't know if it really does I think that

you get to a point there's only so many interventions you can give for so many different patients will not take 30

things yes right and I think it's I think it's more important to do what we

just talked about like the mitochondria the reducing inflammation the sleep the gut health etc

but then if you get to a place where your patient is plateauing

that's if you're a doctor if you're a patient if you get to a place where you're just not getting any better yeah

then you need to look at these other things yeah so that's when I would look at that

yeah that makes sense so we talked about different nutrients we talked about nutrition

avoiding avoiding sugar let's go get into protein for a second what are your general protein

recommendations do people eat more to try to build build up you know after covid or does it really

matter there on the protein you know I think that

you want to get an adequate amount of protein and

that's you know a difficult number to

come up with so sure is it you know a half a gram

per kilogram is it a you know gram per kilogram you

know everyone's different depending on yeah you know what your your status is but the one thing you don't do

is go on a low protein you know diet so nor you know protein intake is

critically important for immune function when you're ill you have a higher protein requirement

so I think going up on protein is what I tell my patients to do yeah

that's why you're lucky that you have a nutritionist with you so you can tell them what that means

same for me that's another area where I defer to my my team

yeah yeah nutrition is really key and so having nutritionists to really guide

expertly guide people is really helpful but you know what I tell my nutrition my

nutritionist and what i'm sure you tell your patients so we just talked about you know pushing nitric oxide because we

want that to go up well dark leafy greens pomegranate and beets

will help nitric oxide yeah yeah yeah that's that's definitely where to start for sure

and then on the vitamin d question you know we had dr frame on here I don't know if you know dr frame at gw but

she's a phd she's done a dissertation on vitamin d she's really big into that and a lot

of the meta-analyses it sounds like it's suggesting that a serum level 25 ohd

of 50 nanograms per deciliter higher was more protective against you know prevention of COVID or prevention of

severe COVID spanish meta-analysis etc do you have a target for that type of you know

d d level I know this is kind of going back to prevention now but just

kind of curious about that and then there's the data though the intervention data

yeah high dose right no that's right that's right you know so it's it's not

just prevention it's also treatment and so you know I I'll give um

you know I always check a vitamin d but I'll give 50 000 a week

you know to me that's pretty high dose or 70 000 a week you know 10 000 a day

you know during acute during the acute phase yeah yeah it kind of ramps up the immune system yeah yeah yeah yeah yeah

yeah Icheck levels I'll give more if they're low but I check levels in that case

because I don't want to get too high you know I don't want them going over 100.

and yeah so that's the vitamin d so I know that for

let's touch on vaccines for a second so I know that there are people working on

pan-chronovirus vaccines I don't know if you have any more data on that at this point but i'm

curious your thoughts about where we're headed with vaccines you know because we're still we're still in the in the era I think of

boosting but the boosting is of the original formulations right now I believe yeah and that

is actually being changed right now as we speak so

there's a lot of vaccine work going on because

many people believe this is going to become similar to influenza meaning it's going to become in-depth endemic and not

a pandemic it's just going to be out there and so people are looking for

different types of vaccines and one of the

the technical term for what you talked about is called a multivalent vaccine which is a vaccine that attacks

different aspects of the coronavirus spike protein not

just one because that's what the differences are with the viruses is that spike protein

that part that attaches to our cells to our h2 receptors is different

so there's theoretical data and biologic plausibility that these

multivalent vaccines are going to be more even more effective and so that's that's promising

and you know now the question is how many

boosts or boosters should somebody be getting

and I don't think there's a good answer I think that if you are

someone that's high risk meaning if you were to get it you were more likely to be hospitalized

die or go to the icu you may need the booster if you're not

then you should just practice good what we would call

social distancing preventive measures stay healthy take take supplements

and you could potentially avoid the booster but i'm not trying to officially say don't get boosted i'm just saying

there's more room or personalization and individualization in

the decision-making process let's go back to thank you so much Joel let's go back to pax of it for a second so it

is it does seem to be pretty well tolerated it's available you know for people

you have mentioned before that that's something you would use first line is that you would use that first line for not only high risk but also lower risk

yes with coved which which I also do as well but I know fda I think they kind of say use it

for high risk more what are your thoughts about about that yeah well I think they say it because it's limited

and because there's so much COVID going out there yeah supply and demand yeah right so i

understand why from a public health perspective they want to do that but when i'm

working with a patient in front of me my obligation is to do the best I can

for that patient in front of me and when we say low risk

people don't die it doesn't mean low-risk people never die right got it yeah and so I want to make sure that

that doesn't happen to my patient the other thing is like in theory you know if

if you get a medication that's inhibiting viral replication you add on some nutrients that help with that like

zinc you know boost the seed the glutathione the vitamin d then then you're in theory reducing the severity

and then and then decreasing chance of long covert as well that's what I think about there too

yeah awesome awesome well you know this is a good overview there's probably thousands of different rabbit holes we

can we could get through on kobit just wanted to thank you for coming on

spending some time with us today but we do have some fun questions for you now joel if you don't mind all of our

guests so we do talk about morning routines because morning routines set the foundation for the day

and really promote health right and we're talking especially in the beginning of this podcast about how we want to support the terrain we want to

support the immune system for whatever is going to get thrown out at that day right

so what is Dr. Evans morning routine if you don't mind sharing that

well i'm laughing i'm laughing because I just got into a conversation with a Functional

Medicine colleague about do you need to make your bed or should

you make your bed in the morning and there's a lot of people

who believe that that's so critically important just in terms of

psychological emotional approach yeah and I would never argue with that

but then I just saw a study saying that you actually

should have an unmade bed because when you have the covers open

whatever sweat that you produce at night will evaporate and the bacteria will die

and if you keep the bed too tight you know tightly made

that those bacteria don't disappear so um

when you talk about morning routine that's the first thing so so the bed becomes a biofilm

essentially exactly exactly that's just a light-hearted humorous way to start

the answer to your question yeah there's always two answers to this to the question right to any question so

but for anyone that's wondering I've stopped making my bed for that reason

now after that what I want to do you know I

think we all know about the importance of good oral hygiene and so

I'll spend time you know brushing my teeth water picking my teeth

because I think that that's very important I will have a personal meditative

practice and part of that meditative practice involves

you know quieting my mind through you know some deep breaths or repetition

of you know different words or phrases um

and then when i'm done with that I try to get myself to feel

gratitude because gratitude is an emotion that has

tremendous physiological benefits and it's even been shown that it's the most beneficial emotion

that one can have so I force myself to have gratitude it doesn't matter how stressed I am or what

circumstances are in my life I force myself to find things to be

grateful and then i sort of push hard because I want to get myself

close to the point of tears with gratitude that's the amount of gratitude

that I try to feel every day i'm not telling you i'm successful that I cry every morning in my meditation but I

really push it hard to try to that to get that close

so I do gratitude followed by an understanding of surrender that I

can't control things yeah

you know and then I have a personal belief about you know asking to be of service just a general

shout out you know can I be of you know service and help those

that I come into contact with so yeah you know that's my morning meditation

ritual then three to four days a week will be physical exercise

I don't eat breakfast because I do time restricted eating

so I try to eat between 12 and 6 if possible or 12 and 8

but I'll have black coffee I enjoy my coffee every day there's another study about

the benefits of coffee and so that's my morning

and then [Music] i'm in a place to start

my day either seeing patients or doing work for ifm

awesome what a beautiful description the morning routine and it sounds like you kind of keep it

varied but also there's some consistency to it in terms of like some of the categories and especially the gratitude

I love the description of the gratitude and you know moving you to tears I mean that's just so good for

you know body mind spirit so thank you for sharing that one one other question

about I have to ask you this since you've done a lot of research you know on the ifm

protocols if if you were on a desert island and you needed three supplements

and you had to pack them along with everything else you're taking you know what would they what would they be for you

well i'm gonna say that because it's a desert island I'll be in the sun and I won't need to

take vitamin d and there's fish you know if you eat fish or anything there's some fish so right

and there'll probably be a fair amount of greens

so I wouldn't need

you know to worry about that and I wouldn't need to worry about folic acid and

my magnesium and stuff like that so that would lead me to say

and that would also be prebiotics i'm just thinking out loud here yeah it's a

tropical island it's definitely there's exactly prebiotics in many cases are better for

you than probiotics yeah so so what I would say is I probably

couldn't get quercetin and that would be one of my biggies

curcumin would be one of my

biggies and probably nac

glutathione yeah yeah quirks that tend to help with antiviral effect or

antihistamine yeah but also there's a lot of cursive benefits to quercetin in the

anti-aging literature oh okay okay we're erupting in literature optimizing yeah yeah

is christensen just to go back to COVID for a second is co is christian one of your biggies for for COVID yeah

yeah a lot of protocols yeah yeah that's a big one okay and it's been shown to actually be good not just for the immune

system but it has actually anti-coded effects so it's got antiviral effects but anti-covalent effects as well okay

that's that's huge well Dr. Evans. Joel thank you so much again for coming on today how can

listeners learn more about you and work with you and learn more about Functional Medicine as well thanks andy

so great to be here if you're interested in Functional medicine ifm.org

and yep a great site for me um

I have a practice at the center for Functional Medicine so it's the center for

Functionalmedicine.com very easy to remember and emails Joel at the center for

functionalmedicine.com I love that website hopefully you haven't gotten too many bids to try to

buy that out you know it's like a nice website for that I know i'm gonna buy it to get it

okay got it yeah that's great well thanks so much Joel for coming on I really appreciate it and

hope you stay healthy and well youtube thanks so much thank you for taking the time to listen

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