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Responding to A2A.This is similar to another question I responded to, so will share that answer with you.I think your key issues involve things such as gut dysbiosis and more, so need to really do more than one thing. As you also noted PTSD, would encourage you to look into EMDR treatment as well. There are some others as well reported to have good success for PTSD, but believe that’s a good, efficient one that’s withstood the test of time and would be helpful.Frankly, job one is to look after your own health.Likely you were not clued in to the importance of either gut health or the immune system. Yes it was covered, but NOT given its due as we see from the way most things are addressed.So you want to work on those things and you’ll be a doctor for it—more effective with your patients.As to immune health, you need to NOT fall ill. Strongly encourage you to:get your Vitamin D level to 60–80 ng/mL rangeSo that is the 25OHD test. You will need to supplement I am sure. Take D3 which is more absorbable, but is not a prescription as is D2. You want some K2 on board with that to help with absorption as well as some fat for the same reason. Would be no harm in taking a product like DECALCIFY which you can find on Amazon—sometimes. Yes that IS 5 mg of K2 and that’s not a misprint and it’s NOT dangerous either. Ever seen the studies of 45 mg per day for Japanese women with osteoporosis? They do just fine. You should be young and basically healthy so likely 1 of those is sufficient for you. Disagreements abound on D supplementation. Should be totally fine with 2,000 IU per day. What about bolus doses as you’ll be far under 60 ng/mL? Depending on how low you are, probably worth some bolus doses and a retest. Would not want less than 30 ng/mL for anyone IN medical field: hours are long (works against immune system with lack of sleep, excess stress) and exposure to all manner of nasty things (masks as you should know are more political than protective outside some very limited applications).Vitamin C is valuable and we don’t make it. Don’t advise OJ: packed with sugar, lacks the fibre, etc. Better off eating some citrus fruit or using supplements.Other things in many of my answers that apply.In fact, Heyteach on Gab: ''Honestly to reduce chances of getting COVID or anything else:Get Vitamin D level in the 60-80 ng/mL range. Take D3, not D2, with some Vitamin K2 (if on blood thinners, you need to work with your doc and probably need to own a home INR tester), fat also aids absorption. You want the 25OHD test to see where your level is and supplement from there. Most people will be very much under the 60 range--that is way over reference ranges which are problematic for many reasons.You want proper zinc levels. Like to balance zinc and copper unless you have Wilson's Disease or some reason to avoid Cu supplementation. Get blood levels of both; would suggest mid to high level of reference range is good for folks. Your doc will weigh in on it. Can get a balanced zinc of 15 mg with 1 mg copper which is a good ratio.Vitamin C throughout the day is smart. IF you have G6PD or cancer, or kidney disease, work with your doctor. People without those concerns can likely supplement 6 g per day throughout the day with only real potential issue of "bowel intolerance" if they take too much at once.Not recommending OJ (too high sugar content; real oranges fine-- you are not going to eat 6 at a time and you get fibre and more in the orange).Selenium is good against messenger RNA viruses. Two Brazil nuts a day should not be a problem; likely 200 mcg of selenium should be safe for folks. Again, there IS a blood test for Se levels.Boosting natural glutathione is wise. IF you can handle goat whey, have a dose or two a day. Grass-fed whey protein isolate is another option. Glutathione supps are expensive; some versions are more effective than others, but because of issues with detox pathways, some folks who take a LARGE dose of glutathione or repeated larger doses may experience issues, esp. if they have asthma. A liquid sup where you can take SMALL doses and see how you feel makes more sense to me. Vitamin C does help the glutathione regenerate in your body.Most folks are magnesium deficient and getting more would be good. Pretty much gone in a day. Different forms are more available; some like magnesium citrate which can reach "bowel tolerance" faster than say magnesium glycinate, can be a good thing (tendency towards constipation) or not a good thing.Best to work with someone who knows things or at least provides some "markers" guidance instead of every time you get a bad result says: Herxheimer's! That's great.No, NOT ALWAYS.Always best to work with a physician but now you know what you can address with him. Do NOT make the mistake of thinking if a little is good, more is better. MOST nutrients have a "sweet spot." Too much or too little are BOTH problems. Best to get nutrients from food but we have soil depletion; have lack of proper picking and storage, etc. So for some nutrients you really DO need to supplement wisely, but over time you should be able to reduce or stop, at least for times, supplements. We no longer make Vitamin C so MUST ingest it. As we age, we see lower levels of glutathione in people. Etc. Lots to know and learn, but the targets I mentioned are good as are better numbers for both fasting insulin and glucose control which are problems that are common and far more serious (like inadequate D) than recognized.Three useful tests with good ranges:Bredesen’s lab values for 3 VERY important tests:Fasting insulin ≤ 4.5 microIU/ml (2.0 is Perlmutter’s target)A1c < 5.6 %Fasting glucose 70-90 mg/dLBredesen is neurologist Dale Bredesen. In fact, hisThe End of Alzheimer's is a great book to follow for general health principles.Yes I do like my tome which goes far beyond the title as well.Diagnosing and Treating Chronic Heavy Metal Toxicity: Patient Guide to Regaining Health. Get the ebook unless you want to build your biceps and lighten your wallet.You are a resident, so far more educated than the general public, BUT still there is wisdom in finding a good primary care physician to do a super good physical for you and decide what makes sense and what and when to monitor. It is ALWAYS possible to do a damage with megadosing and the like. Good liver and kidney function baseline testing; check as makes sense. Frankly, good thyroid panel very sensible for a resident as well (and not just a TSH. May need an endo though some have out-of-date notions like you can’t reverse diabetes 2. Nope, did it. Years of lab work AS a Type 2, years of lab work to show no more.)GutBrain Axis is bidirectional and very real. Great place for residents and others to give some focus. Kelly Brogan, MD (really) and psychiatrist has blog and books, that you can check into. Here’s one:Depression Starts In Your Gut (kellybroganmd.com)Some of my prior responses re: gut health might be useful for you.Alejandro Junger, MD (my preference for health info):CleanGutSupplementpdf (clean-archive.s3-us-west-1.amazonaws.com)Neurologist Dale Bredesen, MD, has done more than anyone else I am aware of for brain health and what is good for the brain is good for the body. HisThe End of Alzheimer’sis worth reading as well as his follow up book with AD SURVIVORS. Yes.Great summary to whet your appetite:The End of Alzheimer's (soler7.com)You do NOT want to do what many do:sugar highs; tons of caffeine; shorting yourself of sleep (yes I know the hours and sometimes you have NO choice, but some folks could be a bit better about sleep and it IS a key to good health); failing to reduce stress with good breathing/meditation/healthy exercise. (That might be HIIT which takes LESS TIME than a lot of other ways and is better as 2–3 times a week for about 30 minutes beats an hour or more in the gym daily. Think you’ll be walking no matter what…But if you could swim, do yoga, dance, something more even for short periods, that is likely to help as well.)How good are your study habits? Too many CRAM. Not really effective. The more senses you can bring in to getting CONDENSED info the better. APPLICATION so you UNDERSTAND so much more important than memorization.You’ll be surprised how you CAN and DO memorize “stuff” when you do understand it and USE it regularly.Don’t think you can EVER take advantage of EVERY opportunity or know it all. No one can or ever has. You have to make choices. Having a tight group of study buddies and you all regularly share what REALLY does matter is a good way to help sort through the deluge of info out there.Have some FUN. Seriously.Keep tight with family and a few true FRIENDS.We lose a doc a day to suicide. That has GOT TO STOP. (And yes med students and residents are in the number counted.) Do NOT let it get that bad.EXHAUSTION: physical, mental, spiritual, emotional is what truly leads to suicide. When you really can’t see hope; when you feel devalued; when you feel impotent.DO NOT LET IT GET THAT BAD.Stand up for yourself as you’ll need to do for patients as well.You CAN do this. Part of how is you have to learn to say NO.You must put your health as a top priority. Dead doctors don’t help patients. Broken doctors don’t do much good either.You were called. You were selected. Hold tight to that and avoid NEGATIVE people. They’ll suck every last drop of energy and hope out of you.

Responding to A2A.Frankly, job one is to look after your own health.Likely you were not clued in to the importance of either gut health or the immune system. Yes it was covered, but NOT given its due as we see from the way most things are addressed.So you want to work on those things and you’ll be a doctor for it—more effective with your patients.As to immune health, you need to NOT fall ill. Strongly encourage you to:get your Vitamin D level to 60–80 ng/mL rangeSo that is the 25OHD test. You will need to supplement I am sure. Take D3 which is more absorbable, but is not a prescription as is D2. You want some K2 on board with that to help with absorption as well as some fat for the same reason. Would be no harm in taking a product like DECALCIFY which you can find on Amazon—sometimes. Yes that IS 5 mg of K2 and that’s not a misprint and it’s NOT dangerous either. Ever seen the studies of 45 mg per day for Japanese women with osteoporosis? They do just fine. You should be young and basically healthy so likely 1 of those is sufficient for you. Disagreements abound on D supplementation. Should be totally fine with 2,000 IU per day. What about bolus doses as you’ll be far under 60 ng/mL? Depending on how low you are, probably worth some bolus doses and a retest. Would not want less than 30 ng/mL for anyone IN medical field: hours are long (works against immune system with lack of sleep, excess stress) and exposure to all manner of nasty things (masks as you should know are more political than protective outside some very limited applications).Vitamin C is valuable and we don’t make it. Don’t advise OJ: packed with sugar, lacks the fibre, etc. Better off eating some citrus fruit or using supplements.Other things in many of my answers that apply.In fact, Heyteach on Gab: ''Honestly to reduce chances of getting COVID or anything else:Get Vitamin D level in the 60-80 ng/mL range. Take D3, not D2, with some Vitamin K2 (if on blood thinners, you need to work with your doc and probably need to own a home INR tester), fat also aids absorption. You want the 25OHD test to see where your level is and supplement from there. Most people will be very much under the 60 range--that is way over reference ranges which are problematic for many reasons.You want proper zinc levels. Like to balance zinc and copper unless you have Wilson's Disease or some reason to avoid Cu supplementation. Get blood levels of both; would suggest mid to high level of reference range is good for folks. Your doc will weigh in on it. Can get a balanced zinc of 15 mg with 1 mg copper which is a good ratio.Vitamin C throughout the day is smart. IF you have G6PD or cancer, or kidney disease, work with your doctor. People without those concerns can likely supplement 6 g per day throughout the day with only real potential issue of "bowel intolerance" if they take too much at once.Not recommending OJ (too high sugar content; real oranges fine-- you are not going to eat 6 at a time and you get fibre and more in the orange).Selenium is good against messenger RNA viruses. Two Brazil nuts a day should not be a problem; likely 200 mcg of selenium should be safe for folks. Again, there IS a blood test for Se levels.Boosting natural glutathione is wise. IF you can handle goat whey, have a dose or two a day. Grass-fed whey protein isolate is another option. Glutathione supps are expensive; some versions are more effective than others, but because of issues with detox pathways, some folks who take a LARGE dose of glutathione or repeated larger doses may experience issues, esp. if they have asthma. A liquid sup where you can take SMALL doses and see how you feel makes more sense to me. Vitamin C does help the glutathione regenerate in your body.Most folks are magnesium deficient and getting more would be good. Pretty much gone in a day. Different forms are more available; some like magnesium citrate which can reach "bowel tolerance" faster than say magnesium glycinate, can be a good thing (tendency towards constipation) or not a good thing.Best to work with someone who knows things or at least provides some "markers" guidance instead of every time you get a bad result says: Herxheimer's! That's great.No, NOT ALWAYS.Always best to work with a physician but now you know what you can address with him. Do NOT make the mistake of thinking if a little is good, more is better. MOST nutrients have a "sweet spot." Too much or too little are BOTH problems. Best to get nutrients from food but we have soil depletion; have lack of proper picking and storage, etc. So for some nutrients you really DO need to supplement wisely, but over time you should be able to reduce or stop, at least for times, supplements. We no longer make Vitamin C so MUST ingest it. As we age, we see lower levels of glutathione in people. Etc. Lots to know and learn, but the targets I mentioned are good as are better numbers for both fasting insulin and glucose control which are problems that are common and far more serious (like inadequate D) than recognized.Three useful tests with good ranges:Bredesen’s lab values for 3 VERY important tests:Fasting insulin ≤ 4.5 microIU/ml (2.0 is Perlmutter’s target)A1c < 5.6 %Fasting glucose 70-90 mg/dLBredesen is neurologist Dale Bredesen. In fact, hisThe End of Alzheimer's is a great book to follow for general health principles.Yes I do like my tome which goes far beyond the title as well.Diagnosing and Treating Chronic Heavy Metal Toxicity: Patient Guide to Regaining Health. Get the ebook unless you want to build your biceps and lighten your wallet.You are a resident, so far more educated than the general public, BUT still there is wisdom in finding a good primary care physician to do a super good physical for you and decide what makes sense and what and when to monitor. It is ALWAYS possible to do a damage with megadosing and the like. Good liver and kidney function baseline testing; check as makes sense. Frankly, good thyroid panel very sensible for a resident as well (and not just a TSH. May need an endo though some have out-of-date notions like you can’t reverse diabetes 2. Nope, did it. Years of lab work AS a Type 2, years of lab work to show no more.)GutBrain Axis is bidirectional and very real. Great place for residents and others to give some focus. Kelly Brogan, MD (really) and psychiatrist has blog and books, that you can check into. Here’s one:Depression Starts In Your Gut (kellybroganmd.com)Some of my prior responses re: gut health might be useful for you.Alejandro Junger, MD (my preference for health info):CleanGutSupplementpdf (clean-archive.s3-us-west-1.amazonaws.com)Neurologist Dale Bredesen, MD, has done more than anyone else I am aware of for brain health and what is good for the brain is good for the body. HisThe End of Alzheimer’sis worth reading as well as his follow up book with AD SURVIVORS. Yes.Great summary to whet your appetite:The End of Alzheimer's (soler7.com)You do NOT want to do what many do:sugar highs; tons of caffeine; shorting yourself of sleep (yes I know the hours and sometimes you have NO choice, but some folks could be a bit better about sleep and it IS a key to good health); failing to reduce stress with good breathing/meditation/healthy exercise. (That might be HIIT which takes LESS TIME than a lot of other ways and is better as 2–3 times a week for about 30 minutes beats an hour or more in the gym daily. Think you’ll be walking no matter what…But if you could swim, do yoga, dance, something more even for short periods, that is likely to help as well.)How good are your study habits? Too many CRAM. Not really effective. The more senses you can bring in to getting CONDENSED info the better. APPLICATION so you UNDERSTAND so much more important than memorization.You’ll be surprised how you CAN and DO memorize “stuff” when you do understand it and USE it regularly.Don’t think you can EVER take advantage of EVERY opportunity or know it all. No one can or ever has. You have to make choices. Having a tight group of study buddies and you all regularly share what REALLY does matter is a good way to help sort through the deluge of info out there.Have some FUN. Seriously.Keep tight with family and a few true FRIENDS.We lose a doc a day to suicide. That has GOT TO STOP. (And yes med students and residents are in the number counted.) Do NOT let it get that bad.EXHAUSTION: physical, mental, spiritual, emotional is what truly leads to suicide. When you really can’t see hope; when you feel devalued; when you feel impotent.DO NOT LET IT GET THAT BAD.Stand up for yourself as you’ll need to do for patients as well.You CAN do this. Part of how is you have to learn to say NO.You must put your health as a top priority. Dead doctors don’t help patients. Broken doctors don’t do much good either.You were called. You were selected. Hold tight to that and avoid NEGATIVE people. They’ll suck every last drop of energy and hope out of you.