Alvina Foo

Complementing Pharmaceutical Disease Management with Natural Medicine with Alvina Foo

Alvina Foo

Complementing Pharmaceutical Disease Management with Natural Medicine with Alvina Foo

In today’s episode, we are chatting with Alvina Foo, an integrative Pharmacist who has a keen interest in evidence-informed nutritional and lifestyle therapies which complement pharmaceutical management of disease. 

Alvina and Andrew discuss how the blending of pharmacy and natural medicine leads to better patient outcomes, from co-prescribing to pharmaceutical induced nutrient deficiencies; listen in to hear how Alvina uses collagen peptides, magnesium and ubiquinol alongside common prescriptions for better results.

 

About Alvina Foo:

Alvina is a certified American Board of Anti-Aging Health Practitioner. Certified Ketogenic Nutrition Specialist & certified BioIndividual Nutrition Consultant and Pharmacist using both conventional medicine and biomedical approach

She earned her degree in Pharmacy from the University of Sydney in 1998.  She is a board certified Anti-Aging Medicine Health Practitioner and has completed her certification in Nutritional and Environmental Medicine with the Australasian College of Nutritional & Environmental Medicine. She has also completed her training with the American Nutrition Association and is a certified Ketogenic Nutrition Specialist.

Alvina is passionate about healthy eating and loves to keep physically fit. She particularly enjoys resistance training and high intensity interval training (HIIT) as part of her active lifestyle. In 2019, she was awarded overall championship in the NatBod Bodysport natural bodybuilding competition. She then gained placing in the Regional, NSW State and National levels of iCompete Natural Australia.

Her keen interest in sports and nutrition led Alvina to complete certifications in both Science of Nutrition and Training the Physique Athlete with the Clean Health Fitness Institute of Australia in 2019.

Since 2009, she’s been training with the MINDD foundation for paediatric special needs, and as of May 2021 Alvina has completed her advanced training on personalising nutrition with the BioIndividual Nutrition Institute. She is a certified BioIndividual Nutrition Consultant.”

Connect with Alvina

website: https://www.alvinafoo.com

Facebook: alvinatheintegrativepharmacist

Instagram: @msalvinafoo

Email: alvina@alvinafoo.com

References from Podcast: 

Gelita Collagen Peptides: https://www.gelita.com/en/australia

 

Transcript

Introduction

Andrew: Welcome to “Wellness by Design.” I’m your host, Andrew Whitefield-Cook. Today we’re joined by Alvina Foo, a pharmacist who has a keen interest in evidence-informed nutritional and lifestyle therapies to complement pharmaceutical management of disease for her customers, her patients. So, thanks for joining us today, and welcome, Alvina. How are you?

Alvina: I’m very well, Andrew, and thanks for having me.

Andrew: Our pleasure, our absolute pleasure. Now, you have a deep interest in nutritional therapies. But first of all, I just wanna go back to where this might have started. Like, were you this way inclined in your childhood from your parents?

Alvina: Well, during my early primary school years, I had, you know, a bit of coughing, which was really not formally diagnosed as asthma. But let me just go back a little bit, you know, giving you a history of my parents. So, they both survived World War II. And life was really hard and mum basically lost her parents when she was 12. And no formal education and debt to make ends meet. You know, he had to work in Christmas Ireland, and I’ve only seen him, like, you know, twice a year for almost the entire primary school years. So, mum basically runs the household. And so whatever information that she gets, you know, it’s from family, and friends, and relatives. And so, during that time, you know, I was just coughing a lot and mum, who… Basically, the management was to give me herbs. We used to go to the Chinese herbalist down the road from us, getting lots of herbs, and I have very memorable experiences with herbs and the good old cod liver oil. I grew up on that and lots of, yeah, lovely bitter herbs. And also, you know, friends of hers said that “Oh, well, you know, friends of mine said that swimming is actually really good for your coughing.” So, from a very young age, I was swimming, you know, like, weekly. Mum would take me to a swimming pool and swim. So that is sort of, you know, the management. And then I remember there was a period of time where my coughing or asthma got pretty bad. And so, I was sent to my auntie, that’s my mum’s eldest sister, one of the eldest sister, and it’s like a detox program, to be honest, for a trial because basically, I mean, she was a little bit more health-conscious than my mom. And I would have no junk food, and that’s just terrible for a primary school kid. And I remember drinking lots of vegetable meat bone broth, pretty plain food in, well, my opinion. But during that time, I actually got better but, of course, you know, as a child, you really don’t wanna admit to that because you’re still on your tree.

So, you know, I think that experience actually really… I don’t know, it had a profound impact on me. And so that was sort of my little, you know, like, childhood story. And on odd occasions, I remembered going to the doctor and I don’t recall having that many lots of antibiotics. But I remember, you know when we had some big… And also doctors in Singapore actually dispenses. So, I never knew what a pharmacist role… Like, I don’t even know that they existed but I remember seeing the antibiotics on the shelf and trying to, you know, pronounce this drug and couldn’t even pronounce it and think, “Wow, wouldn’t it really be cool, you know, that I could actually know what all these drugs are for, and yeah, and know how to pronounce them.” So that was interesting. And yeah, I am a pharmacist.

Andrew: So, well, there was a lot that happened in between there. So, you emigrated to Australia. I would imagine that that would have been in your sort of late high school era. Is that right?

Alvina: Yes. Yes. So, I did my year 11 and year 12 in…

Andrew: Right. And then it was like pharmacy all the way. Was it, like, I know what I wanted to do? Why not medicine? What was the change? Was it because you’re more interested in the drugs, what the drugs do?

Alvina: Yeah, to be honest with you, Andrew, when I was in Singapore, I went to a… well, it was a top-five junior college in Singapore. And the amount of stress, it was really stressful, and because I played in inter-school, you know, badminton, so I train a lot too. And so, there was a very… It was very demanding. You know, like, on one hand, they actually expect me to do really well in sports and on the other in academic as well. In fact, I actually took triple science. In Singapore, you know, that sort of, like, pave the way into medicine. But with the pressure, I decided that, I don’t know, I just thought that medicine… You know, knowing about drugs was actually quite interesting for me. So, I just took that path and I really enjoyed chemistry. So, yeah.

Andrew: And so, what was… I mean, you became a pharmacist, and orthodox pharmacists, at least, are pretty suspicious of natural medicines. So, what was it that led you to be open to natural medicines? Normally what happens is people, I did this, my father was interested in natural medicines, and as soon as I did nursing, it was like, “Get away with your natural medicines. They don’t work and only drugs, they work.” And so, what was it that reopened your mind to natural therapies or did it never leave? Were you always open to natural therapies and their benefits?

Discovering the power of Natural Therapies

Alvina: I guess I was always open to nutraceuticals, to nutrition and, you know, especially when I have my children, that really got my interest going again. So, both my kids when they were young, they have eczema and I remember talking to an integrative immunologist, and he actually said, “Well, try going off dairy.” And I thought, “Oh, really?” So, I thought, oh, well, you know, like, I can just give it a try. And her eczema, it was sort of, you know, appearing on the face and was like she got [inaudible 00:08:18]. And so, within a couple of weeks of staying off dairy, her face was clear, and I thought, “Wow, this is really interesting.” And then along came my sun cheese later. And the same thing happened but this time I thought, you know, like all parents you want to give your kids really good food choices, and I was actually making my own yogurt, right? And so, I took everything off, like, you know dairy, whatever, you know, cheese and everything and I thought, “Okay, well, no…” But, you know, “I made this yogurt so it should be okay,” but until I actually removed that yogurt from his diet, I noticed that you know, the eczema on the back of his knee cleared. And so, I thought, well, again, it’s interesting. And then a couple of years when he was, I think, three, he had three or four, I can’t remember now but, you know, he developed asthma and he also had some nut allergies. So, when I went to the pediatrician, you know, had a chat but by then, you know, like, I have actually done the primary course with ACNEM, which is the Australia College of Nutritional and Environmental Medicine. So, I did the primary course, so I knew, you know, a little bit about nutritional medicine and the environment and, you know, food, how it can actually impact on the health itself. So, when I had a chat with a pediatrician and I was just sort of saying, “Oh, well, you know, could food have anything to do with his condition?” And I got a pretty straight answer go, “No, food has got nothing to do with it.”

Andrew: Not even nuts. Like, what?

Alvina: And so, it really didn’t make sense. I thought, “Okay, well, so I’ve got this child that has nut allergies, I mean, you know, macadamia and some worse than others that, you know, with macadamia that’s almost, you know, close to anaphylactic actually. You know, like, you wheeze, throw up and can’t breathe, which is not a good thing.

Andrew: No.

Alvina: And then to turn around, you know… And also, you know, obviously my experience with dairy and my kids. And then to turn around, you know, all these things, it’s not just local, you know, not just gut dysfunction and having all this different inflammation, and to say that food has got nothing to do with it. So, I just thought, “That’s really, really interesting.” And I guess that takes me back to uni too when we learn about certain interactions, drug-nutrient interaction, it’s almost like, whatever you learn, I don’t know about you, Andrew, but whatever I learned in uni, you don’t seem to question it. You know, it’s like dogma. We’ve learned certain things like, okay, well, warfarin, remember, you have got to counsel the patient about, you know, food that’s rich

in vitamin K, that could actually reduce the effect of warfarin, reduces the INR. And another typical one would be, you know, grapefruit juice. So, people are in felodipine and certain calcium channel blockers and statin, you need to advise them, you know, not too much grapefruit. And also, the use of folic acid in methotrexate treatment, you know, clearly depletes that folic acid. And so, you know, I’m just naming three things that I could recall, you know, from uni and think, “Well, what about all the rest? Obviously, you know, these have profound effect on the body. It’s amazing. I mean, you know, there’s a common saying, I think it’s called absence of evidence is not, you know, evidence that’s actually absent. Did I get it right or is it the other way around?

Andrew: Yeah.

Alvina: So basically, I’m like, yeah. So, it’s not like, you know, you have to look to find it sometimes.

Andrew: Well, that’s a very interesting thing you say because Yvonne Coleman, a dietitian, has actually… Every few years, she decides to harangue a class of drugs, and she will contact the drug companies. They have this information. So, plasma binding, things like that. They know this stuff with nutritional depletion. And it may not be presenting a true clinical deficiency if you’re on one drug that does that. But certainly, when you have patients who are on 2, 3, 4 drugs, then you start to get into real issues of depletion, nutrient depletion. So, it’s really interesting, her work, and she has these cards, where you write down the drug then you write down the plasma binding and the nutritional deficiencies, and you see a picture emerging and you go, “Holy crap. No wonder they’ve got, you know, tingling hands and fingers. Yeah, it’s really interesting what you see is what you find out.

Alvina: It is interesting. And the fact that, you know, sometimes these patients might be taking the drug for a very long time, like, you know, 10, 20 years and while they may not have the problem before but at the same time, you know, they’re getting older and, you know, if they haven’t been correcting their nutrient depletion, then it just keeps getting worse. And, for example, you know, hypertension, for example, you know, that’s a good example. You know, when they go, “Well, I have a really healthy diet.” And I’m not knocking back a healthy diet. Like, you know, nothing can replace a good foundational, you know, well-balanced diet but if you have so much repair to do and I tell patients all the time then, you know, you need those extra nutrients, all of a sudden you know, all, you know, the nutrient may not be sufficient. So, for example, you come out of an operation, you know, you need more to prepare.

Andrew: Yeah, absolutely. Convalescence is a big area. So, can I ask you, by the way, so, did it cement in your mind your interest in nutrition and lifestyle interventions? When the medical model failed you with your son’s asthma, was that when you just went, “To hell with it? I mean, like, I’ve got to search for answers.”

Alvina: Yeah, well, look, I always see a place in medicine, I mean, I wouldn’t give up the Salbutamol when he has an asthma attack.

Andrew: I don’t. I don’t.

Alvina: No. No. No.

Andrew: No. Don’t be doing that.

Alvina: I don’t do that. And, you know, don’t get me wrong, Western medicine is really good for acute conditions, you know, your antibiotics, you know, surgery and all that kind of stuff is really important but when someone actually has a chronic disease then, you know, you’ve just gotta go upstream. And that’s what, you know, my son, you know, with his condition actually taught me. And so that’s when I went upstream and go, “Well, what’s actually really happening here?” And so, I really, you know, not giving up per see, you know, with Western medicine but to really integrate, you know… And looking at the biochemistry and look at the physiology and looking at, you know, exactly what is this drug trying to mimic in our system?

Andrew: Absolutely.

Alvina: For T CAR cell receptor, so to speak, but they are things like receptor site for your magnesium or transporters for magnesium, sorry, and different neurotransmitters so exactly. So, I tend to really question and get quite nerdy about it to actually look at what is this drug trying to mimic in our body?

Andrew: Yes, well done.

Alvina: And then very often it really then gives me a bit of clarity. And so, what I find really interesting too is actually look at the side effect. And sometimes I don’t even need to look at the consumer medicine information to actually look at the side effect because when you know, you know, the drug way actually works and, you know, or what other system it actually affects, then the side effect is actually quite obvious if that makes sense. So, for example, beta-blocker, you know, affects sleep and go, “Oh, it actually affects melatonin there to go, okay. No wonder.”

Andrew: So, I’ve got that same interest in how drugs work and I’ve gotta give a shout out to Dr. Robert Buist, Bob Buist. Years ago, he was the editor of, I’m gonna get this wrong, the Australasian Journal of Clinical Nutrition. And I remember reading excerpts and summaries of studies and I thought, “Where do you find out about the side effects of the biguanide drugs and, you know, the lactic acidosis that some people back then could get.” And I can’t really find this stuff out. I was never taught this in nursing. And it took a real mind switch to…

Alvina: To think that way. Yeah.

Andrew: Yeah, to think about the biochemistry. So, for instance, if somebody is, for instance, got the side effect of a cough with a beta-blocker or what does a beta-blocker work on the receptors and, for instance, sorry, if I’m talking about ACE2 inhibitors, and if you think about angiotensin and angiotensinogen, and the 1 and 2, then goes from the kidneys to the liver. And then you go, “Oh my God, these receptors are in the lung, and that’s why you’re coughing.” And that’s when the side effects to me make sense.

Alvina: Yeah, you know what? To be honest with you, I used to hate biochemistry. I used to hate the biochemistry I just studied… Like, who loves who? I mean, I know we’d like the TCA, the Krebs Cycle, but yeah, I never really did understand why, you know, study that, but now I actually referred to it back and back, you know, to those biochemistry pathways and finance, which is fascinating. Yeah.

Andrew: Yeah, absolutely. And forgive me, I forgot to mention, I only mentioned her name, Yvonne Coleman, her business is Nutrition Consultants Australia. So, for anybody watching or listening, you can go to her website and you can get her folders. I mean, they’re huge. The folder is huge. And it’s just so interesting. Yeah. So, I’ve gotta ask, Alvina, how do you juggle the responsibilities and I’m gonna say the restrictions of scope of practice as a pharmacist? How do you juggle that with your love of integrative medicines and lifestyle interventions with your patients? Because I’m sure I know your customers are demanding these answers, correct?

Alvina: Yeah. Look, I don’t even see that as… I think it just comes naturally to me because, you know, like, when I see the patient and, you know, when I dispense a certain medication for them or they’ve started taking, say, for example, a diabetic medication and they’re newly diagnosed, then it’s about caring for that patient and to give them an idea, you know, like, with like lifestyle intervention… It sounds so cliche in lip service but say, for example, you know, they would have come in for, you know, nearly diagnosed diabetic, then I would obviously talk about their medication, you know, how it works and what to expect of the medication but I’ll talk about the condition as a whole. And, for example, you know, alerting them to go wild… This is actually not…so that you can actually get away with your poor diet, you have to actually book in, you know, see a dietitian and just to make sure, you know, that they can actually further educate you on food and to then alert them to say, for example,

the impact of high, you know, blood glucose level. And we know that you know, we study showing something ridiculous like 45%, like, diabetic actually have a 45% increased rise in all-cause mortality. That is, like, let it just sit for a while and just think 45%. It’s like, wow, that’s huge. And even someone with the HbA1c of more than 5.5. We like to look… You know, and you think, well, there are a lot of non-diabetic with, you know, more than 5.5 and the alarm bells haven’t actually rung yet, you know, because maybe they haven’t actually been to the doctor but they’re the category of people who are, you know, non-diabetic but they’re still increased risk. So, I’m really trying to, I guess, you know, make sure that they don’t have a serious cardiovascular event.

And just to warn them, because sometimes, you know, they might have gone to the doctor because our doctor says, you know, some people are more proactive than others. And so, you know, the people who are not as proactive and not as in tune with everything else and they’re just sort of, like, warning them and go, “Well, look, you really need to keep this under control and if you haven’t…” And I’ve got people who actually not bothered to check their blood sugar level or they’ll say that you know, “Oh, check…” I’m serious. Like, I have come across… People will go, “Oh, look, you know, I get that test done, you know, like the HbA1c every six months and yeah, I’m fine. I’m not kidding you. And so…

Andrew: My wife’s complaining that I’m a little bit ratty lately. Imagine that conversation.

Alvina: And I have to… And especially, you know, I find that you know, when they’re newly diagnosed, that’s where I want to really give them that education and to say that, “Look, you know, maybe in the beginning, perhaps it might be a good idea, and so that you know what your favourite food has…what kind of impact that it has on your blood sugar level.” And so, I’ll tend to then educate them too, you know, do it, you know, before their food and two hours after and, you know, things that they may not think that it affects their sugar because there is a lot of seasoning and, you know, sources and that could actually carry a lot of sugar. And then I talk about, you know, this sleep and, you know, just addressing and really having that time to actually really listen and then just to address the other issues. And they might… For example, you know, someone with high blood pressure may have a lot of stress, funny that stress may have something to do with hypertension. And so, from that point of view, you know, or they have, you know, some… Like, but you have to really, I guess listen and really want to know what’s actually happening. And from there, you know, you find that patients will start to open up or they go, well, look, I’m really stressed about some things. And then that really opens up the conversation. And also, well, you know, how do you sleep? And then may then when it’s appropriate, recommend some, you know, supplement. For example, you know, I might say, “Well, do you know about magnesium?” I mean, look, yeah, that’s one of the things that I recommend a lot, you know, magnesium. You know, so magnesium is like a private chaperone for your melatonin, which helps you sleep. So those are some of the things that I do. Sorry.

Andrew: Forgive me. So, I was just gonna say, from what you’ve told me, I would actually say it’s not just within your scope of practice, I would actually posit that it’s your responsibility to cover other factors that might play a part in long-term management with medications. For instance, we know that… Yeah, I mean, you’ve just mentioned 30% increase in all-cause mortality with diabetics. There’s an increased risk of kidney injury. When people are on IRBs and they have added a fluid tuber like a hydrochlorothiazide. Yeah, and then it’s also your responsibility to if they’re on, forgive me, sorry, an IRB, a CCP plus a fluid tablet, now you have to make sure that they avoid NSAIDs because of the triple whammy, which is a known massive increase of 34% increase in kidney damage. So, what to do if the patient in front of you has a sore knee? So, I would say it’s actually within your scope of practice and your responsibility to say “Okay, well, you can’t take NSAIDs. So, you’re either stuck with paracetamol or we investigate things like curcumin, glucosamine, fish oils, collagen.” So, I would actually think it is your responsibility to do that. You’re looking out for the patient’s health.

Alvina: Yeah, so Andrew, I do see that often, and sometimes I do see even prescribers, they would prescribe, believe it or not, your NSAIDs when the patients are actually on this medication and they do say, “Look because, you know, the only thing that they have in the two boxes NSAID and paracetamol, I mean, you know, what else can you offer? So now, I’m trying to expand my toolkit. And so, you know, when those patients come in and they’re taking the NSAID, like, firstly I’ll, you know, never undermine what, you know, the doctor says. And because our doctor says I can use it for about a maximum of three days, I go, “Okay, well, that’s fair enough and then, you know, I’ll warn them about the repercussion that may happen. And then to also gonna go, “Well, do you know that on long-term, these are some of the things that you can actually take.” And so that’s where I talk about the curcumin and collagen peptide. That’s one of my favourite things I actually recommend a lot for various, you know, different reasons.

Andrew: When you say for various reasons, so not just for pain relief and joint sort of support but what else?

Collagen Peptides

Alvina: Okay. So, you know, with collagen peptides, I use it a lot for sports injuries. So, for example, you know, someone would come in, and funny that, you know, because sometimes they’re coming with, it’s good for NSAID or they’re coming for or just wanting to buy something over the counter, a knee brace, or something and that’s when I start the conversation. And I always like having a conversation with people and find out, like, what’s happening? You know, I want to know. Let me know what’s going on so I can help. And the guy will look, you know, I’ve just had a twist and, like, you know, like, I did something silly, dah, dah, dah, dah, dah, you know, ankle’s now really swollen or tendonitis or whatever. And I go, “Well, look, okay, well, take the NSAID, you know, just to help with the pain, acute pain.” But to help you recover, like, I have, you know, really, really good reports. In fact, I had this person that came to the pharmacy and they were actually in the military and they really had no time to be injured. And so, I recommended some curcumin for the person and also, collagen peptide. So, collagen peptide is actually really important for connective tissue. I mean, it does so much more but, you know, so just from a repair point of view, it’s really important for the tenon and cartilage for your bones. What about collagen peptides? I mean, they’re not all the same. So, the one that I get quite excited about is actually the manufacturer is actually GELITA. And I knew of GELITA probably about seven or eight years ago. And honestly, it was through a conference that I went to and I was talking to an integrative doctor and he says, “Oh, GELITA has got really good collagen peptides.” And I was like trying to search for it and I had to jump through hoops to actually, you know, get the stuff. You know, the company was from Germany.

And so, I kind of really gave up on the search because it was just so hard. And, you know, this particular company that brought in the GELITA collagen peptides and I just got so excited. And so that’s the stuff that I use because there are so many different collagen peptides and they actually go according to the molecular weight distribution profile. So, they all do different things. So, this particular one, you know, you have, like, for example, the collagen peptide that could actually help more with the cartilage and one for the bone and, you know, certain ones, you know, for the skin. So that application. And the other way I use collagen peptides is just to help repair. You know, for example, someone I have, she comes out of a postdoc, you know, or having a gut issue and they’re not able to, you know, get a nutrient, you know, maybe they’ve got some gut dysbiosis, just maybe, not many people do. Sorry, Andrew, I was just being sarcastic there. And so, that’s how I use it as a food, you know, as almost like a protein supplement because…

Andrew: It’s kind of like going back to your bone broth.

Alvina: Yeah, it is actually a broken down a protein. So, you know, you’ve got all the building blocks that are ready to be used. So…

Andrew: Have you found that the use of collagen is displacing the historical use of glucosamine? Have you found that your collagen sales have gone up and your glucosamine sales gone down or do they work side by side?

Alvina: No, they do work side by side. I mean, glucosamine, well, that’s different… I mean, it’s a gag glycosaminoglycan. And collagen peptides, I think we got it as a proteoglycan if I’m not wrong there.

Andrew: Right. So slightly different?

Alvina: Yeah, they work differently. I mean, glucosamine sulfate, I use it a lot too, not just for the joint but for the sulfur component for the sulfation. It’s wonderful for the gut, but, yeah. And it’s a really good tool for other things. Yeah, very, very nice.

Other Co-Prescriptions

Andrew: So, what other nutrients or lifestyle interventions do you commonly use in your pharmacy? I guess what I’m thinking here is, you know, name me a GP who will talk about what I mentioned before when they’re on an IRB or a CCB, and they add a fluid tablet, and they have an increased risk of kidney disease. Name me a GP that would talk about fluid intake, to increase your fluid intake because of the sulphate action to the kidneys. Do you go into this because of attending to the risks of medications? Is this what you do with just as normal day-to-day?

Alvina: Yes. So, you know, I mean, GPs don’t tend to… I don’t know, in my opinion, anyway, unless they have, you know, heart failure, then, you know, there’s a conversation about, you know, fluid intake. But most of the time, you know, they really don’t talk about it. And actually, what I find, Andrew, is that, you know, when they’re actually on a diuretic, they tend to actually all the tests, look in the biochemistry of potassium and sodium, but what really gets missed is actually, I’ll say, magnesium. So, I talk a lot about magnesium because, I mean, the gold standard for magnesium cases, which sometimes you think it’s ridiculous, you know, we look at the plasma magnesium, which constitutes less than 1% of magnesium and we know that 50% of magnesium is in the bone, 20%, 25% in the muscle. So, it’s really… And then I actually had this conversation with patients to say that, you know, well, in terms of bone health and also with heart health, especially when they have… Well, they’re taking all these cardiovascular medications, right, and I’ll say, well, you know, magnesium could be actually really depleted and there’s no real good test. And sometimes, you know, they could present with the clinical symptoms of cramping. I mean, that’s one but sometimes, unfortunately, you know, you see them taking a CCB, a calcium channel blocker down the track and you think, well, guess what? Magnesium is also an actual calcium channel blocker. So that’s something that, you know, I try to address. And that’s where, you know, I like using… And because, you know, some patients are quite complicated and I sometimes like to use just pure magnesium, you know, generally, you know, sometimes a powder as much. I like the flexibility of, you know, using a powder where you can actually dose, you know, a bit lesser or a bit more. And that’s something that I use quite often is magnesium and people actually notice a difference and go, “Oh, I sleep better.” And as I’ve said before…

Andrew: Well, and also hypertension is one of the quickest actions I’ve found with magnesium, essential hypertension, quite incredible.

Alvina: And the thing is, you know, like I say it all the time, like, magnesium, depending on who you talk to, I mean, some data would say that, you know, magnesium is involved in 300 enzymatic pathways in the body. And I remember going to a different conference that scientists were saying, “Well, actually, in fact, it’s 600 different pathways.” And so, it’s, you know, well between three and 600 different pathways. And so, you know, when you’re dealing with stress, you know, the HPA axis and everything else, you know, and magnesium is also really important for your mitochondria function, which actually leads me to one of my favourites is Ubiquinol because it is actually required. I think the co-transport, the step… I think it was the step two and three of the mitochondria, in terms of, you know, making ATP is really important. So, someone with a heart condition and remember, you know, one of the examples is someone who actually mitral valve replacement, you know, using Ubiquinol. And she found a profound difference in terms of her energy level. And I think, you know, that is well documented and some cardiologists won’t actually dispute that. They may roll their eyes with some of the different supplements but Ubiquinol is something, you know, that they’re I think quite aware of. So ubiquinol is one with an easy… Sorry?

Andrew: This sort of goes off the back of Professor Frank Rosenfeldt at the Alfred Hospital in Melbourne. And, you know, he is with valve replacements and CABGs, coronary artery bypass grafts. He used magnesium orotate, CoQ10, lipoic acid, and selenium, and forgive me, and fish oil.

Alvina: Interesting. I [crosstalk 00:39:03] that.

Andrew: Yeah. And fish oils. Yeah. So, it was really interesting. The thing I love about magnesium orotate is that it basically works… It helps the muscle cells, particularly the myocytes, to work under deoxygenated conditions. So, [crosstalk 00:39:22], it’s a failing heart or a stressed heart. Really interesting stuff. And I think Professor Frank Rosenfeldt isn’t given enough honour because of his work for helping transplant patients to receive a heart, not just for hours post-medical, exhuming, not exhuming, but anyway, take it out of the body. So, previously, a heart would only last around about four hours out of a body. He extended that to 12 hours. So, what does that mean? It means that somebody can fly a heart from Sydney to Perth and you can still get a recipient. And that’s dramatic.

Alvina: Amazing. Wow. Wow. Three times.

Andrew: Yeah. So, with regards to CoQ10, he was also involved in the Q-Symbio study and again, looking at heart failure. But it’s really interesting work that just isn’t listened to enough by, you know, these cardiologists that you’re talking about. I’m glad that some of them are waking up.

Alvina: If a Ubiquinol is actually used in the sports and nutrition as well, I mean, that’s been, I mean, yeah, quite known for a while. I think, you know, it’s the fact I think Lleyton Hewitt was known to be taking, you know, CoQ10. And I mean, these [crosstalk 00:40:49] take a really high dose.

Andrew: Did that make his hand go like this? Alvina, we’re running out of time. So, I just wanna cover off on one more thing, and that is that I understand you’ve written a book. Tell us quickly about why you wrote that book. What happened?

Alvina: Yeah, so, when my son was in primary school, he volunteered me to do a talk. He said, “Mummy, you know, like, the teacher wants someone, you know, to talk about healthy eating. So, I thought you could do it.” And so, I thought, “Okay.” So, I have, like, I’m thinking, 25 kids, you know, in primary school, “How am I gonna capture their attention? I can’t be talking for 20 minutes. I’ll just lose them.” So, I started drawing, you know, little pictures. And so, I presented the whole story, you know, about the gut, you know, about different food. And so, when I was actually presenting, you know, so I was, like, holding up these little pictures and comics and all that, and I was actually pretty proud of myself. “Well done, Alvina. Well done.” And so, when I presented to them, like, you know, we went for about 20 minutes or so, and the kids were so engaged, and they had so many questions, you know, because, of course, you know, I was asking them questions halfway through and trying to engage them. And so that really inspired me to write a book, well, you know, drawing and illustrating. And so that’s what I did, you know, about the microbiome and, you know, how you bring a joke. So, it’s not as serious. You know, you learn best when you’re having fun, and, you know, laughing, right? So that’s what, you know, the book was like. And during that time, my kids were really into the treehouse story. I can’t remember the names. There’s so many treehouses, Andrew Jenson, not Andrew Jenson… But anyway, I can’t remember the author now. But it’s that kind of humour, yeah, that I just wrote it…

Andrew: And how did the kids deal with it? How did the kids deal with that book?

Alvina: Yeah, no, it’s good. Like, I had some parents that told me that… And even, you know, parents, were entertained because some kids are too young to actually read it. So, you know, the parents will be reading to them and, you know, they had a laugh too. They’re things like, you know, multiple-choice question, you know, what is our body made off? You know, is it cells or bananas or, you know, jelly beans? And so, they have to pick the right answer. It’s like, “Oh, don’t be silly. It’s not a jelly bean,” you know.” So, yeah, so it’s like fun… It was a fun book.

Andrew: Yeah, I think a book that has poo in it is always gonna get a giggle out of kids.

Alvina: Yes. Yes. Very true. When you talk about poo, you get a laugh. Yes.

Andrew: Alvina, your dedication to nutrition and helping patients to either achieve or regain their health after injury but also medication mishaps, things like that, I mean, it takes true dedication to lead a patient through that. And I really applaud you for your… It really is a dedication as a pharmacist, as a caregiver in the community, and I really do applaud you for that. And thanks for taking us through a little bit of what you do in your local community as a pharmacist today on “Wellness by Design.” It’s been great.

Alvina: Yeah, thank you very much, Andrew.

Andrew: And remember, everybody that you can see all the show notes and the other podcasts on designsforhealth.com.au or, of course, your best podcast at your favourite one. So, thanks very much for joining us today on “Wellness by Designs,” I’m Andrew Whitefield-Cook.