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The Importance of Vitamin D In my practice treating infections, chronic illness, COVID, and weight-related conditions, the topic of vitamin D deficiency comes up often. Vitamin D plays over 200 roles in the body and is essential for immunity, energy metabolism, cellular growth, and more. More than half of our human cells have receptors for vitamin D, highlighting its importance in overall health. Understanding Vitamin D Levels In 2010, the Institute of Medicine (now the National Academy of Medicine) defined vitamin D deficiency, insufficiency, and sufficiency based on serum 25-hydroxyvitamin D [25 (OH)D] levels: Deficient: < 12 ng/ml Insufficient: 12-20 ng/ml Sufficient: 20-30 ng/ml However, these values were based on bone health, not immunity or chronic illness. In 2011, the Endocrine Society recommended levels above 30 ng/ml, but emerging research suggests that levels between 50-90 ng/ml are necessary for functional health and 80+ ng/ml for optimal health . Factors Influencing Vitamin D Your vitamin D levels are influenced by: Geography: Latitude, season, time of day Biology: Genetics, skin pigmentation, age Metabolism: Vitamin D3 is processed in the liver into its active form (calcitriol), which has a longer half-life in the body Since vitamin D3 has a short half-life (1-2 days), but its metabolized form lasts 2-3 weeks, testing the 25-OH hydroxy vitamin D is the best way to assess your levels. Click here to order your test. Supplementing Vitamin D If you’re deficient, it can take months to achieve optimal levels with 5,000 IU daily. However, prescription-strength 50,000 IU vitamin D is highly absorbable, low-cost (~$3 for a 3-month supply), and often covered by insurance. Vitamin D3 vs. D2: Vitamin D3 is 30% more bioavailable than D2. Combining Supplements: If taking >8,000 IU/day , add: Vitamin K2 (100 mcg/day or 800 mcg/week) Magnesium (250-500 mg/day) Both vitamin K2 and vitamin D have anti-cancer properties. Click here to request a prescription-strength vitamin D supplement. Vitamin D and Weight Weight Loss Studies suggest vitamin D can help with weight loss by: Regulating appetite: Vitamin D receptors in the hypothalamus reduce food intake. Reducing fat storage: Vitamin D promotes apoptosis (cell death) in fat cells. Improving metabolism: Clinical trials show vitamin D supplementation supports weight loss better than a placebo. Weight Gain Conversely, low vitamin D levels contribute to weight gain by: Disrupting glucose regulation Promoting fat accumulation Interfering with insulin signaling in muscles My Perspective on Vitamin D Testing Given the obesity epidemic and rising cases of long COVID and frequent infections, I find it concerning that the Endocrine Society (July 2024) recommended against routine vitamin D testing for the general population. Their rationale is that only specific groups—such as older adults, pregnant individuals, and children—need supplementation without testing. However, I believe most people are not in optimal health . Of those I test, only 10-15% have levels at or above 70 ng/ml. What About Your Vitamin D Levels? I am offering vitamin D testing at no extra cost during your next visit. I can submit this through insurance, or you can use Ulta Labs , which offers discounted testing through Quest Labs. Lab costs are: With a visit (provider order): $24.12 Without a visit (self-order): $49.95 Click here to schedule your visit and test your vitamin D levels. If your levels are low, treatment may be as simple as adjusting your daily dose. If prescription vitamin D is needed, you can request it here . For a full supplementation guide, check out the IMA Health Protocol here . Sincerely, Anna Yoder, DNP, APRN, ANP/GNP-BC References: Sisley SR, Arble DM, Chambers AP, et al. Hypothalamic Vitamin D Improves Glucose Homeostasis and Reduces Weight. Diabetes . 2016;65(9):2732-41. doi:10.2337/db16-0309. Sergeev IN. Vitamin D Status and Vitamin D-Dependent Apoptosis in Obesity. Nutrients . 2020;12(5):E1392. doi:10.3390/nu12051392. Lotfi-Dizaji L, Mahboob S, Aliashrafi S, et al. Effect of Vitamin D Supplementation Along With Weight Loss Diet. Clinical Endocrinology . 2019;90(1):94-101. doi:10.1111/cen.13861. Xenos K, Papasavva M, Raptis A, et al. Vitamin D Supplementation and Genetic Polymorphisms Impact on Weight Loss Diet Outcomes. Frontiers in Medicine . 2022;9:811326. doi:10.3389/fmed.2022.811326. Abboud M, Liu X, Fayet-Moore F, et al. Effects of Vitamin D Status and Supplements on Anthropometric and Biochemical Indices. Nutrients . 2019;11(12):E3032. doi:10.3390/nu11123032. Benetti E, Mastrocola R, Chiazza F, et al. Effects of Vitamin D on Insulin Resistance and Myosteatosis. PloS One . 2018;13(1):e0189707. doi:10.1371/journal.pone.0189707. Bouillon R, Carmeliet G, Lieben L, et al. Vitamin D and Energy Homeostasis: Of Mice and Men. Independent Medical Alliance (IMA). Retrieved March 20, 2025, from: IMA Health Protocol .

The Biden administration has proposed expanding Medicare and Medicaid to cover popular weight-loss medications like Wegovy and Zepbound, recognizing obesity as a treatable disease. These medications help reduce weight by 15-25%, potentially lowering risks for heart disease and diabetes. If approved, this change could cut the cost of these pricey drugs (often over $1,000/month) by 95% for 7.4 million beneficiaries, but it’s projected to cost taxpayers $35 billion over a decade. The rule isn’t final yet and could face changes under the incoming Trump administration, as HHS nominee Robert F. Kennedy Jr. has voiced skepticism about drugmakers and favors focusing on access to healthy nutrition. "I do not share this to express support or opposition to the proposal. My considerations include improved and equitable access to medical treatments, use of taxpayer dollars, prioritizing systemic solutions for obesity over medication, and ensuring patient suitability. In my practice, I’ve observed that Medicare and Medicaid patients often have more complex medical needs and take multiple medications. These weight-loss drugs can affect how other medications work, necessitating frequent monitoring and dosage adjustments. Additionally, some geriatric patients tolerate GLP-1 and GIP weight-loss drugs poorly and experience more side effects. These are important factors to consider." https://www.cnbc.com/2024/11/26/biden-proposes-medicare-and-medicaid-cover-weight-loss-drugs.html

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As a nurse practitioner, I often come across valuable resources from my patients. Recently, one patient shared their experience with Galleri®, a multi-cancer early detection test. This blood test screens for many of the deadliest cancers before they become symptomatic, including some cancers that currently lack routine screening options. Cancers growing in the body shed DNA into the bloodstream, and these DNA fragments carry a unique "fingerprint" of cancer. The Galleri test analyzes this DNA, potentially detecting cancer signals and identifying where in the body the signal originated—even before clinical diagnosis through conventional methods. The Galleri test is designed for adults with an elevated risk for cancer, such as those aged 50 or older, obese (BMI >30), or former and current smokers. It is not designed for individuals who are pregnant, under 21 years of age, or undergoing active cancer treatment. And, although it detects over 50 cancers, it does not detect all cancers and is not a substitute for regular cancer screening. As with any medical test, good judgement is needed when deciding to proceed. Every test has risks considering, such as cost, the potential for unnecessary worry, or false positives/negatives. Nonetheless, for individuals seeking a highly sensitive cancer screening option, the Galleri test may provide valuable insights. To learn more about Galleri®, visit their official site: https://www.galleri.com/what-is-galleri Sharing this information is intended to inform and empower, but any medical decision should be made in consultation with your healthcare provider.

I recently read an excellent book: “ Trust: Knowing When to Give It, When to Withhold It, How to Earn It, and How to Fix It ” by Dr. Henry Cloud. I found its principles deeply relevant to my work as a nurse practitioner. Trust is the foundation of all meaningful relationships, including that of patient and provider. Dr. Cloud asserts that "trust impacts everything and is essential for life" and is indispensable for "doing life well"—with ourselves, family, friends, businesses, and even matters of faith. Think about it: we rarely choose to engage with a person, institution, service, or product unless we have some level of trust in the person or product’s ability to deliver on its promise. In healthcare, the best outcomes occur when a patient and provider establish a trusting relationship. So, if trust is important, how do you know when to give it or how to fix it when it is broken? And when it comes to your health, how do you determine which healthcare provider is worthy of your trust? Using Dr. Cloud’s five essentials of trust —understanding, motive, ability, character, and track record—let’s explore how to find a provider suited to your unique health needs. 1. Understanding A trustworthy provider listens to you. They need to understand your concerns, goals, and values. Do you feel heard during appointments? Does your provider take the time to grasp what’s important to you about your health? If you feel understood, you’re more likely to engage in the care process fully, leading to better health outcomes. 2. Motive Is your provider motivated to improve your well-being, or are they more focused on external factors like profits, schedules, or credentials? A provider’s "Why" matters. When a provider is genuinely in healthcare for the good of others, it’s evident. You’ll feel like a partner in your care, rather than a number on their schedule. 3. Ability Understanding and caring are essential, but they’re not enough without ability. Does your provider have the expertise and skills necessary to address your specific health concerns? A cardiologist might be excellent at treating heart conditions but would not be the right choice for managing seizures or joint issues. Trust isn’t transferable across areas of expertise. Always verify that a provider has the qualifications and experience to address your concerns. 4. Character Character is the backbone of trust. Even the most skilled and caring provider can be untrustworthy if they lack integrity. Are they honest, reliable, and ethical? Do they follow through on promises? Trustworthy character ensures that the person you’re entrusting with your health will act with your best interests at heart, even when challenges arise. 5. Track Record Finally, consider a provider’s track record. What has their past performance been like? Have they successfully handled similar cases to yours? A proven history of reliability and success is one of the best indicators of future behavior. That said, if a provider is actively working on improving a skill or knowledge set, their actions are also worth noting. Putting It All Together Trust is not simply given; it is earned. Understanding, motive, ability, character, and track record form the framework for assessing whether a person is trustworthy. Importantly, no one is perfect—no provider excels in every area—but finding someone who demonstrates these qualities in their lane of expertise is critical. As a nurse practitioner, I’ve seen firsthand how trust transforms patient care. Patients who trust their providers are more open, more engaged, and more likely to follow through on treatment plans. Conversely, misplaced trust can lead to disappointment or even harm. Takeaways for Patients Trust isn’t blind. It requires discernment and due diligence. Look for a provider who: Actively listens to you and seeks to understand your concerns. Centers their care on your well-being rather than rigid protocols. Demonstrates competence in the specific area of care you need. Maintains integrity and ethical standards. Has a proven track record of reliability and success in their field. Healthcare is deeply personal, and trust is the bridge that connects providers and patients. By carefully assessing potential providers through Dr. Cloud’s framework, you can build a relationship that fosters both health and peace of mind.

As Thanksgiving approaches, we are reminded of the profound importance of gratitude—a simple yet transformative act that fosters connection, kindness, and resilience.

Your body is an amazing machine, constantly sending signals about its well-being. But sometimes, those signals can be subtle or confusing, leaving you wondering: "Is this a sign of something serious, or just a minor inconvenience?" At Telehealth NP, we understand the importance of early detection and want to empower you to become an active participant in your health. This blog aims to demystify some common signs and symptoms, helping you recognize when it's time to seek professional guidance. Understanding the Language of Your Body: Fever: Often a sign of infection, but can also be a response to various other conditions. Monitor your temperature and seek medical advice if it persists for more than a few days. Fatigue: Feeling tired can be caused by many factors, including stress, lack of sleep, or underlying health issues. If fatigue significantly impacts your daily life, it's crucial to consult a healthcare professional. Pain: Pain is a crucial warning sign, but its location, intensity, and duration can vary greatly depending on the cause. Don't ignore persistent or severe pain - seek medical evaluation to understand the underlying reason. Changes in appetite or weight: Unexplained fluctuations in weight or appetite can be red flags for various health conditions. If you experience significant weight loss or gain without changing your diet or exercise routine, consult a healthcare professional. Unexplained changes in bowel or urinary habits: Significant or persistent changes in your bathroom routine, including constipation, diarrhea, or blood in the stool, can signal potential health issues. Don't hesitate to seek medical advice. Remember, this is not an exhaustive list, and these symptoms can sometimes appear due to less serious causes. However, if you experience any of these signs consistently, especially if they impact your daily life or cause significant discomfort, it's crucial to seek professional medical evaluation. Telehealth NP: Your Partner in Early Detection At Telehealth NP, we offer convenient and accessible healthcare through telehealth consultations . Connect with experienced nurse practitioners from the comfort of your own home, discuss your concerns, and receive personalized guidance on managing your health. We believe in early detection and empower you to take charge of your well-being proactively. Don't wait until a symptom becomes a bigger issue. Schedule a consultation with Telehealth NP today and start your journey towards empowered health!  Together, let's listen to your body's signals and prioritize your well-being! Book an Appointment now!

 Your heart, the tireless engine powering your every move, deserves your utmost care. Yet, navigating the complexities of cardiovascular health can feel overwhelming. Fear not, knowledge is your strongest ally! This blog, brought to you by Telehealth NP, aims to demystify this vital topic, answer your burning questions, and equip you with actionable insights to keep your heart humming. Understanding the Threat: A Glimpse into Cardiovascular Disease (CVD) CVD, encompassing a spectrum of heart and blood vessel conditions, remains the leading cause of death globally. From high blood pressure and cholesterol lurking silently to the more dramatic heart attacks and strokes, CVD paints a diverse picture. But don't let that scare you! Early detection and management can significantly improve outcomes, making knowledge your first line of defense. Burning Questions Answered: Unraveling the Mysteries What are the risk factors for CVD? Genetics, age, lifestyle choices like smoking and unhealthy diet, and even stress play a role. Understanding your individual risk profile empowers you to take preventive measures. What are the warning signs of CVD? Chest pain, shortness of breath, fatigue, and even seemingly unrelated symptoms like leg pain or jaw pain can be red flags. Don't ignore them! How can I prevent CVD? The good news is, you have the power to significantly reduce your risk! Embrace healthy eating, regular exercise, stress management, and regular checkups. Every small step counts! Beyond Awareness: Actionable Insights for a Healthier Heart Fueling Your Engine: Ditch processed junk and embrace a diet rich in fruits, vegetables, whole grains, and (take out lean) and proteins (lean meat is old scientific data). Remember, you need all fats, saturated, poly unsaturated and monounsaturated. Saturated fat comes from meats and poly unsaturated and monounsaturated fats come from vegetables and seeds! Moving Your Body: Aim for at least 150 minutes of moderate-intensity exercise weekly. Find activities you enjoy, from brisk walks to dancing, and make movement a joyful habit. Taming the Stress Monster: Chronic stress hurts your heart. Practice deep breathing, meditation, yoga, or simply spend time in nature to find your zen and keep stress at bay. Talk to a friend, shed the emotions. Know Your Numbers: Regularly monitor your blood pressure, cholesterol, and blood sugar levels. Early detection of abnormalities allows for timely intervention and management. Telehealth NP: Your Partner in Cardiovascular Health Telehealth NP brings experienced nurse practitioners directly to you, by phone or video (virtually). Schedule consultations, discuss concerns, and receive personalized guidance – all from the comfort of your own home. We believe convenience shouldn't compromise quality, and our platform empowers you to take charge of your heart health proactively. Remember, your heart's health is a lifelong journey. This reading is just the beginning! We invite you to explore our resources, ask questions, and join us in creating a community dedicated to empowered health. Let's keep the beat going, together!