June 24, 2026

Are You Treating the Athlete — Or Just Following the Protocol?

In this episode of The Fringe, Mitch Hauschildt (sports medicine specialist and clinical director at Fringe) sits down with Corey Tremble, Director of Medical Operations for the Miami Marlins and a 20-year veteran of professional baseball. Together they dig into how sports medicine has evolved, what a truly collaborative athlete care team looks like, and why workload management is at the heart of keeping athletes healthy and on the field. Corey and Mitch share their philosophy of "loading tissue" and building resilience rather than simply reacting to injuries. Red light therapy gets a central role in the conversation — not as a magic bullet, but as what Mitch calls a "condiment": something that layers on top of manual work, dry needling, and blood flow restriction to speed recovery and reduce tissue damage. They walk through specific case studies including how RLT has transformed bruise recovery, post-op UCL rehab, and the shift away from ice as a default intervention. If you work in sports medicine, coach athletes, or are simply curious about how elite performance teams think about recovery, this conversation offers a candid look at real-world application — and why the most effective approaches are always about stacking the deck, not following a single protocol.   Listen on the go — The Fringe podcast is available on Spotify and YouTube. Subscribe so you never miss an episode.   Transcript Mitch Hauschildt: All right. Welcome to the fringe. Excited to be here. So, my name is Mitch Hauschildt. Those of you guys I haven't met — this is actually my first time hosting our podcast. I am the sports medicine and clinical director at Fringe. I've got a long history of working in the sports medicine fields, as an athletic trainer and a strength coach. My role at Fringe is to really support our clinical staff and make sure they have all the education they need, all the product they need, and everything that needs to be put in place for them to be successful. But I am also still a practicing clinician. I'm the rehab and injury prevention coordinator at Missouri State University. My days are spent doing injury prevention and rehab with Division 1 athletes, which keeps me in the weeds and busy. I get to use our products and relay a lot of that information back to our clinical friends. I'm super stoked to have Corey Tremble with us. Corey is a longtime friend of mine, has a long history of working in professional baseball. I'm gonna kick it to him and let him do his own intro. Corey S. Tremble: Yeah, no, great. Thanks, Mitch. Love being on the fringe here today. So a little bit about me — my name is Corey Tremble. I've worked in professional baseball the last 20 years. Currently, I'm the Director of Medical Operations for the Miami Marlins. In that role, I oversee the entire medical umbrella from the Major League team all the way down to our Academy in the Dominican Republic. Anywhere between 20 plus direct reports with a bunch of physicians and the whole paradigm of the sports medicine contingent. I'm in my second year here. Prior to that I spent one year with the Texas Rangers and then before that was 17 years with the Detroit Tigers. Most of my experience is with baseball which I think really plays into what Fringe does and the products they put out because we are constantly chasing workload and trying to find ways to stack the deck any way we can. In my current role I'm leveraging the doctorate I achieved at Florida International University in academic and entrepreneurial leadership — really utilizing that in creating process and feedback loops and mentoring programming and really starting to zoom out and look at how can we create a department built on trust, integrity, and a player-centered approach. That's what we try to do with the Marlins. And that's where products like red light therapy have really become a huge piece to our day to day. Mitch Hauschildt: You and I, when we first met, you were the rehab coordinator with the Tigers. You happened to stumble into a tape class I was teaching. We started talking. You guys had some of our Missouri State guys that were in your system. That's really what our background is and how we met. Mitch Hauschildt: I love what you were just saying and I think a lot of our clinical friends that are listening can relate. You've had this natural evolution of patient care now moving into a leadership role. Maybe expand on that just a little bit of how that has worked for you. Corey S. Tremble: Sure, and I think everybody in their career has these lulls where they run into kind of a wall and go like, you know, is this what I really want to continue doing? Instead of pivoting or trying something different, I just kind of leaned into how to make the zoomed in program or the athlete better. I was taking a ton of courses, reading a bunch, but it really wasn't anything next level or bigger picture. I just started having higher level conversations with really intelligent people in a lot of leadership spaces. And it just seemed that that was going to be an avenue that would fulfill that hunger I had, but also allow a bigger picture mentality that could affect growth throughout an entire department. I think in a lot of our sports medicine settings, you just go from an assistant athletic trainer to a head athletic trainer to a director of athletic training — and it has nothing to do with more than time served. And I've seen that fail because it was just a higher paycheck of the same messaging. If we were going to do something bigger and better, we were going to have to reimagine and look at it a different way. So my day to day is filled with how can I mentor my younger clinicians to find out what makes them tick and put them in the position to get to what they want. And it's also — if everybody's thinking the same, nobody's thinking. That's where different modalities and different trains of thought can really come into play. We need a forum where everybody can talk about what they've seen and really bring that back to the forefront of what we're trying to do, which is put the player in the center of all of our decisions. Mitch Hauschildt: I love that. Especially in pro baseball, you'd have guys working rookie ball for $18,000 a year on a nine month contract, slowly working up through the levels. Now it's really looking at the bigger picture. You not only have athletic training, but strength coaches, physicians, dietitians — this whole team approach. And then I'm guessing you've got some sports scientists, because you mentioned workload. Corey S. Tremble: Yeah, and to see it evolve over the last 20 years is just bananas really. Right now we're holding our major league performance meeting before every game. It has six athletic trainers, two physical therapists, two dietitians, three strength conditioning coaches, our GM, and our pitching coach. Those days of just the head athletic trainer writing down on a piece of paper what this guy is going to do today — those days are done. We have one of the more robust staffs. We travel with five athletic trainers, one physical therapist, three strength coaches, and two dieticians. That's just the major league team with a roster of 26. And then we have our facility in Jupiter with four physical therapists, two athletic trainers, four strength coaches, and three dietitians for when players are on rehab. Mitch Hauschildt: So what does that collaborative look like now? Because sports medicine was always king. You had the biggest voice, the most implication to the roster. Corey S. Tremble: For a long time, athletic trainers knew we had the biggest piece to the pie and the strongest voice. And I think what ended up happening was we're starting to phase out those clinicians that are like my way or the highway. Now it's a much more collaborative, much more inclusive approach — we make sure that we touch every single department on every single player in our lineup. Because if we're fueling them better, if we're helping them recover better, if we're doing strategies in the strength conditioning side of things to not just maintain their strength but gain strength during the season — that creates such a better net for the player to have success. One of the biggest myths in all of baseball is that you just want to maintain during the season. So you're going to tell me that we're going to take the next six months of a 12 month year and just maintain our strength? And then you're going to take a month off at the end of the season? In a 12 month calendar year, you're going to try to get stronger for less than 5 months? We've had to change that mentality. Sports medicine is really the bystander in a lot of it. It's all these other spaces that are allowing us to have the good results on the back end on paper. Mitch Hauschildt: Right. We've evolved as athletic trainers really to primary care physicians in a sense. We're the main contact point, but at the end of the day we're referring to PTs, sports psychologists, registered dieticians, strength coaches, and really tying those pieces together. And one of the big evolutions we've had in the last few years is we're now involved in conversations before we offer scholarships, which for the bulk of my career we never did. That's been good — now we at least know what we're getting ourselves into. Corey S. Tremble: At the minor league level, we're still a one man band for the most part in a lot of spots. And that's where how can I leverage different modalities? How do I do some manual therapy with this player, and also get this player going? We have to be intentional of what we're buying, why we're buying it, and how it's benefiting our players day to day. Mitch Hauschildt: So if you were to describe your practice philosophy, what does that look like? Corey S. Tremble: Sure, and I think it's shifted over the years. When I got into baseball early on, I was so manual therapy minded — we were going to just make guys' tissue feel better. And it was like, well, why are you coming in every three or four days consistently? I guess I'm not doing a very good job of making you feel better. So then it shifted to more movement-based. The body just wants to move. Muscles don't know anything besides contracting and not contracting. They just know they're using their hamstrings — the hamstring has to contract. So now the philosophy with the Marlins is we are going to load tissue. We want to make sure that if we're going to get the most out of our athletes, we need to make sure they can accept that load, they're robust, they have the capacity to increase their volume and accept the intensity that we're asking them to do. The biggest shift for me has been getting away from being scared that if we load the tissue too much, that's gonna hurt them — versus understanding that actually if you load the tissue more often, more effectively, they're going to be more robust and actually a better athlete. Mitch Hauschildt: I love that. So we have to load tissue, but then there's this word that keeps coming up — workload. Especially in pro baseball. You go back 50 years and guys were throwing 120, 150 pitches on an outing and coming back three or four days later. Now everything is about how do we manage workloads. How do you balance loading tissue with managing workload? Corey S. Tremble: I think you have to be really strategic about it and look at it from a slightly different lens. Workload has this negative connotation — like we're going to stop players from playing. Reimagine it: we're going to track workload to give you the ability to do more. We're going to take away some of this fluff that might just be adding to chronic fatigue and we're going to be really intentional with the things that are going to give you the biggest bang for your buck. Instead of the two hour lift, we're going to do a 15 minute lift. Let's figure out how much time do you really need to prep the tissue, how much time do you really need to put the tissue under tension, and let's get minimum effective dose across the board. For instance, our relief pitchers don't throw before the game in the minor leagues. Historically, guys would go throw at 3 or 4 o'clock and then not throw again until 8:30 or 9 at night. Why would you let them throw high intensity at 3 o'clock and then not throw again until game time? It's like sprinting at 3 in the afternoon for your 8 o'clock race. So now if a guy doesn't throw in the game and wants to throw, they play catch after the game. We're putting all of our eggs in the basket of being the best version of ourselves when we're asked to do that in competitive game situations. Mitch Hauschildt: What I'm hearing is intentionality. Get rid of the junk. Why are we playing catch just to play catch? And I think the workload problem in baseball isn't in game — it's all around the game. A relief pitcher going out there and throwing 16 pitches max effort — it's tough to say that's the workload that's hurting our players. What are the tools your guys are typically using? Corey S. Tremble: Sure, and I think it's definitely shifted away from pain modulation as our focus. When I got into athletic training, it was stems and ice and how can we just take pain away and stop inflammation from happening. Versus now we're much more into creating inflammation. And there's a difference between throwing the kitchen sink at a player versus stacking the deck. You should know what is creating the change or improvement that you want. It's an easy one to say that red light therapy is an easy add-on to what the athlete's doing — it's an easy piece to add to their treatment process when they're not doing any treatment. If we're being very invasive on a player through needles, through shockwave, through anything really invasive that can cause soreness and kick-up inflammation, and we want to give that player a really good recovery day the next day, there are so many avenues to use red light therapy. It's not a patient-clinician interface that has to happen for it to happen. What can we do to allow athletes to recover well when we as clinicians aren't around them? And this is where I'd always challenge anybody that says a player just needs a treatment day. We're doing treatment to put the tissue in a better spot to go load the tissue again. So it's dry needles, the blood flow restriction machines, the pneumatic devices. And honestly — and I hate saying this because it's what we do for a living — the most inexpensive best way to recover is eat better and sleep better. It's also a big part of our process. Educating on food choices, how much sleep they're getting. It's okay to get 10 hours of sleep as an athlete. Do it. We want that. Mitch Hauschildt: Yeah. I mean, I love that. And there's a difference between throwing the kitchen sink at somebody and stacking the deck. In our younger years it's like, well, I don't know what to do, so we're just going to throw everything we can think of. Then as you get older and more experienced, you start to look at, okay, I can use this tool for this mechanism, this tool for that mechanism, and I can stack them together. One of my favorite stacks we've discovered with our athletes for bruising — take a quad contusion, a guy takes a foul ball off their shin. We stumbled across this last fall: if we do dry needling with small 15mm needles throughout the area to stimulate lymphatic flow, then do red light over top of that, then put BFR on that extremity at a recovery setting — 4 minutes with 80% occlusion, a minute and a half reperfusion, repeat for 30 minutes — those guys come back the next day looking like nothing ever happened. We're getting lymphatic flow, we're regulating inflammation, and we've got blood flow being flushed into the area. That's stacking, not just throwing stuff. Corey S. Tremble: Right, and your why is really strong. Athletes are way more well-read now. They are way more intelligent than they probably ever have been. You can't car-sales them into a treatment plan or a rehab program. They really want to know the why and we should be able to tell them it. Mitch Hauschildt: Talk to me about inflammation because you mentioned you're actually introducing more of it now than you used to. Corey S. Tremble: In baseball, you have so much that's acute on chronic or chronic — it's constantly trying to play catch up. You never have three days where it's like, okay, we're just going to get this under control. It's just constantly bringing the gauge down. What really changed our mindset is understanding that inflammation wasn't the villain. Our athletes aren't coming in unable to move their elbow because of inflammation. They're sore in their flexor pronator group because of chronic workload. So it's how can we make them feel better, and how can we jumpstart the process. A lot of what we see in baseball — these acute on chronic or chronic tendinopathies — is actually a lack of blood flow, not true inflammation. By kicking it up, we're actually helping the tissue. Stacking the deck: if we use dry needles or BFR to increase blood flow to an area that's going to create some micro damage and kickstart the inflammatory process, what can we do to make sure that inflammation is doing good by us? That's where red light therapy is so great. We know there's going to be traffic, but red light therapy comes in and it's like — I'm the traffic cop. I'll make sure everything goes right. How are we leveraging the healing process? How do we make sure we're not just kicking up inflammation, but making sure that's actually benefiting us and not hurting us? Mitch Hauschildt: So I'm guessing there's not a lot of ice and NSAIDs in your training room anymore. Corey S. Tremble: No, we've gotten away from that quite a bit. Ice is for our post-game drinks. That's about it. And where do I put red light therapy in my clinical flow? Exactly what you said — the things we used to heat and ice, replace that with red light therapy. You're going to get a similar pain-relieving effect but now you're getting healing properties, upregulating cellular metabolism, working at a cellular level. Mitch Hauschildt: Is there anything specific your guys are using red light therapy for in the field? Corey S. Tremble: We're using it a ton for our post-op UCL reconstructions — putting it right over the elbow. The surgery has evolved now. They don't just reconstruct the ulnar collateral ligament — now they're also putting in an internal brace, so there's more tissue and more to heal. We're also seeing more flexor strains on top of the ligament. We're seeing them out front now where it's almost like this eccentric pull off the medial epicondyle — big pronated and supinated pitches held for much longer, so it's this eccentric pull ripping the tendon along with the ligament. There's just so much more damage going on in the elbow than with the traditional Tommy John surgery. So we have pitchers that are two or three years out that will still red light their elbow the day after they pitch, and before they go out to pitch. We're also using it in place of ice — guy fouls a ball off his shin, we're putting that on it instead of a big bag of ice. And it travels really well. Baseball is 81 road games — if we can't travel with it, it's a really tough thing for us to buy. When you showed me what Fringe had, that also changed my mind — it's cost-effective, portable, can be used every single day for every single athlete at some spot in their treatment program. Mitch Hauschildt: I have personal experience with this — we actually have a case report on the Fringe website of a post-op elbow UCL repair, which happened to be my 16-year-old son. He's a catcher. He evolved a UCL at the distal end when he was 16 — travel ball all spring, caught every game through the high school season, finished districts on a Thursday, and Saturday morning we're playing a travel ball tournament. I used red light with him after surgery, once a day every day, and his outcomes have been phenomenal. Is that the only reason? No, but it was a real game changer compared to ice. And one of the things I want to mention — we just launched our red light mats, a full-body solution. I actually think full-body red light therapy is where we're going to evolve to. There's such a systemic effect. We have so much inflammation in our bodies because of the amount of sugar we consume, the caffeine, the crap we're putting in our bodies, and the lack of sleep. Since I got my red light mat — it's just like a yoga mat with a lot of red light in it, cordless, rolls up — my body feels amazing. I'm 48, I've had six knee surgeries, I've got some miles on my body. I do think we're going to evolve to the point where that is where it's at. Corey S. Tremble: And that's what you need in baseball — something portable. I can't remember the last time we turned on an ultrasound machine, the therapeutic kind. E-STEM has really kind of died except with dry needles. IFC and all that is just really not it anymore. But the thing that's great about red light is it's like a condiment to some of the other therapies that we're doing. It's not a standalone add-on — it's an add-on in conjunction with. It's not invasive. It's not to the point where we're hurting tissue or hitting on tissue more. A really deep massage, you know that might bring some soreness the next day. Red light isn't going to do that, but it's definitely going to help. That's where it's been the biggest bang for our buck — such a great add-on to what we're already doing. Mitch Hauschildt: I love that idea of the condiment. You've got your hot dog and it's good — but it's a little bit better when you add some onions, some relish. I'm a ranch guy, so ranch can go on anything. Any final thoughts or pearls for our listeners? Corey S. Tremble: Stay open-minded. I think all athletic trainers want to say that they're open-minded and constantly learning, and you hear all these buzzwords, but then they always gravitate back to what they know works. Get uncomfortable. Get really comfortable with being uncomfortable. Challenge how you think. Challenge what you believe. And especially for our young clinicians out there — don't be scared to speak up. Inexperience can be a real superpower because you don't have biases. You don't have things that you think work or don't work. Speak up to some old guy like me and say, no, no, why don't we look at this again? I want all of my staff to think independently and critically. Everybody in sports medicine uses the tagline of I'm a career learner — well okay, then be about it. Open up your mind. Be willing to change. And I would say red light is one of the microcosms of that bigger picture thinking. I was not a big fan. I didn't believe in it. And now, from changing the way I thought, I think better. Mitch Hauschildt: Greatest moments of discomfort are also our greatest opportunities for growth. Red light therapy is all over social media because it looks really good — it looks awesome on Instagram. Us as clinicians, we naturally push back: great for Instagram doesn't mean it actually works. But in this case, you and I agree that we've seen some pretty amazing outcomes with it. It's been a really valuable tool. All right, well on that note, we're gonna sign off. Corey, thank you so much for the time. I always enjoy our conversations. Hopefully I can see you soon in person. And I do have some Marlins gear still in my closet that I pull out every now and then. Corey S. Tremble: We'll have to get you updated. Wonderful. Thank you.

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June 24, 2026

Understanding Seasonal Affective Disorder — and What Actually Helps

Alyson and Dr. Abby Kramer address seasonal affective disorder (SAD) — not just as a clinical diagnosis but as a spectrum that affects nearly everyone who lives through shorter winter days. The root is circadian rhythm disruption: when light exposure drops, so does the synchronization of the biological clock that regulates sleep, mood, energy, and hormones. Understanding this makes the solutions intuitive — get outside for 20–30 minutes in the morning, redesign your evening light environment (dim overhead lights, swap bulbs for red, amber, or candlelight), and use targeted tools to fill in the gaps. Dr. Abby breaks down the role of melatonin (a symptom indicator, not a sleep fix), the consistent efficacy of SAD lamps for morning light exposure, and why supplementing vitamin D becomes especially critical in winter months. Her target blood level is 40–60+ ng/mL, and she walks through why water-soluble D&K is worth the upgrade. Magnesium glycinate gets a strong recommendation for winter specifically — both for sleep quality and mood support, with Dr. Abby noting she personally doubles her dose in winter months. The Fringe head wrap closes out the conversation: 20 minutes before bed, delivering red and near-infrared light transcranially to support the glymphatic system’s nightly brain-clearing process. Published research on PBM and depression provides the clinical grounding. This episode is practical, specific, and timely — whether you dread winter or just notice your energy dipping with the daylight.   Listen on the go — The Fringe podcast is available on Spotify and YouTube. Subscribe so you never miss an episode.   Transcript Alyson: Hello everyone. I'm Dr. Allison and this is Dr. Abby and we're coming to you from the fringe, our podcast where we talk about all the things to make ourselves feel better and live better lives and thrive and today we are going to talk about what a bummer it is that it's so dark in the winter in the majority of this country. Dr. Abby Kramer: What? Yes. Alyson: And i'm coming from colorado where we have tons of sun in the day but it still is dark right now at five pm and it really affects you so today we're talking about seasonal depression disorder. want to start this podcast by saying i really don't think you have to be diagnosed with it the amount of people that get diagnosed with it i really feel for them because it's probably a very severe case. Dr. Abby Kramer: early. Alyson: Of depression for them in these winter and darker months but i would say for everyone who lives somewhere. In this country where it is dark at five pm and especially in if you're in the northern latitudes the midwest areas where it's dark and gray and you're not able to get sun in the day and then you finish your work day or whatever it may be and it's dark. This podcast is for you. Dr. Abby Kramer: rough. Yeah. Yep. Alyson: So yeah, so we're talking about seasonal depression disorder disclaimer. You don't have to be diagnosed with it. You basically just have to feel a little down in the winter, not motivated winter blues. That's it. Yeah. So what is what is it by definition, Abby? And then how do you sort of Abby is still in clinic. So I'm sure you see an influx this time of year of people just saying like. Dr. Abby Kramer: Winter Blues. Alyson: I'm in more pain, you know, everything relates to our mental health. They are not separate. Our mental and physical health, everything's worse. Yeah. So, so how do you explain it to patients and, and what are you seeing this time of year? Dr. Abby Kramer: I see it a lot because I live in Wisconsin and so basically Canada, right? So I mean, when I drive my daughter to school in the morning, right now we barely just started, the sun is rising when I'm driving her to school. But a month ago it was dark, right? And it's dark again at like four, 430, it's pretty wild. And I remember that growing up, I grew up in the Midwest as well. Alyson: Yeah. Yeah. Dr. Abby Kramer: and I was a swimmer and it would be dark when I went to school and dark when I left the school. And you never see the sun, Jim was inside. honestly, yikes. So I mean, our bodies are, How I explain it to patients is our bodies are designed fundamentally to be outside so much more than we actually are. And it really comes down to circadian rhythm health. So overall, even in the summer, people have problems with this, but especially in the winter, we really should be outside seeing the sun during the day. And that helps set our circadian rhythm for nighttime. So it's not really, a lot of people don't think about this, like getting morning sunlight is actually so impactful for your sleep. And if your sleep is off, everything else is off, but you know, we should be getting like UV rays and real sunshine in our eyeballs, even when it's five degrees outside and cloudy, right? We still get. that like light signaling to our body, even if it's overcast, even if it's snowing, being out for even just a few minutes a day is super beneficial. I definitely find my patients with either young children where they like are outside with them more, or even animals, dogs, tend to do better because just it's part of your lifestyle. You've got to take your dog on a walk, like, or kids tend to do a lot better. They've got recess, you know, like my daughter's school, unless it's under 10, they go outside. Dr. Abby Kramer: for two recesses a day, right? So the children, I think, are faring better getting that natural light. But the data is really just kind of like you were saying, if you feel like you have the winter blues, if you know come fall, especially for a lot of people, daylight savings is usually where a lot of people go downhill. And you just notice like it's a lot of the same keynotes for depression, low energy, lack of motivation, you don't find joy in the same things you usually would find joy in like you all of a sudden you stop doing xyz in the winter time. Low energy, low metabolism, and there's science to that our metabolism does slow down a bit in the winter and that's kind of the way we're designed to be but a lot of people feel like they don't even necessarily change a lot of their habits when they gain 10 pounds every winter. Right? So, and then like you were saying as well, think inflammation just tends to go for people as well. People with joint issues, inflammation, arthritis. You hear this all the time. People are like, I feel it in my bones, right? My pain is worse in the winter. My eczema is worse in the winter. A lot of people just, they're kind of, I don't want to say normal because it's not normal, but quote normal problems tend to be amplified in the winter months. So if that's you and you just don't feel as well, in the winter as you do in the summer, which is true for many people. The good news is there's so much you can do about it and a lot of traditional Western medicine doesn't have great answers other than prescription drugs, know, having to be on medications and so between lifestyle, light therapies, supplementation, you can make a massive impact. Alyson: Yeah, it's it's a lift, you know, it's it's an effort when what you just described is, you know, a situation within people's bodies where effort becomes even harder. But there is quite a bit that you can do to feel better in these dark and dreary months. So I definitely think we should tackle them something, you know, to help people understand when you talk about circadian rhythms. Alyson: It's really I think that's maybe a term that people don't understand it it's basically summarizing that our physiology and our biology is really set to the sun. And so inside of us are our hormones are neurotransmitters all the feel good feel bad chemicals inside of us really regulate to the sun so this sort of like. Alyson: The sun is down the sun rises the sun goes down again when you look at so many of the chemicals that we study in our body they do the exact same thing and it's in response. To essentially the sun so if you don't have that signaling when you wake up in the morning. And it's dark you right off the bat or like your body's like what's happening here because we are designed to sort of wake and rise with the sun. and then you know as our. Alyson: Bodies are waking and our energy starts to increase were supposed to be receiving all this bright blue light from the sunlight that energizes us it brings our cortisol levels up which are good we need cortisol not just too much of it or excessive it but we need it to be energized and to be productive throughout the day and then our bodies really. The one of the more powerful signal going for our bodies is the disappearance of light. Alyson: or the arrival of darkness because darkness signals melatonin, which is that hormone in our body to sort of relax us and get us in a sleepy state. So when you think of the fact that for some people, like you said, wake up dark, drive in dark, inside all day, basically, yeah, go home dark, never see real light, your physiology, all those feel good, feel bad hormones are all like, what is going on? Alyson: You know what's happening inside of me so let's start with a conversation about light and it's comical to say because the best advice to everybody is that they wake up that they go outside that they get twenty to thirty minutes of natural light every single morning in through their eyes no sunglasses. You know it'd be great if you pair it with a walk or whatever it may be but at the end of the day you are not through your windows. actually outside. I know that you're not doing that this time of year in Wisconsin. It's sunny here and I don't do that any morning. I have things to do. Dr. Abby Kramer: Yeah, and I think this is important to talk about because at least in my bubble in the holistic, crunchy world, right? Everyone's like, here's my perfect life. I'm my homestead with my homemade cheese and I'm stepping outside barefoot with my goats with the sunrise every day. Like, no. For the majority of people, it's just not realistic. Alyson: Bright. Dr. Abby Kramer: If that is you, that's amazing. But you know what? When the real feel is negative four, I'm not going outside with the sunrise. It's not happening. Alyson: Yes, yeah, yeah. And I think the compromise there is, okay, there's going to be people where it is actually just too cold. They're not going to be outside. Maybe they have little kids or whatever. I don't do it first thing. I've so many things to go do, but I do try to walk my dogs sometime before noon and get that 20, 30 minutes, or probably outside 30 to 45 minutes of bright. Alyson: Natural sunlight so that's my compromise but if you're in a scenario where for a few months that's really hard to do there are. Things that you can do to supplement like people they actually have names for them they call them sad lights seasonal effective disorder lights but at the end of the day basically people try to simulate that bright bright bright sunlight. Alyson: In their homes in the day so if you read all the research on seasonal affective disorder. You know this sort of state of sort of depressed. Way of feeling. You can go get a sad lamp you can go get a really it's a bright white lamp it's super bright you sit in front of it and you basically just. It's really intense and you basically blast yourself with bright light so that is a way to tackle these hard months we obviously we don't. Alyson: make at fringe those bright white lights you can buy them on amazon or or wherever and i think for some people they they really help we try to talk more about. of these natural wavelengths of light we receive from the sun like in the morning with sunrise this red and near infrared and then in the evening with you know sunset this red and near infrared so how are you. Talking to your patients maybe just about like lighting in their home and what you want them to be doing to try and. make a couple changes to their lighting environment. Dr. Abby Kramer: Yeah. it's like you said, I think, man, it's such, you get such a big bang for your buck and it's really, it can be a very affordable change to make for people. And it's, you know, not sexy. It's not some like fun new, you know, crazy vibration plate you need to buy. It's like changing your lighting environment. So you can go all the way, like the cheapest, easiest way to start. is at the beginning of the day, that period where it's still dark, maybe like a little bit of sunrise, at both bookends of the day, you wanna keep your lighting as low as possible. That can be just dimming your lights. That can be using candles instead of these bright overhead LEDs that everyone has in their home now, right? No one has those soft, glowy lights anymore, but I do think there's a big movement back to that. Dr. Abby Kramer: You can do like salt lamps instead. You can even buy like LED little fake candles that are more orangey. Like that's going to help all the way to there's some companies out there that make really, really healthy lighting for your home that are in like good healing wavelengths of light that are no flicker, that are low EMF. You know, that's kind of the top tier, but even if you don't have those lights right now, you can just start having really low lighting. Like I have a lot of lamps in my house. I don't like the overhead bright strips LEDs and we like dim everything and then my ultimate favorite is you know, of course I have one a lot of my patients have a red light therapy panel okay, so I tell my patients you want to have that sucker in like your main living area on the ground and have it on like the first hour you're awake an hour to before bed. Makes a really really big difference for people because that's how Dr. Abby Kramer: we're designed to see, you know, sunrise, sunset, right? Like higher red, it doesn't disrupt your circadian health. So, and they're really quite bright. I don't know if you guys could like kind of tell from that visual, but that panel lights up our entire family room area. No problem. You really don't need much else. So, and we did like, I have red bulbs in our bedrooms, in our nightstands. So, but there's companies that make ones that can switch from like, blue to red to amber based on the time of day. So the really nice thing is there is like we've been talking about, this should be like an empowering conversation, not a doomsday. We're all dying from LEDs. Like now we just have an awareness of why we feel so crappy in the winter. And there's so many easy things we can change to shift that. Alyson: Right. So basically in the day, absolutely everyone's working. We do work in some harsh lighting environments. If you can change your lighting in the day to be more natural lighting, it's really great for you. But basically in the evening, dimming your space because like what I said, when we started this podcast, the absence of light or that sun going down is what signals the release of melatonin in our body, which is our rest hormone. Alyson: and a lot of people supplement melatonin. So let's unpack that because I would think a lot of people get into these winter months, their sleep gets super disrupted because they're in dark all day, and then they're popping melatonin gummies left, right, and center, whereas light can actually be and is what's designed to be what stimulates that melatonin release. Dr. Abby Kramer: Yep. Yeah, mean, true light deficiency is really the root cause of people needing melatonin, right? So I just did a post about this, about how melatonin isn't fixing your sleep. If you need it, it's actually showing you what's wrong. If you have sleep problems and melatonin doesn't help you, then your circadian clock is probably pretty well established. But sun goes down, cortisol lowers. That is what allows melatonin to rise. So if your house is lit up bright blue like it's 2 p.m., you don't stand a chance. There's no way, right? And then that commonly shows up at least for my patients as they often explain feeling wired and tired at night. So they're physically exhausted, but their brain is going, going, going. They could like. Alyson: No cortisol stays high. Yep, yep. Dr. Abby Kramer: plow through emails at 930. Like that's so not normal, especially when it gets dark at 430. So your body thinks it's, you know, after lunch and it's time to get ready for bed. And it's really hard to fight that. And so then of course that person, I would much rather have them taking melatonin than like a sleep aid, right? Or like Nyquil. But what that really just means is what we've just said. You need to get outside earlier in the day, throughout the day, in a five minute break on your lunch. Dr. Abby Kramer: get your eyeballs on the sun, right? And dim lights as the sun goes down, just make your indoor environment in alignment with the outdoor environment. And very quickly people see a difference and then they usually can wean off melatonin completely. Alyson: Which is, it's important, like that conversation about melatonin is a hormone that our body makes. And so when you supplement it, your body is like, what are you doing? I'm making this. Dr. Abby Kramer: Yeah, correct. It's what's called a negative feedback loop. So if you are stuck taking melatonin, I really feel for you because it is kind of like a catch 22 that it can work really well and your body has then shut off making it on its own because it's present in your system from your supplement. Right? So my goal with patients is always to get them off melatonin, eventually. It doesn't have to be like a cold turkey situation where then you don't sleep. But, you know, there's good data on melatonin supplementation for other things, but for sleep support, it's more just showing you where the cracks are. Alyson: Yes, for sure. Okay, so to summarize, for me, my whole house just glows. I don't know what the neighbors think and I don't care, everybody. This house glows a nice amber-y red in the evenings. You walk in here and you may need to adjust a little bit because there isn't bright lights anywhere. I do change my light bulbs. I have incandescents. They have a low, like, glow to them. Alyson: I have those over my kitchen island, which is the busiest place. Dr. Abby Kramer: And tell people too, when you switched to that, you immediately feel different. It's nuts. Alyson: Yeah. You immediately feel different. It's so for your kids, for you and your family members in your home, just saying, OK, I'm going to try and make, if you have one, some sort of panel, use it to illuminate the room that everybody's kind of hanging out in after dinner. It's after the sun goes down, low and dim lighting in your house. The panels are a red wavelength of light that we do receive through our retina in our eyes and have a lot of effects on our physiology. But it's just it's so important for me to then honestly say to that that darkness, lack of sunlight is so important for our bodies too, so don't take it like i have to have a red light panel to illuminate my home. Nope. Alyson: That's not the message here the messages that bright light in the day needs to be natural in the evenings our environments need to be dim. And low, you know, orange-y, red-y environments if they can be. If not, like you said, just dimming your lights, keeping the darkness there so the body isn't confused in the evening. So that's a summary on light. I would say the panel for us, a lot of people use it on their body which can have a lot of benefits for depression as well too. You can sit 10 to 12 inches from it and just take light in all through basically like a third of my body. I do eyes closed just because it's so bright and I just do that. Dr. Abby Kramer: And you do eyes closed. Correct. Alyson: As a session which also is helpful for depression. So just switching from my home environment, how does that affect things? Also there's a lot of things you can do for your body to make you feel good. Before we talk about the internal environment and talk a little bit about the lack of sunlight and that effect on vitamin D levels, let's talk about magnesium because I know that you recommend that for a lot of your patients who are dependent on melatonin, wanting to improve their sleep, depressed, all this sort of stuff. Dr. Abby Kramer: Magnesium, man, it's probably up there in my top three supplements that everyone should take every day for a million reasons. This being one of them. It's such a low lift, big bang for your buck, relatively inexpensive. You know, if you struggle with stress, sleep, you want to address heart health, inflammation levels, muscle tension, like magnesium, headaches, I could go on and on. But magnesium... Dr. Abby Kramer: is really effective at helping to calm. And so, I mean, there's a reason so many people, it's like been a trend for a couple years now on TikTok, like magnesium cocktail before bed, right? There's a reason because it's super effective for a lot of people. And magnesium also helps lower cortisol. which we were talking about earlier. So many people, I do a lot of hormonal and cortisol testing in my practice and so many people are high cortisol at night. when you do a cortisol map test, which kind of maps your cortisol throughout the daytime hours, right? A lot of people get a spike at night. In my opinion, that's hugely due to light environment, right? So nighttime, body doesn't know what time it is. You're looking at, you know, blue light right here in your face. Hi, right? Anyone here that feels like they get a second wind, like, at 9 p.m., I'm like ready to go again at 7:45, I'm exhausted, but then I get a second wind, that's a cortisol spike. Magnesium is super powerful at lowering that cortisol. Thus, in a roundabout way, magnesium can also help melatonin, which we were saying. But I also really love one of the forms of magnesium in our product is magnesium glycinate. And glycinate specifically, glycine, is very effective at calming the mind. So especially if you're the type of person where you're tired, but your brain won't shut off at night, you lay down and you're like making lists in your head and thinking about the day or the next day and just can't shut your brain off, magnesium could really help that come down. So I love to have my patients take it, you know, after dinner, an hour or two before bed, somewhere in that window, just part of their kind of nighttime routine. And it really is helpful. Alyson: Would you say for patients that sort of are in the winter blues, seasonal affective disorder, are they taking more magnesium than normal or just normal amounts? Dr. Abby Kramer: That's a good question. I would say more the people that struggle with a specific symptom would take more. So a good example would be people with more pain and inflammation during the winter. People that get a real bad second wind and can't sleep. People that are more stressed out, more anxious in the winter. But I would always tell people first start out with like one dose a day at night and see. If that does it for you, but if you feel like you take magnesium and it does great and you don't feel like it works as well in the winter, then you certainly could double up on the magnesium you're taking, especially if it's one like ours that doesn't disrupt the gut and have any negative digestive effects. Alyson: Yes. Yeah. I'm doing two scoops right now. And that's new for me, doing a scoop in the morning, always do a scoop at night, but doing a scoop in the morning, just to see if it helps with some of the inflammation, that sort of stuff, you know, that happens more this time of year for me, plus just hormone stuff as well. Okay, so vitamin D. So if you pull up seasonal affective disorder, and you read about it, and you read the research, yes, there's a lot of pharmaceuticals that are prescribed, a lot of antidepressants. Basically, that's first line of defense. If you go in, doc, I'm really feeling down, like here's all my symptoms, you'll more than likely be prescribed antidepressants. We've talked about light, we've talked about magnesium as two really incredible approaches to help with some of the symptoms. But the interesting thing is starting to look at vitamin D, which we talk about a lot. Alyson: how we're so deficient in light and what those effects are on our circadian rhythm. But the effect on our vitamin D status and the impact of that on more than just being able to fight the average cold and flu is staggering. So talk about vitamin D, mental health, physical health, like the whole picture. Dr. Abby Kramer: I mean most people realize this because they notice, they just feel a better mood in the summer. Or even like today, the sun's out. I was outside with my dogs, it's like 30 degrees, I'm like, it's amazing, I wanna stay outside, right? you just, I mean, some people are now classifying vitamin D as more like a hormone. It's like one of the happy hormones, right? And we make it naturally from the sun. So like how we were just talking about, then in the winter, we especially don't see the sun. You like don't stand a chance at making vitamin D, which kind of like magnesium is so foundational for so many effects in the body. But I mean, I could go on all day about patients that actually I think don't really have seasonal depression. They just have extreme vitamin D deficiency. Dr. Abby Kramer: I've seen people in the single digits. For reference, I want people between usually 40 to 80. 60 is like a great target in my practice and I've seen people at like eight. The majority of people I test, even in the summer, are under 20. I mean, it's shocking. And they will, most Western medical doctors won't even test their vitamin D because they tell them it doesn't matter. Even if they will, the scale, the normal range for vitamin D is between 30 and 80. That's such a massive range. So patients test and they're like 27. They're told, ah, you're fine. You're close enough. And I'm like, oh my gosh, at 27, you probably have pain. You're probably inflamed. You probably feel depressed or anxious. And they're like, yep, yep, yep, yep. You probably get sick all the time. Like it's such an easy fix. It makes me so mad that basics like this are missed. Dr. Abby Kramer: And they're told to go on medication. And it's like, let's just get your vitamin D up and see how you feel. So I've had, I just had a patient, kind of the perfect storm postpartum, baby blues plus winter blues, really not feeling well, considering medication. Her doctor of course said blood work isn't important. She doesn't need it. So we drew labs. Her vitamin D was like 13. I put her on a higher dose and in like a week, she was better. So it's just so impactful. So I always tell people start there, you know, because a lot of people for whatever reason, light environment, not being outside enough, genetics, they just don't absorb vitamin D well and especially in the winter. Dr. Abby Kramer: It's such a no-brainer to get your levels checked. And a lot of people need to take two or three times their normal dosage in the winter to maintain a healthy level. There's a genetic thing, it's called a SNP, it's like a blip in your genes if you want to look at it that way, that makes it so it's really hard for you to absorb vitamin D and to get your levels higher. A ton of people have it. A lot of people don't know they have it. I'm this case, so I have to supplement vitamin D year round. Even in the summer, I would be under 30. It doesn't matter if I was at a soccer tournament all day long. It doesn't matter. I just run low. And so I always encourage people, we say this at Fringe, like once a year, at least get your vitamin D levels checked. You can now just go get that yourself at most lab companies. It's a benign test, and see where you're at, because then you can really customize your dosage for your physiology. Alyson: Right? Yes, because you can take too much vitamin D. So here's an important fact, because we get asked this all the time. We make vitamin D in our bodies through the absorption of UVB light. None of the red light therapy products you buy in anyone's markets have UVB light. There's very few products that have UVB light in them, but your tanning salon does. Alyson: So we make vitamin D in our body from the absorption of UVB light on our skin. Think of your environment — not through clothing, not through sunscreen, not through your windows. So if I even think of myself in the summer, I don't want to burn, so I protect and try to avoid midday sun and just wear hats or covering or whatever. But in no way or form am I getting hours a day of sunlight through the majority of skin on my body. And I don't think most people are. The lifeguards, power to you, you probably are. So I do think you're right. Some people in the summer, they don't need to supplement vitamin D. They get enough light exposure. Their genes are right. But for the rest of us, it's pretty hard to get that much UVB exposure. Alyson: Which is why we talk, when we started making supplements, I said to you, as the worst supplement taker possibly in America of all time, I said, okay, I think this is gonna be a great pair because you and our scientific director, Jen, are so knowledgeable and so good at this stuff and you guys would like drink mud if it was good for you. I'm not drinking mud. Alyson: I need it to taste good. I need it to be easy to do. And I hate pills. So Fringe, owned by the worst supplement taker in America, now has to create a good balance. And so I said to you and Jen, I said, what I want is a very honest account as to what we tell people is actually essential to take. There is so much we can take that helps us. I want a company to be honest about what you actually need to take because you cannot get it every day from the environment we live in. And yes, there are some exceptions to the rule with some people with vitamin D and some exceptions to seasonality. But for the most part, for most people, supplementing vitamin D is essential. Alyson: Then we went down this road of making vitamin D. And I do think talking about vitamin D for seasonal affective disorder is so important. It should be foundational that if you are feeling down in these dark months, that you go test your vitamin D levels, and you understand — ask your doctor, can you please check my vitamin D levels? They're 27. You know what? I'd like that to be 50 or 60 or 70. And then you start taking vitamin D. So then you go to Walgreens and you stand there and you look at the sea of vitamin D and what do people need to know, Abby? Dr. Abby Kramer: They all suck. Turn around and walk out the door. Because this is the other thing I have seen over and over and over again in 10 years is that many of the people with the vitamin D of 27 are actually taking vitamin D every single day, but they're taking a poorly absorbed form and they're taking a dose that is way too low, that it will never raise their levels. So most if you guys go in Walgreens, even Whole Foods, I'd say the standard over the counter vitamin D supplement is around 1000 to 1500 IUs. And they'll say that's the daily recommended dose, right? One capsule, one squirt of your tincture, you get your 1000 IUs. Dr. Abby Kramer: Most people need 4,000 IUs a day to even maintain their levels. So that's not even to raise them. right? And let alone raise them quickly. So it can take quite a bit of time. In my practice, I will put patients on a very high dose for a few weeks, and then retest their labs to move the needle so that in a week or two, they're feeling better, right? So 1000 to 2000 IUs is just not going to do that for most people. Which is why most higher quality vitamin D supplements you will see, the average dose is gonna be around 5,000 IUs in a capsule, in a scoop, in your daily dose, and it needs to also be, for the people listening, vitamin D3, which is the active form of vitamin D. Dr. Abby Kramer: Many Western medical doctors actually prescribe prescription strength vitamin D that you have to get from the pharmacy. And it's vitamin D2, which is the inactive form. So people will be taking like 20,000 IUs of vitamin D2. Their levels are still low. It's like, yeah, because you don't absorb it well. It's not the active form. Alyson: And so, so there's the form of the D. There's also what it's paired with, which can you talk about, and then we'll talk about the delivery oil versus what we went and did. Dr. Abby Kramer: Yes. So most super high quality vitamin D products are also paired with vitamin K, specifically vitamin K2. So a lot of people get that confused and are like, doesn't that give you bleeding disorders or whatever, because they've heard of K1. That is kind of responsible for that and blood clotting and all of that. Vitamin K2, it's actually not really for the absorption of vitamin D, but it's really important that D and K go together. Think of them like superhero sidekicks, right? So what D does when it gets into our system is it frees up a bunch of calcium. If you do not have enough vitamin K2, which, spoiler alert, you don't — it's in really weird foods we don't eat enough of. Much like vitamin D, much like magnesium, most people are deficient in K2. K2 is really, really cool. It goes and scavenges all this free calcium in our tissues and puts it back where it needs to go, which is the bones and the teeth. So there are studies on K2 and osteoporosis. It's amazing. It's amazing for heart health. There's studies on athletes supplementing K2 and their aerobic capacity increases as if they were training in altitude just from supplementing K2. It's so cool. So D3 and K2 should go together, especially for that calcium regulation. Dr. Abby Kramer: Because if we have a bunch of free calcium floating around in our system, which so many of our foods are fortified with calcium, it can stick to the arteries and then plaque sticks to that causing atherosclerosis. It can cause stones. A lot of people have kidney stones, bladder stones. It just builds up in places it shouldn't go because you don't have the vitamin K2. So especially if you are taking a higher dose vitamin D in isolation without K2, you want to pair those together so you don't end up with issues down the road. Alyson: Correct. And then for me, who was taking 5,000 IUs of vitamin D regularly as like a general daily dose, but taking it in an oil format. There's actually nothing wrong with it in an oil format. You just need to know the nuances of the fact that when we take any supplement, not just vitamin D, any supplement in an oil format, the absorption into our small intestine is really reduced. It's affected by what we're eating when we take the supplement and just the fact that oils are very poorly absorbed. Dr. Abby Kramer: Yeah, it still works. You just need more. Alyson: We dove into that. We knew quite a bit about making water soluble supplements at the time. I was super excited because my vitamin D was in a capsule and I'm the worst pill taker in the world. So we went down the road of making a vitamin D K supplement that's in a powder that people can take 5,000 IUs and actually get 5,000 IUs, which is really important. They don't have to take as much of our supplement to feel the benefit of supplementing vitamin D. Dr. Abby Kramer: Yes, and I feel like a huge benefit of it as well is because so many people don't eat breakfast, right? They're running out the door, whatever. Vitamin D and vitamin K are fat soluble vitamins, meaning they're oils. Meaning in order to absorb them, you have to eat something with fat in it, which a lot of people don't. Either they're having a quick smoothie or they're not eating till 11, but what are they doing? You wake up, you take your supplements, you run out the door. And so then that's also working against you to absorb the vitamin D. Right? So you need to do the food or your kids are picky. They don't want breakfast that day. It's kind of a mess, right? So you're just doing your best to get it in them. But it's so poorly absorbed when it's in an oil format. And that's what I've seen with patients on oils. They'll have to take 20, 30, 40, 50,000 IUs to really get their levels up because also how many people's guts don't absorb things well? They have gut issues, they have leaky gut, they have low enzyme load. So this just makes it so easy and takes the work off of your body too. It's completely flavorless. I have moms that sprinkle it on their kids' oatmeal in the morning and they eat it, right? But you can put it in water, a smoothie, juice, whatever you want. It's so easy. Alyson: Yeah. Yeah, if everyone else out there is just a normal person trying to navigate feeling better and living on this earth, I'm with you. Send me an email. So if it's easy to do and easy to integrate, you know that we're going to try to have it be a part of products that we offer. Okay. So I think that that's amazing. Change your lighting. Alyson: Look at what you're doing to support your sleep. Consider looking at melatonin and what you're doing. Magnesium, foundational and so important. Vitamin D, really, really critical for how you feel during these winter blues. There's one thing that we forgot to talk about and we'll close out our talk today on it, which is the Fringe head wrap. This is designed to deliver red and near infrared light into your brain. And there is definitely some really great information out there about depression, severe depression, studying and looking at red and near, mainly near infrared light absorbed into the brain to help with inflammation in the brain. Alyson: And then also the brain's ability to kind of rid itself of toxic buildup or waste. So utilizing this hat, this head wrap, and actually utilizing it at night before you go to bed. So doing your 20 minute session before you go to bed at night. When you sleep, that's when your brain washes itself. It's when a lot of your body washes itself, but especially your brain at night. Alyson: That's when there's a system in your brain called the glymphatic system. It's basically like the lymphatic system in our body, but for our brains. And it washes your brain and gets rid of any sort of gunk that's built up in there throughout the day. We've had some incredible testimonies of people with mental health and other mental health struggles utilizing this before bed. So seasonal affective disorder, lighting in your house, magnesium, vitamin D K, and then also looking at treating your brain with some light. Dr. Abby Kramer: The last thing I would add, for a lot of my patients, I think it's almost like a constitutional thing you're born with if you're just really struggling with the cold winter. Honestly, I like prescribe them — you have to go on a vacation somewhere warm. Like it makes a real difference. If they know in February, I'm going to Florida for a long weekend or whatever, it honestly makes a big difference. It's really underrated. Get somewhere where there's more sunshine and where you can have some time off. That can really boost your vitamin D levels really fast if you're somewhere outside that's warm for a bit. Alyson: Right. So now we've prescribed you a vacation as well, which is really important. I will say, you know, like you said today, it's 30 degrees and you got outside. It's not the easiest thing to force yourself outside when it's super cold. But I do it for the dogs. I just thank them in the process because there I am, out there, and I'm like, oh my God. Dr. Abby Kramer: Yeah, it's helping you too. Alyson: I'm also not the person who's like, ooh, I am really enjoying this. Walking these dogs in the freezing cold, you know, it's like, I'm like, wow, this is extremely cold. And I'm head to toe geared up, but you know, the more we push ourselves to do things like that, the easier it becomes. Dr. Abby Kramer: Listen, our ancestors were still having to be outside regardless of the weather. Like, it's not fun, but they were out there and it helped their bodies in a lot of ways. Alyson: Anyway, thank you for listening with us today talking about the winter blues. They're almost over guys. Sun's setting here now like 5:30, which seems celebratory because it was 4:30 about three weeks ago. And I think the seasons are extremely healthy for us. So for our southern neighbors who don't know the struggle that we're on up here, we're just going to come vacation where you guys live all year. Dr. Abby Kramer: We got more grit. Yes. Alyson: Yes, but we're tougher. We're tougher than you. Just kidding. OK, thanks for joining us, everybody. Bye bye. Dr. Abby Kramer: Bye.

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June 24, 2026

From Sunlight to Supplementation: A Deep Dive on Vitamin D

Dr. Abby Kramer and Dr. Genevieve Newton take on vitamin D — arguably the most important supplement most people are still getting wrong. The episode covers the basics (D is fat-soluble, comes from food, sun, and supplements) and quickly moves into the nuances: D2 vs. D3, the superiority of D3 for raising blood levels, and the question of source — most D3 comes from lanolin (sheep's wool), while Fringe uses lichen-sourced vegan D3. K2, sourced from natto, rounds out the formula by directing calcium to bones and away from arteries. What makes Fringe's vitamin D product distinctive is the delivery mechanism: a water-soluble powder rather than an oil-based capsule. Because vitamin D is fat-soluble, it's typically suspended in oil, but the Fringe formulation achieves roughly 2x the bioavailability of standard oil-based D3 — meaning 2,500 IU in their product functions like approximately 4,000 IU from a conventional supplement. Dr. Gen covers the deficiency statistics (94% of Americans don't meet the RDA from diet alone) and explains why the commonly recommended 600 IU daily is almost certainly insufficient for optimal health. The target blood level conversation is practical and actionable: aim for 40–60 ng/mL, test regularly, and don't be surprised if you need 5,000 IU or more to get there. This episode gives you the science to make informed decisions about one of the most foundational supplements in a wellness routine.   Listen on the go — The Fringe podcast is available on Spotify and YouTube. Subscribe so you never miss an episode.   Transcript Abby: Hello everyone, welcome back to the Fringe podcast. I'm Dr. Abby Kramer, the medical director at Fringe, and I'm here with the lovely Dr. Genevieve Newton, our scientific director, and we're here to have a conversation about vitamin D, because it is the season. Genevieve: Yes, ma'am. Abby: All right, so Jen, can you please tell us a bit about vitamin D? I feel like everyone has heard about it, but just so our listeners can better understand what exactly is vitamin D and what's its role in the body. Genevieve: Yeah, because it's actually a confusing one compared to some of the other nutrients that we have to intake on a daily basis. okay, let's start at the basics. Vitamin D is what's called a micronutrient. Those are our vitamins and our minerals, meaning we need them in very small amounts, but they are essential for health and many of them, you know, are literally essential for life. So, we get into this micronutrient category of vitamins and then we also have a division between water soluble vitamins and fat soluble vitamins. So vitamin D is a fat soluble vitamin which actually means that in fact we don't necessarily need to take it in on a daily basis which we certainly do recommend that you do but your body stores fat soluble vitamins for a period of time as well. So water soluble vitamins will be excreted quickly, fat soluble vitamins will be stored. Now everyone's probably heard that vitamin D is called the sunshine vitamin and that's because unlike other nutrients, we have another non dietary source of vitamin D and in fact this other source of vitamin D is in fact the dominant really source throughout our evolutionary history. Meaning when we are exposed to the sun and it hits our skin there's this chemical pathway that takes place by which vitamin D essentially gets synthesized in the skin and it gets transported throughout the body and it can do all of these amazing things that we know. No it does. So really we can say that we have three sources of vitamin D. We've got food, we have sunshine, and then this third source is where fringe comes in and that is that we have supplements as an additional source of vitamin D. We need an additional source of vitamin D because dietary intake and distribution in food tends to be very very low. We'll talk about that probably in a little bit. Another reason why we need it is because for example you and I living in cold climates, northern latitudes, and we don't get enough exposure to sun. Even people who do live in climates where they can have sun exposure during the day, many of them are working indoors or they're wearing sunscreen, they're limiting their sun exposure. So we tend not to, on aggregate on a population level, get very much vitamin D either from our food or enough from sunshine. And so we end up needing this additional intake of vitamin D through supplements. In terms of what it does in the body, Genevieve: So historically speaking if we were to go back into the early 1900s people really recognized the importance of vitamin D because it became very obvious that when individuals didn't have it they ended up with this skeletal deformity called rickets and so you would see these children that would grow into adults with this deformity where their legs bowed out. That was because their bones were essentially soft from a lack of dietary intake and a lack of sunshine. And so for many many years the scientific community and the medical community really focused on vitamin D as being essential for bone health, which it absolutely is. But in the meantime, we entirely missed the boat of recognizing that it was actually involved in all of these other biological processes as well. And really, I would say that at least as important as its role in bone health, and perhaps more so, is its role in regulating the immune system. So it's a primary regulator of the immune system. we look at the genes in the body that are regulated by vitamin D in some way or another, are hundreds of them. There are so many biological processes that depend on vitamin D being present in order to function properly. So we see things like and anti-inflammatory related to immune function effects. see brain cognitive effects relating to things like mood and dementia and Alzheimer's disease. We see cardiovascular effects. So you've got this whole bucket of your skeletal system, which actually ends up being not just the skeleton, the musculoskeletal system requires vitamin D, but also all of these other things as well. So it's a very important nutrient. but it's not just a nutrient. We have this other really, you know, source, reservoir of it that is coming from our sun exposure and then we've got this bucket of supplements that we really need because of our modern lifestyles. Yeah, so it's extremely, extremely important and I know Abby that you would agree with me on that and I know that you love supplementing or vitamin D is one of your favorite supplements to use in practice. So Genevieve: Who do you recommend it takes vitamin D? Or, and who don't you recommend take vitamin D? Abby: Yes. I mean, first, the simple answer is pretty much everyone. And I know that's like boring and sounds like too good to be true. It's kind of like the red light conversation, honestly. It's like, who couldn't benefit from red light therapy, right? However, I feel like the individuality is dependent on the person, on their lifestyle, and on their lab work. You know, if people... I recommend everyone every six to 12 months get a vitamin D test done. Because everyone is so different, their amount of sun exposure is different. Most, vast, vast, vast majority of people are deficient and at least need a maintenance dose of vitamin D to maintain healthy levels. But some people are so deficient, they really need to do a high dose for a handful of weeks. And then I like to recheck their labs, right? Because some people respond so well to supplementation. they can end up with really high levels really quickly. Some people can take months to get their levels to like a healthy, optimal level. So the short answer is everyone pretty much. I've seen a couple unicorns in 10 years that have healthy levels without supplementing, but like I could count that on one hand. The vast majority of people have kind of, from what I see, like a winter time dose and a summertime dose. They certainly might not need as much in the summer months, but I'm one of those people I need to supplement year round. I supplement more in the winter, but if I do nothing in the summer, even with being outside with my daughter and dogs and all of that, it still isn't enough for me to be kind of optimal. The only people that I pull off is if we pull out work and they're really high, which that has happened to me a few times with people, especially in winter, especially during the pandemic. a lot of people rightfully so. The data was very clear that if you have robust levels of vitamin D, you do a lot better with a COVID infection. So people were like, great, and going ham and doubling down, taking 50,000 IUs every day for a year. And their levels are too high, right? So then you can pull off, pull off for a couple months, recheck your levels, and find a good maintenance dose. But pretty much everyone needs it, honestly. Genevieve: That really speaks to what I was saying about and it illustrates how it's something that we store in the body because it's fat soluble. So yeah, you can take breaks and there are different supplementation strategies and we can maybe talk about what we see in the clinical literature and what protocols you like to use. But I would say like the scientific literature is certainly in agreement with what you're seeing in practice. There's no doubt about that. But where things get really kind of Genevieve: Murky is how do we define deficiency, right? Like what is the definition of deficiency? And first of all this raises confusion with respect to okay. Are we just looking and measuring deficiency with respect to how much dietary intake someone has or are we going to use those blood levels and use those as our metric of deficiency? And I think you and I would certainly agree. We want those blood levels to be the reflection Genevieve: of what's deficient. Now, but where things get even more complicated is that even if we look at those blood levels, we don't have a uniform cutoff that is universally accepted by different medical communities and it's all over the map. Abby: correct. Well, in the normal range is like, I mean, on standard labs is like 30 to 80, which is just such a massive range, right? So people are told, you know, they come back with levels at 31 and they're told you're perfect. You know, meanwhile, they're like depressed and have all these other problems. So it's, it's really hard to find a consensus, but like you're saying, that's also, everyone is also so different. Like for someone. Genevieve: Right, meaning the... Abby: They might feel great, have a healthy immune response, feel awesome, and they're like cruising at 48. And maybe that's a good level for them versus other people might like really need to bump it higher. Genevieve: Mm-hmm. Yeah. Genevieve: Yeah, it's definitely one of the vitamins where we have the greatest amount of inter-individual variation. But one of the things that I remember reading the statistic and being just blown away by it is is if you look at the dietary intake, so that's only vitamin D coming from food, not including coming from supplements. So you start there and you say what percentage of the population has a deficient dietary intake. Statistically speaking, it is 94 % of people over the age of one on the most recent American survey. And that's using the conventional amount of the dietary Abby: Yeah, right. That's a low bar, too. Genevieve: That's confusing the conventional RDA of 600. It's 600 international units a day. So at 600 international units a day, 94 % of people over the age of one don't meet that 600 level. Now, are a significant, or there is a significant percentage of the population, including children and adult males and females that do supplement, but that supplementation range is all over the map. So some are taking 200 units a day, 400 units a day 600 all the way up to you know 10,000 or even more. And then what you're seeing in practice when you get into looking at what those blood levels are then again we end up being all over the map. So if you have two people that are doing the same supplementation protocol eating the same diet their blood levels and specifically what we're talking about our blood levels of 25 hydroxy vitamin D which is that biomarker of vitamin D that we use as a lab map. Abby: Yeah, yeah, yeah. Genevieve: metric, they can be very different from one another. this has to do with things like how is someone metabolizing vitamin D? You have protein that transports vitamin D around the body and takes it to different places where important things happen and that's different between different individuals. So if you're somebody who is missing this vitamin D transport protein insufficiency, you're not going to have high levels no matter how much you intake. There's polymorphisms of receptors, there's differences obviously in people's Genevieve: sun exposure, there's shocking differences related to body weight and how that affects people's vitamin D status with overweight and obesity causing a lower level overall. So those individuals can require a greater level in terms of their oral supplementation dietary intake. So the reason I think that you're so bang on with telling people this is something that you know we can come up with a strategy and I can give you a general recommendation for some Genevieve: supplementation, but unless you test and unless we can look at that number and see how you're responding, it's going to be really, really hard to know what the optimal protocol is for you. Now, I'm curious, what sort of like clinical responses have you seen in practice using this over a decade with your patients? What do you see with respect to how people respond to supplementation? Abby: okay, I'll go through, let's say like the top three, four things. Number one is obvious for people immune system. So those people where you hear this goes for adults and children. They get every cold that comes around. They're constantly sick. All winter long, it's like you're sick, you get a few days break, you're down with the next thing. You're around, you know, family that are sick and you just, always get everything. That's like a low immune response. You get your vitamin D levels up. People are like, this is the first winter in three years. I haven't really been sick. So that's a huge indicator even without testing. If you or your child are the people that are always saying they're sick. start taking a vitamin D supplement, get your levels checked, get it higher than like 32, you know, and just monitor that. Another huge one that isn't talked about enough is mood stabilization. So depression and anxiety. It's the sunshine vitamin, the sun makes us happier, vitamin D makes us happier. And that's a big one, especially for seasonal depression folks. We talked about this a little bit on the seasonal depression podcast with Allie, but a big one to address that people forget about a lot. Genevieve: Yeah, absolutely. And I mean, from what I've seen, that's entirely consistent with the scientific literature. So what is pretty remarkable about vitamin D is it actually has been subject to some pretty rigorous clinical trials, some of which were massive and extremely well-funded. And it's a bit complicated to dig into. Genevieve: Because when you do look at all of these studies, you see that, you know. They're confounded and it's difficult to compare them one to another. Certainly some of them were better conducted than others. But with respect to the clinical outcomes that we've looked at, like you mentioned the depression studies and yeah, the depression that you're seeing in practice and there are studies that absolutely support that. There was another really interesting cognition study that I saw where healthy adults that took vitamin D showed improvements in memory. from supplementation. So they weren't necessarily showing cognitive impairment, but they nonetheless showed improvements in memory. Most of the studies on vitamin D early on really, really focused on that bone mineral density outcome. if we break down the mechanism of how vitamin D affects your bones, what's going on is that it increases the absorption of calcium from the gut and then through effects that involve vitamin K, Transport that calcium to your bones and your teeth and then you get stronger bones you get stronger teeth So a lot of studies were first of all looking at okay Can we supplement with vitamin D and improve things like bone mineral density and decrease the risk of fractures and again the studies have been have been challenged by methodology issues so for example they almost never include vitamin K so most of the studies of vitamin D supplementation didn't include vitamin Genevieve: Now they got better at making sure that they supplemented with calcium as well because if you take vitamin D and someone still has low dietary calcium well then that calcium is not gonna get like there's no calcium to absorb right so you're not gonna have bone benefits and then as you mentioned like a lot of your response depends on where a person is starting from so really when you do a study where you want to look at what the supplementation outcome is you want to know exactly what their vitamin D status is at Genevieve: baseline and that's not always done consistent consistently in the literature either but despite these issues we still see a lot of research that shows bone benefits we see research that shows improvement in in the teeth like so for example decreased dental cavities There's some infection research that shows, as you mentioned, COVID, for example, like a reduced incidence of viral infections. Absolutely. There's also some really interesting cancer research. So cancer studies, in terms of the incidence, are hard to do, right? Because it takes a long time for cancer to manifest as an outcome. Most clinical trials don't run for 10 years. That being said, there have been some studies that have associated vitamin D or have demonstrated that supplementation can. reduce the incidence or is associated with a decreased incidence of a few different types of cancer which isn't surprising because the immune system is what manages the development of cancer and exactly exactly so if you if you look at that as an outcome it's not surprising improved biomarkers Abby: Correct, I was gonna say it's an immune system disease. Genevieve: like C-reactive proteins. So again, relating to the immune system and inflammation, supplementation with vitamin D has shown that. People have shown benefits in blood pressure, like reduced blood pressure. There have been some broad studies that have looked at just general mortality and have found a decrease in all-cause mortality associated with supplementation. So yeah. Abby: That's what I wanted to, I wanted to speak to inflammation too, because, and see what you had to say about the literature, because I've seen with some patients too that were under the, let's say it's like a woman in her mid forties is like, I think I'm starting to get like arthritis in my knees. Like I'm having this weird joint pain and we get their vitamin D levels up and it goes away completely. Genevieve: Yeah, so there's definitely, and I mean, just studies looking at C-reactive protein. It's a very simple biomarker for inflammation, has shown a reduction in clinical trials of vitamin D supplementation. Polycystic ovarian syndrome is another one that has shown benefits to supplementation. And so I know you've done a little bit looking at some of the literature on women's health and vitamin D supplementation, and it's pretty remarkable. Abby: I mean, a lot of people refer to vitamin D as like, it almost acts more like a hormone in the body. Yep. Like it's not only a vitamin, you know? Genevieve: Well, it is a hormone in the body. Yeah, yeah. So when it comes into the body... No, no, that's and that's why I said it's it's a confusing it's almost a misnomer to call it a vitamin because so you've got when it's when it's synthesized in the body through sun exposure that's not a vitamin at all right the vitamin part means that it's a micronutrient coming from the diet when that comes in it undergoes these hydroxylation reactions that actually make this hormone and the hormone Genevieve: is what triggers these biological effects. So really when we get to looking at like, what is vitamin D doing in terms of its actions in the body? Well, by that point it is a hormone. And so technically that's the correct term to use once you get to that stage. But if you're looking at it from a dietary source or a supplemental source, the correct term to use would be vitamin D. And of course there are molecular differences between what those molecules look like. Genevieve: So yeah, what do you recommend for protocols for your patients then? We've talked about differences related to what people's baseline blood levels are, but do you have like a standard protocol that you like to go to? Abby: Um, it of course depends on the person, but I would say if I'm making generalizations on average, I'm having adults do like 5,000 IUs a day. I feel like that's a really good... therapeutic dose that will slowly for most people raise you over time, but not too aggressively. So if people, they're in a winter climate, you're indoors quite a bit, you know, you're probably low on vitamin D. That's a pretty safe dose to take. And that's kind of the equivalent of what we made our DK product at. Some people less, some people a lot more. I do pretty aggressive high dose protocols with patients that are really low, but I only do that if we see it on blood work first. And then I'll always, I'll put them on whatever protocol. Like I've put people on 20,000 I use five days a week, take a couple days off. that for a few weeks, four to six weeks, then recheck labs, then see where you're at, and then we know if we need to stay high, potentially go higher, or back off. But that's more based off of not just their number, but also their symptoms, right? I'm not afraid to go pretty high with someone if they're sick all the time, have no energy, feel terrible, and they're 18 on blood work. I'm like, I want to get you feeling better in two weeks, not two months, right? So I'm gonna be a lot more Genevieve: Yeah, absolutely. Abby: aggressive in that case. If someone's cruising at 32 and they're like I feel pretty good but I know that's not optimal we could do a five to ten thousand IU likely and you know have a little bit more of a gentle approach. Genevieve: Yeah, no, that makes perfect sense and... When I kind of look at that relative to what's been done in the clinical research, it's totally consistent with what the approach that some researchers have taken where they've done this like higher bolus, 50,000 I use, 10,000 I use. I've even seen one study that was 100,000 and maybe they're doing that like once a month kind of thing. there isn't a standard protocol in research and it doesn't sound like really that there's gonna be a standard protocol. Genevieve: clinical practice, right? Like you're going to... Abby: No, and I think as long as you're monitoring and testing, it's fine. mean, my folks that are real low, I'm not above doing, I'll do like 50,000, I use three days a week and take the other days off. give your body a break kind of mimics more like having a day at the beach. get a ton of sun exposure. You're probably not doing that like seven days in a row. So you give your body a bit of a break works really nicely. Huge disclaimer. Do not do any of this without consulting your physician first, right? I only do this with patients I'm working with directly in practice as a patient with lab testing results and all of that. Had to throw that in there. Genevieve: Mm-hmm. Yeah, well, yeah, no, for sure. think of I think of very, very crucial number that for for people that kind of have awareness of is what is the Synthesis which is going to happen in through the skin from the sun exposure. Like if you're out in the sun and we used a lot of this rationale when we were developing our vitamin D product and that's okay so you spend a day at the beach how much vitamin D are you going to synthesize in your skin? What's the equivalent in terms of dosing that's coming in orally? And that comes in at ballpark is around 10,000 units because when you have this exposure Genevieve: to the skin. It's basically a chemical reaction which takes a molecule that's already present in the skin and it turns it into something else when it gets exposure to UVB rays. But for those people who have studied chemistry, you know that you're limited by the availability of how much of that chemical is there. So you're going to reach a point at which you just can't make anymore from the sun. Yeah, So we've got this like built-in kind of regulatory check mark from Abby: It stops. Genevieve: sun exposure that we actually don't have from dietary exposure from supplementation. Yeah, and this is this is where you know there there was there were for many years a lot of talk about excessive vitamin d exposure vitamin d toxemia and and what's going to happen from that and certainly over the last 10 years or so we've realized very very very rare even with supplementation protocols of you know 10 25 50,000 Genevieve: and done properly using monitoring under a physician supervision, you just really very, very, very rarely see side effects from vitamin D supplementation. Abby: Yeah. Even people that they come back and their levels are crazy high, they don't feel bad. You know, it's like, OK, you've overshot. Let's back off. You know, they're not like in grave danger. Genevieve: Yeah, oh yeah, absolutely. Yeah, yeah. No, they don't have hypercalcemia, which is like excessively high calcium in their blood, which is what was thought to be the potential harmful consequence. Just don't see that. The other number that we really zeroed in on as being kind of like our target, you'd mentioned that 5,000 units a day. There was a series of research studies that were conducted where Genevieve: We ended up with this kind of loose consensus in the scientific, certain members of the scientific community, but in the traditional scientific community where they concluded in a publication, a scientific publication saying that they think that most people would benefit from supplementing with around 4,000 international units a day, you know, give or take a bit. and so I think, I think that that, that target makes a lot of sense given what we know about exposure to vitamin D from the sun being at around a maximum of 10,000 units per day. So that gives you room to take in some from your diet. It gives you room to make some from being outside. And it's entirely consistent with, you know, what you say you're, you're like how people are responding in. in clinical practice. it does like it definitely does make sense for people to know these things and be educated and have an awareness of what numbers are because it is pretty easy to you know, overdo it with supplementation just like it's quite easy to under do it. So, you know, especially if you're buying like a multi vitamin that has vitamin D incorporated into it. Oftentimes that will yeah, will be an inadequate inadequate value even though the number on that supplement fact Abby: It's like never anything. Genevieve: table tells you that it's 100 % of your daily value, for example. Like it's, it's, you know, it's right there. So yeah, we, mean, as we know, we're, always trying to educate people and get them to really understand, you know, where does this number come from? So we're talking about, obviously we've mentioned, we ended up formulating our own vitamin D supplement. Can you tell us, cause you've worked with a lot of different products in your practice over the last 10 years, some of which you liked a lot, but yet you Genevieve: still felt pretty strongly about wanting to develop a new product and you thought there was room in the market for something that kind of came at things a little bit differently. So can you tell us about how our vitamin D supplement is unique and kind of what needs it fills? Abby: Yes, so there's a few different reasons. I think the most glaringly obvious one is that it's water soluble. So If you guys look at the vitamin D product, you might have at home unless it's ours, which if it is, we love you for that. But they're We talked about how vitamin D is fat soluble. It's an oil-based supplement. It's usually a tincture and a dropper or in a capsule. And so You'll be able to see it's like this yellowish liquid inside. What that means when a vitamin is fat soluble is it's a lot harder for our bodies to absorb it. You lose a lot of that absorption through your natural digestive process. It's a fat, right? A lot of people know same thing applies with fish oil. People take fish oil, they get the fish burps. because you can't break it down well, right? So The same thing happens with vitamin D, which is part of the reason why people have to take crazy doses, like 20,000 IUs to get their levels up. And then so many people I see in practice over the years, know, our guts are struggling. We don't observe like our guts don't even digest things well, let alone a fat. so People are having to do higher doses than ever. And it's kind of hard on their system. And so we've made a fat soluble vitamin, a water soluble vitamin. And so what that means is you have to take around half the amount to get the same effect. Vitamin D is also kind of pesky. Like you have to take it with food. You have to take it, you know, with food, with fat, preferably a lot of people take their vitamins on an empty stomach when and they're running out the door in the morning. That's just reality. It's what it is for a lot of people or they forget. I know this after 10 years of seeing people and being like, can you please take your supplements with food? And people skip breakfast and fly on coffee and run out the door. So this solves that problem. It's tasteless. Abby: They can put it in their beverage of choice and a little bit of water. They can mix it into food for their kids or a smoothie or even just their water and get it really easily. So the water soluble technology I feel like is the biggest differentiator. And then the other one that blew our minds that I didn't fully realize, I don't think either did you, is that most vitamin D is made and extracted from sheep's wool, which is called lanolin, which is kind gross if you think about it too much. And so we sourced our vitamin D very differently. It's a vegan source made from lichen and the vitamin K2 is also not synthetic and is made from a Japanese food called natto. So it's also vegan. So the vast majority of vitamin D products just so you guys know are not vegan, which I feel like not many people are aware of. Genevieve: No, they're not aware of it. I remember when we were working on this formulation, we, you it really felt like we came up against a roadblock when we realized. that the source of vitamin D3 specifically because vitamin D3 I didn't talk about this but we have two forms of vitamin D in food we've got D2 and D3. D2 is found in things like mushrooms so some some plant food and then D3 is the animal source so it can be found in things like egg yolks and liver so we've got this these two forms and when you do research look Genevieve: at how bioavailable these two different forms are, meaning when you eat it, how much of it actually gets into your body and will increase that level of 25-hydroxy vitamin D. There is a difference between D2 and D3. D2 is not useless. It's absolutely a useful molecule, but it's not as good at raising vitamin D blood levels as D3. So we wanted to make our product accessible to everybody, whether you were vegan or not. Genevieve: but we also wanted to use vitamin D3 because that's the one that's more bioavailable. And so we found this lichen source which fits all of, ticks all the boxes that we wanted to tick. And as you said, like our... priority and value is to make things food-based as much as possible. And this is something else that people don't know about the supplement industry is almost all of your vitamins are synthetic. They're not sourced from food and they are not made in the USA either. So it's very, very difficult. They're made from the lab in China. Yeah, yeah. So certainly there are still times when Abby: They're in a lab in China. That's the reality. Yup. Genevieve: I find myself needing to take something and that's the only source that's available because we haven't made it yet. But you know, that's that certainly was a it was an eye-opener to me. I had no idea. It really was a it really was an eye-opener. Abby: Yeah. It really is. It really is. Like all your B complexes, multivitamins, that's what it is. It's not real, unfortunately. And listen, not to say that stuff doesn't work, right? You can start a great quality B vitamin synthetic, you know, because you have low B12. And a few weeks later, your B12 is going to be great. So you know, Genevieve: Yeah, yeah. No, it's not food based. It does, yeah. Abby: better than having a deficiency, But it's really mind-opening to learn that stuff. Genevieve: Yeah, yeah, it's kind of a good, better, best scenario where we're trying to do things in a different way. And, you know, we also, we thought a lot about dose and we went back and forth. So let's explain to people the science of this water solubility issue. And I'll talk about it in terms of numbers, because you talked about it with respect to absorption. So as Abby was saying, when you take something that's water soluble, it's able to get into the body through the intestine much Abby: Mm-hmm. Mm-hmm. Genevieve: more readily than if it's a fat, fats require transporters and it's just a much harder process to go through. So what this means with in terms of numbers is that if you take a supplement that has 2000 units of vitamin D and you measure the change in the 25 hydroxy vitamin D in the blood, what you see is that it's approximately comparable to that number that we saw as the target. in the scientific community of around 4,000. So it's around twice as bioavailable. And that's something that is a bit challenging for us to get across to our customers because when you look at our supplement facts, it will say that we are in one scoop, it's 2,000 international units of vitamin D. But in fact, that 2,000 international units of vitamin D is the equivalent of around 4,000 of a Genevieve: traditional supplement that's not water soluble. Abby: Yep. And it's 2,500. Genevieve: Yes, it's 2,500 exactly. So we went for that number that you were seeing in clinical practice that we were talking about with that ballpark of 4,000 international units of being kind of that scientific consensus, give or take 1,000 or so. So yeah, we really thought long and hard about how much to put into this. Abby: what dose it should be. Yeah. then, because part of the other reason is we really wanted children to be able to safely use this product and we could have children dosing that we felt good about, you know, saying, yeah, young kids can totally do a fourth of a scoop of this, no problem. And get their daily vitamin D. And then would say the other big thing is in a lot of other water soluble formulations, because obviously, It takes a bit of work to take something from being an oil to being a flavorless powder in a jar. We used like really, really clean ingredients that I've never really been able to find elsewhere in a water soluble product. So in a lot of water soluble products, you'll see maltodextrin, you'll see citric acid, you'll see the silicon dioxide, you'll see all sorts of like kind of funky stuff. And we were able to do it with chicker root inulin. Abby: MCT oil and licorice root extract and that's it. Which is pretty amazing, yeah. Genevieve: Yes, yeah, exactly. Yeah, it is, it is. And you talked about our vitamin, talked about our vitamin K. And I've mentioned before when you look at the studies of vitamin D supplementation and how so many of them, like literally almost none of them used vitamin K, along with it, it's wild. Abby: Pretty wild. I mean, I guess it makes sense, but because they're trying to really just look at D, but. Genevieve: That's the rationale, right? The rationale, but... it's almost dangerous, especially if those levels of supplementation were in the thousands because the vitamin K is needed to make sure that any increased absorption or any calcium that gets absorbed is going to end up in the bones and the teeth and not get deposited in your cardiovascular system. So it's really like if you're going to be supplementing with vitamin D, you need to add that additional vitamin K to make sure that you don't Genevieve: up with know calcification in the vascular system like it Abby: Yeah, now I have a question about that though, Dr. John, because I know there's not really an upper limit on vitamin K2. So what does the literature say? Like, say someone is taking 25,000 IUs a few times a week to really raise their levels would just be supplementing with like a normal daily dose of 100, 150 K2. Abby: be enough, or would you also need a super elevated dose of vitamin K to complement? Genevieve: Yeah, no you shouldn't because you have to think about it this way, right? What that K is for is to get the calcium to where it needs to go. If you're not taking, if you're not changing and also doing this like radically high calcium supplementation, that's not going to be an issue, right? That number is going to stay constant. So as long as you have, you know, couple hundred Genevieve: vitamin K units, you'll be, you should be okay. Yes, yeah. So that along with food, you're gonna be. Abby: Yeah, like ours is 130 micrograms, right? So it's like, some patients, they're doing such high dose, they might take their provider might give them like a pill that's like 50,000, right? So they could do add Rdk2, get the K2 you need, which will help that issue. Genevieve: Yeah, yeah, and it's a very safe supplement. But certainly, it's just a cover your bases kind of thing to make sure that it's included in the supplementation. And if you are taking, I think a lot of people don't understand calcium supplementation very well. Genevieve: And The main point about calcium supplementation is if you're going to do it, which certainly it's warranted for some people, you just need to make sure that you're never taking more than around 200 to 200 200 to 300 milligrams at a time. Because that's bolus or a bulk dose of calcium that really exceeds what your body would normally. Genevieve: see and because calcium is so it's very biologically active and it can get deposited in the cardiovascular system. if you were wanting to supplement with higher levels, you'd want to break those supplements up into maybe two doses a day or three doses a day. And I mean, we certainly get asked sometimes by people, like, should I take calcium along with your vitamin DK? And I mean, I think it depends on the individual and that requires an analysis of what their diet is like, what their weight bearing exercise status is like. But certainly for people who don't consume any dairy products, yeah. Abby: All I can say is I've seen so many people that are told by their primary care that their bones are terrible because so they need calcium and they're chugging these synthetic calcium pills from CVS that are literally chalk in a pill. And then they're having heart issues and their bones are still suck. they get a dexa and it's like Genevieve: thousand milligrams a day. Genevieve: Yeah, Usually five. Yes. Yeah. Abby: when you get them on D&K or even a just smarter bone supplement that has a lot of minerals in it and other things that actually build their bone, their bones actually get better and start doing weight bearing exercise. So I'm like, I just, think it's hard to find someone that has a true calcium deficiency. I'm sure it's out there, but I don't think it's as common as everyone's told. Like as you age, you need a calcium supplement. And I think it's caused so many problems. Genevieve: Well, mean, see the challenge is that there's not like there is a definition of what the dietary intake is supposed to be. But when you look across populations and different regions in the across the globe, first of all, there's a huge variability in dietary intake, but there's also variability in terms of the recommendations. So our recommendation in North America is quite high. There are recommendations that are in other parts of the world that are not nearly that high. And so Genevieve: just don't think we have clarity about how much the body needs and it does relate to what you were talking about. Like it's this complex pathway that involves vitamin D, that involves vitamin K, that involves all of these other minerals that are needed for structural integrity of our bones. And so just taking a thousand milligrams of calcium, you know, in one sitting or you know, even two sittings, it's not an advisable supplementation strategy from a cardiovascular. Never, never. Abby: You would never eat that in real life. And this goes back to our last podcast we did of we should also be getting calcium from our water, not just our food. And so it's just like all the minerals, all the more we read, go figure, everything works together. So whenever you're just like high dosing one mineral or one vitamin, that's probably going to come at a cost long term. Genevieve: Yeah. Yeah. Yeah. Genevieve: Yeah, no, I agree completely. And so I think as we've talked about today, we've really shown, I think the rationale for why we developed our product the way that we did, how it's consistent with what we've investigated in the scientific literature in terms of absorption and dosing, the clinical outcomes that people can expect, the formulation with vitamin K. Is there anything in kind of closing that you think people should understand about supplementing with vitamin DK on a daily basis or on regular basis? Abby: I think the biggest thing is just the reality of our modern world, which this is the case with our three essentials products, is that the vast majority of people can benefit and should probably be consuming a vitamin D product. And if maybe you've been consuming a different product that's lower dose or not as high of quality to try out our product and see how you feel, know, take it every day for 30 days, get your vitamin D levels checked. Get your levels up, I think we say officially in our blog, try to aim for between 40 and 60 in that range. See how you feel with your vitamin D levels at 55 versus 30. Most people notice a massive difference, you know, before getting in the weeds and trying all these herbs and things like that to stabilize your mood. Like start with the basics, you know, in my opinion, solve like 80 % of people's problems. Abby: Vitamin D is such like a no-brainer that impacts so much in the body. Genevieve: Yeah, no, I agree completely that we had that conversation last time about just deal with the foundations first and make sure that you've got those bases covered. And then if you need additional supplements on top of that, that's when you can be sure that you're... Genevieve: you're giving your body what it needs. Yeah, under those circumstances, awesome. Well, thank you for chatting with me about all of this today and hopefully soon we'll be out of winter. But as you mentioned, know, even... Abby: Thank you. Yes. Genevieve: I personally have a summer dose of vitamin D and a winter dose of vitamin D and I have a vacation dose of vitamin D when I go to the beach and the only way to know really what you need is to test and thankfully we have those tests available that are now easy to use which is great. All right well thanks everybody, thanks for joining us today and we'll look forward to seeing you next time. Abby: Yep. Yes. Abby: Yep, totally. All right, thanks Jen.

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June 24, 2026

Red vs. NIR Light Therapy Explained

Alyson and Dr. Genevieve Newton get into the physics and biology of red versus near-infrared (NIR) light — and why understanding the difference actually matters for how you use photobiomodulation. Starting with the electromagnetic spectrum, Dr. Gen explains how wavelength determines depth of penetration: red light (620–700nm) works more superficially on skin, blood vessels, and surface tissue, while NIR (750–1400nm) reaches deeper into muscle, bone, and organs. Both wavelengths share the primary chromophore (cytochrome c oxidase in the mitochondria), but NIR has additional targets including water molecules and the production of structured water inside cells. The conversation digs into nitric oxide — a key signaling molecule released during photobiomodulation that drives vasodilation and improved circulation — and explains why the 1:1 red-to-NIR ratio in the Fringe face mask and pelvic wand differs from the 2:1 NIR-to-red ratio in products like panels and wraps. Application site drives the decision: products touching the skin's surface lean red, products targeting deeper tissue lean NIR. The head wrap is a special case, including 850nm and 1050nm NIR specifically for transcranial penetration. Dr. Gen also addresses a common misconception: LED chips don't emit a single precise wavelength. They emit a spectrum of roughly ±30nm around the peak, which means "660nm red" in practice covers a range of red wavelengths — much more like sunlight than a laser. This episode gives you the conceptual framework to read product specs critically and understand why Fringe makes the design choices it does.   Listen on the go — The Fringe podcast is available on Spotify and YouTube. Subscribe so you never miss an episode.   Transcript Alyson: Hi everybody welcome to the fringe my name is Alyson and i am one of the co founders and owners of fringe and i am with Genevieve, our scientific director at fringe and today we are going to talk to you about red and near infrared light and get into a little bit more detail about those two types of light i think the thing. that confuses some people is that when we generally talk about red light therapy, which we talk about a lot, we are talking about both red and near infrared spectrums of light. And there are differences in the two of them. even, gosh, from when we started a few years ago learning about red light therapy, feel like Genevieve and I have learned so much about what exactly is different about them and kind of where we are probably headed in the future of red light therapy and talking about how it works and why it works. And just like everything, we know a lot and we know nothing. that's where we're at. So let's begin by really having you, Jen, just explain to us the differences between those two lights and just from the basics of what they are and that sort of thing. Genevieve: Yeah, for sure. So, I think most people have heard about something called the electromagnetic spectrum, but I suspect that if you were like me, five years ago, ten years ago, didn't really understand it very well. So, this is a spectrum in which we find sunlight falling. but we also find things like X-rays and gamma rays and microwaves, are like all of those radio waves. So it's this really massive spectrum of energy and red light therapy can really only be understood by recognizing that light from the sun fits into this electromagnetic spectrum. So. When we look at the light that comes from the sun, we see that it's actually not a massive range of wavelengths. It spans from, we measure these in nanometers, so that's 10 to the minus nine meters. So it's 250 to 2,500 in total from the sun. Of that though, really interestingly, there's only a small portion of that that's actually visible. So that spans from 380-ish to 700. So this little teeny, tiny spectrum of this infinite spectrum is what our eyes perceive. So you know when you when you wrap your head around that you start to think like what are we not seeing that's in our environment, right? Alyson: Right. Energy is not visible. Genevieve: Yeah, we're not seeing all the wi-fi signals and everything that comes in and we actually don't see all of the wavelengths that come from the sun either. So we see that visible spectrum that gives us our rainbow, you know, the red, orange, green, yellow, blue, violet, all of those colors. But what we don't see are the invisible light that falls on either end of that spectrum. So if we come in on the short end, when I say short, that means they're going to the nanometers, the wavelengths are going to be shorter, they're going to be So if you were to draw a graph, would see this like tight little wave going up and down. wave is very tight, it carries a lot of energy and this is gonna become important, I'm gonna circle back to that in a moment. But as we get into these first wavelengths of the sun, the really high energy ones, that's our ultraviolet light. So ultraviolet light is not visible to the naked eye, but then when we get into the visible light, we'll start at violet and we'll move all the way up to red and those wavelengths will get longer and longer and longer and So really the only thing that distinguishes one color of light from another is its wavelength. And of course it's not a single wavelength, there'll be a range for each color. So for example, red is around 620 nanometers to 700. So that red is going to fall into that longer end of the visible spectrum. If we keep going out from there and we see the light that's still coming from the sun, so I said we're ending at about 7. hundred but the Sun keeps going to about 2,500 so we've got lots of these really really really long wavelengths and they don't carry as much energy they get longer and longer and longer and we don't see them but the first the first ones that we get are near infrared light we feel those a little bit a little bit of heat is generated from those and then if we keep going from that we've got far infrared and that will generate even more warmth so we can essentially characterize this Genevieve: like beautiful spectrum of these different wavelengths of light based on one whether they're visible or not visible and two the length of their wavelengths and then three the amount of energy that they carry. So if we go back to that UV light that has that tight short wavelength if we were to graph it it's considered to be somewhat harmful because the energy that it carries is so great that when it gets into in contact with our body it has the ability to create these reactions called ionizing reactions. So it's considered ionizing radiation. And so when people think about light from the Sun and why is it dangerous? Well that's the reaction that is causing that DNA damage. But of course that's really only in excess. We're understanding more and more every day that light, even the UV light, is... actually really beneficial for us. You just don't want to overdo it. It's important to, you know, not have excessive exposure to that ionizing radiation. But when we get to the red and the near infrared and we isolate those wavelengths, those are completely non-ionizing. They don't have that effect. And this is why we can safely use them for their beneficial effects, which I know we're going to talk about in this podcast. And it's also one of the reasons why when we're doing light therapy on this kind of regular daily basis, we do want to choose these wavelengths that one, we know are effective, and two, we know are safe. Alyson: Yeah, absolutely. We truly get asked this every day by people that are interested in using our products or just generally have questions for us and know we like to talk about this. We are very much so choosing a large range of wavelengths when we look at red and near infrared light, but we are choosing these wavelengths of light that our body responds incredibly well to from a healing standpoint so it would be good for sure as we jump into talking about this to kind of just recap. And remind everybody how our body does respond to light in general but specifically red and near infrared ranges and sort of on a cellular level what's happening so because then i think it helps us really unpack the differences between red and near infrared which you know there's a. more similarities than differences, but there are some differences. Genevieve: Yeah, what's fascinating is that there are many different types of what we call bioactive light. So bioactive light is just simply light that is biologically active. It creates a biological response. So for example, that UV light, we know that when it interacts with our skin, we have the synthesis of vitamin D. It's so fascinating that we make this hormone when it's made from the sun, it's not technically a vitamin coming in from the diet, but it's essentially the same. it's going to have the same biological effects. So that's what we see with our UV light. Our blue light has these really interesting antimicrobial effects. Light like yellow and green and orange, they haven't been nearly as well studied, but they're starting to be investigated and we're starting to realize that they're biologically active too. of course, how could they not be? Yeah. Alyson: Yeah i think the funny thing how could they not be right right yeah so we just have to learn more in order to say you should consider you know maybe utilizing a yellow because we have had people ask us how come you don't put green light therapy in your face mask and it's like we might someday you know when we could answer questions better we absolutely might yeah. Genevieve: Absolutely. Yeah, yeah, for sure. And so when we get into looking at that red and the near infrared. That falls into what's called this optical window where the light is able to come into the body and induce these biological responses by interacting with our cells literally on a molecular level. So we have molecules inside of our cells called chromophores and chromophores interact with a specific wavelength of light. You'll have different chromophores that interact with different wavelengths. And so if you're figuring out what you want to do to treat a particular condition, for example acne, we know that the acne producing parts of our skin will have a response specifically to the blue light because they have a chromophore in the microbes that cause acne. you can essentially, it's just like a matching where you can match the chromophore to the light wavelength. But when we get into looking at the red and the near-infrared. So there are many chromophores that interact with red and near-infrared, but in terms of kind of taking this to the next level. Genevieve: Some chromophores are what are called photoreceptors, meaning they react with light and they create this signal, like a cellular signal, that's very measurable. so both the red and the near-infrared interact with something in our electron transport chain, which I'm going to explain to you in a moment, called cytochrome c-oxidase. So that's our sciency explanation. The kind of easier way to understand it is if you look at your cell, we've got this cellular machinery that makes energy. It's like probably if we had to figure you know, let me say what's the most important part of a cell? I think we have to say it's the mitochondria which contains this machinery because if without the energy we we just can't do anything we're dead so our mitochondria contain this cellular machinery and in that is this specific enzyme that's part of a big group of molecules, it's not the only thing that does this, but it's really important. And it interacts, it's a photoreceptor for both the red and the near-infrared. Now interestingly, there are some subtle differences in the specific way that those interact there, but that's kind of irrelevant to the big story. The big story is that through those interactions, we have this kind of increase, and it's not a dramatic Increase it's it's a nice, you know physiologically manageable increase in the production of cellular energy. So it allows that cell to do what it is programmed to do much more effectively. And if that cell is healthy, it will help it function more optimally. And if it's unhealthy, it can help to restore health, whether that be a muscle cell, a skin cell, a liver cell, right? So all of our cells. Alyson: Yeah, I think that's that is the part that it's like every day we are asked Mike could this help my hair growth my eyesight my skin my you know joint tendon ligament muscle kidneys lungs I mean the list literally goes head to toe inside and out and then you realize that this signaling a system is us is how. Alyson: Is how we are and so we respond to light in a variety of different ways and this one we're talking about energizes all these different types of cells so they can go do their job like they were designed you know to do. Genevieve: Yeah, we don't have a distinction between the mitochondria in a skin cell versus a muscle cell that says, no, this one doesn't react to the light and this one does. It's consistent across all of the mitochondria that this particular enzyme, this cytochrome C oxidase, is a photoreceptor for both the red and the near-infrared light. It's just a matter of getting the light into that location. Alyson: That's correct. So let's talk because occasionally we will discuss and debate and sometimes conclude and not conclude how deep can light penetrate. I sometimes say now how important is that actually because we now know so much more about how important it is for what you just said, which is that the light is absorbed in the first place. Alyson: That step number one that we actually can create a scenario where we help the light be absorbed once it's absorbed you know how deep does it go how deep does red light go how deep does near infrared light go does it matter. Genevieve: So I actually do think it matters a little bit. First of all, think it matters to understand why you would use one light over another or how you would combine those lights maybe in different ways. And I think we'll talk about that later because we've certainly taken all of this into consideration when we've designed our products. But that issue of absorption is that first, is the first part of the... penetration story. So we will call this the depth of penetration into the body. So when we're talking about red light, we know that red light doesn't penetrate very deeply into the body. It does an amazing job of getting into the surface. So our skin, if you were to put it into the nose or into the vagina or the rectum, you'll get in around one to two millimeters. And so what happens essentially is that the red interacts a lot more with chromophores that are at the surface. And so when it comes into the surface of our body, the surface tissues, there's a lot that just kind of grabs onto it. It gets absorbed by these things. So it doesn't penetrate in deeper than that, usually around two millimeter range. In contrast to that, the near infrared light doesn't interact nearly as much with those chroma forms and the chroma forms at the surface. And so it's able to penetrate much more deeply. Now... The challenge is actually giving a number that you can feel confident in terms of the depth of penetration. It's pretty much impossible because when you look at the studies, they really, really vary. I mean, up until about 2025, the consensus was we're probably not going deeper than around 40, 50 millimeters. That's like the deepest that we saw the penetration for the most part. Like, so it's multiple centimeters. It's going in deep. It's remarkable. Genevieve: But then in 2025, there was this study that was published that showed that near infrared light. was measured as passing actually fully through the thorax of the body. now it's not, importantly, it's not passing through unchanged. There's not a lot of it that's passing all the way through, but there are measurable photons that are coming out on the other side. So we know that that penetration is very deep. And there's another issue. Alyson: Yeah, yeah. Genevieve: in addition to absorption that's different between these two lights and that's scattering. So the red light scatters more when it comes in and so you can picture like a pool ball coming in and like bouncing back up instead of going straight down. So the near-infrared light doesn't scatter as much. so when you're looking at them in combination, so this is why I do think it's important, is that if you're talking about, you know, a particular condition that you're trying to treat. So let's say that you want to treat like the metacarpal joints or something, right? Like there's not a lot of tissue there. You don't have to get in too far. So you know that you really are going to be wanting that combination of getting at the very surface because you're going to be seeing lot of stuff going... on at the surface and then getting in more deeply. Whereas there are some other applications where you know, okay maybe there isn't really anything that I need to do at the surface here. I just want to go in all the way. And so you do see some studies for example with the brain research that use exclusively near-infrared light. They're not interested. But as I've looked at more and more and more studies, you really see that at least over the last few years, people have used a combination of light for things that in the past they only used one light type or another. So for example, skin. People would only use red light for skin. Well now we know that there's benefits to combining the red and the near-infrared. Are there cases there we might say you really only need red? Yes, but there are benefits to most skin conditions in terms of combining them. The brain stuff has been really interesting because you think that there's really no benefit to having that note superficial. But the research suggests that there are benefits to combining the two. And so, yeah, I think it's important to understand what you're doing and how these different wavelengths are penetrating differently. But at the same time, as you said, is it really something that you are gonna mess up if you choose to Genevieve: only use a combination of red and near infrared light? No, you're not. Now, could you mess it up if you chose to only use red light? Yes, you could. And could you mess it up if you only choose to use near infrared light? Yes, you could. So, the combination I think is the powerhouse, but it's also important to think about your target, how deep you want to go, and then build your device accordingly with like changing the ratios of light chips or something. Genevieve: along those lines. Alyson: Right. Yeah. So speaking to that, the deceptive part is that we've already identified that near-infrared light is not visible. And most of the light in the red light therapy products that we see appears visible. Interestingly, this is a great example in our panel, which is one example of like, you can see all the dots that aren't shining. Well, those are actually near-infrared light bulbs. And we do have a setting, which is kind of interesting, it's an interesting thing for the mind. We have a setting where you can just run the near infrared on our panel. You don't feel the experience as much almost because you don't see the bright light. But in our wraps, even though you see one red light growing, this little light actually has three chips in it. Two of the chips are near infrared. So almost all. of the products we've made at fringe especially just general healing products we do a two to one near infrared to read and. And you know we could just say that's cuz it goes deeper that's not exactly it can you speak to a little bit about some of the pathways that the near infrared that you and i discuss sometimes just talking about things like it's interaction with water or. Alyson: you know, its effects on blood flow and things like that. So we do, we definitely do lean at Fringe towards more near infrared in our products. Genevieve: Yeah, yeah. Genevieve: Right, except when we've built our wand and our face mask, which are meant to be more superficial, right? So that's where we have a one to one ratio of near infrared to red versus our other products, which are a two to one ratio of near infrared to red. And that just speaks to, are we trying to kind of match and get a lot of that surface interaction happening or are we focusing more on going a bit? Alyson: Right, yep. Genevieve: deeper and getting that deeper penetration. So you mentioned water and this is definitely a really interesting story and you and I have been talking about this now for years and it's starting to kind of get some traction. But the research is there, there's not a lot of studies but for example what is very clear is that water is a chromophore for near-infrared light. It absorbs near-infrared light. So when near-infrared light Genevieve: hits some water, it's going to get absorbed, especially at, you know, some of those longer wavelengths. That was thought to be a problem by all of these early researchers. It was thought that, it's a waste. can't, we go through water and we lose the near-infrared light. It's, I mean, it's water, right? What does water do? Well, it turns out that water does a lot. And when water interacts with near-infrared light, there are some changes to that water. that make it different and potentially make it more efficient at producing energy and possibly doing some other things than its earlier state. it's something that we think about a lot when we talk about being outside in the sun and these light wavelengths passing all the way through our body and our body being filled with water. I strongly suspect that that's one of the most important things that sun is doing for us. So these water changes, the term that's most often used is called the structuring of water. And this is like the fourth phase of water, Jerry Pollock's research. It's more complex than light structures water. But I think the main point is that interactions of near infrared light with water in the body are causing changes, chemical, structural, physiochemical changes that change the way that water functions. Like if you look at every single cell in our body, it is full of water. If you look between the cells in our body, it is full of water. If you look at our blood, if you look at our lymphatic tissue, we are the majority water and it's really, really, really important. And so there are ideas that as that water changes structure, and the viscosity of it changes, that can be one of the factors. It may also change the way that energy signals pass in that water medium. So I suspect that we're gonna find out that this is critically important to the red light therapy story and the benefits that we see so consistently but it's not been even remotely clearly unraveled yet in terms of its mechanism. So I'm looking forward to that. Alyson: Yeah, yeah. Genevieve: So that was one of the questions that you asked me. You'd also mentioned about blood flow. So blood flow actually could be related to this water story in part, but we also know that red light therapy relates to the synthesis of something called nitric oxide, which is this little tiny gas molecule that when it's present helps blood vessels to get bigger and lets blood flow more readily when there's this process of what's called vasodilation, so the blood vessel's dilating. And anytime you've got better blood flow, that blood is carrying your oxygen, and it's carrying your nutrients, and it's carrying away waste. It is so important. So blood flow improving is a really important element of red and near-infrared light therapy. And we know that the near-infrared light has a greater effect on nitric oxide production. So as we said, like that... Shared pathway of that cytochrome c oxidase is between the red and the near infrared light some slight differences in terms of how it interacts but then this water pathway is entirely unique to near infrared light and the nitric oxide pathway is Going to be greater with our near infrared light so you can see that there's really like this this shared pathway this different pathway and then this pathway that's shared but is predominant affected by near-infrared light. So it's really amazing how much what we call experimental or pre-clinical research has been done in red light therapy where we've unpacked these mechanisms. We've really looked deeply into how it works. And so for us coming into it, it's just been amazing being able to look at this body of literature. There's so much. Alyson: Yeah there's so much there's so much there's many things that we read about now where there's very little and so you're left to try to. Speculate and imagine and you know connect the dots and we still do that i think in many ways with with light but yeah there is a lot of foundational science to go back on and just you know be able to say. why did you guys pick this wavelength i mean we get these questions a lot and. It's like what we have a reason why we picked every wavelength but then we also get to say but also please don't get so fixated. On one wavelength knowing that we receive this vast spectrum of wavelengths from the sun there's no way that one specific wavelength is what you need to heal this specific thing and also. LEDs deliver a spectrum of wavelength. So even though we list a product at 650 or 670 or whatever, you're receiving a spectrum of wavelengths. so, yeah, you know, it's there is a difference between these ranges of wavelengths, the red wavelength range versus the near infrared wavelength range versus, you know, all these others. But yeah. There's no way that one specific wavelength is what we need. And so that's really hard because that's some messaging in the market now. And we just have to continue to be nerdy and share our message and help people try and learn and understand about what they're investing in and what they're buying. Alyson: So I think okay so i think we've kind of covered every covered everything so i always summarize by saying red light therapy in general energizes the machinery inside the cell and that the cascade or like the. The series of events that comes from that is just very naturally what that cell is doing anyway which is turning away and working at whatever it's job is if it's a little cell that builds bone then it's. In their building bone or if it's building collagen or elastin or whatever it's doing but there's more to the story when light is absorbed than just energizing a cell there's these incredible you know effects on water effects on blood flow there's effects on inflammation there's sort of like a what i would say what we talk about more is most people don't say. I need more blood flow in my shoulder joint they just want pain to be gone they want movement you know to be better but. Surprisingly that's a lot of things happening you know for for pain to be gone and movement to be better so we can get a little granular and talk about energy and blood flow and these types of enzymes and reactions but. The outcome is healing I mean very much so if you were to summarize what light does it stimulates. Alyson: how our body naturally heals brings blood, nutrients, reduces inflammation, energy you know, and, and potentially this ability for light to affect the water in the region, be that through the structure of the water, the energy that the or the charge that the water is carrying, you know, that is going to be pretty cool when we can maybe talk intelligently about that even more. Yeah. Genevieve: Agreed. Agreed. And I think that's bang on. Light heels. Light heels. Alyson: Yeah, absolutely. Okay, so let's go into, let's just summarize, because you've touched on this a little bit, but clinic, because this is really all that people ask us every single day. All the questions come in, could this help this? Could this help this? So what are the best applications for red? Very specific red. And like you said, we have red only options in our skin. Genevieve: enough Alyson: products, our face and neck mask, also our transvaginal or our pelvic one option as well anywhere where where we felt like having just a red option made some sense, then we put it in there. Genevieve: Exactly and so you just nailed it. It's any time there's a superficial problem, right? So if we're talking about the skin we would be looking at things like Acne as being the main superficial issue. So Acne of course is is most responsive from the perspective of kind of healing the acne or Getting rid of the acne lesion that would be blue light therapy but then the red has been studied as coming in and helping to decrease the inflammation. So it's like a supporter for the whole process, right? It'll decrease the inflammation help with the oxidative stress and help with the cellular repair process. But I still struggle with really saying that even for the skin, just using red is a more appropriate application than using red and near infrared. Because when you think of the structure and the depth of the skin, you have your epidermis and your dermis and then your subcutaneous tissue, right? you've, once you get into the dermis, you are needing near infrared light. So most of the scientific research on skin therapy has focused on using red light only. It did for many years. Genevieve: it started to layer in near-infrared light and it's showing benefits. I definitely think for things like wound healing or scars which need to get in deeper, you want that combination of the red and the near-infrared light. The other implication where red has been used almost exclusively is hair growth. So those hair follicles are very superficial. There are a few studies, not very many, they've combined with the near-infrared light and they've also shown benefits. And when I think about putting light onto the head, I think if you're Genevieve: going to shine light onto the head, the brain is right underneath there, why don't we include both? You know, it makes much more sense to me to do that. So I really think that combining red and near infrared light, even in these more superficial applications makes good sense. Alyson: I'm rolling to our head wrap because I think that we made this for brain health, but it has a very well studied red light wavelength range in it for hair growth. And so, no, we don't say FDA approved for hair growth. The crazy thing is we'd have to go make another one. with like these very specific criteria that would have the same wavelength in it and then we'd have to apply for it to be FDA approved for hair growth in order to say that right now we just generally say you know blood flow and you know these very general claims but you know at the end of the day this is I can't put it over my maybe I can but you know the the red and near infrared is is combined in here so so yeah that's Genevieve: Now, yeah, now in terms of the intravaginal, like using the pelvic wand, one thing that may be red only is microbiome support, because that is not a deep penetrating thing. That is a superficial. So that's an area. And then as you said, we've structured these products so that they have a mode that is red light only. And that would be really for people who... are it's not it's not so much that it would be for a particular clinical application it's more for comfort when people are heat sensitive because the near infrared light generates a little bit of warmth and some people have extremely sensitive tissues our face tissue and our pelvic tissue is more sensitive than other tissues in our body so we have that programming there exactly Alyson: Yes, so many blood vessels too. So many very superficial blood vessels. So, yeah. Genevieve: Yeah, so just to recap, we intentionally designed the face mask and the pelvic wand to have a ratio of one to one for the red to the near infrared light because we want to get more surface application than we do on most of the other parts of the body where we've changed that ratio to two to one. So that's the one thing. And then the other thing is we've included these modes that allow you to use red light only should that be either indicated, let's say you did want to just work Genevieve: on microbiome support or you were heat sensitive then you have that option. Alyson: Yep okay so some so that kind of leaves the obvious for near infrared but let's talk about it so what are the most common conditions for near infrared and also reminding everybody near infrared has a really big range and and we have. Started and will probably start doing even more. Genevieve: We can. Genevieve: It sure does, yeah. Alyson: In playing around in some of the bigger larger numbers so bigger waves of light that travel with that near infrared so yeah so kind of review that with us. Genevieve: Absolutely. So the one application where If you look at the scientific literature, the majority of studies have used exclusively near-infrared light is brain health. So a lot of brain research using only near-infrared light because the rationale is, the brain is not superficial. So why would you use red? Almost all of these studies find benefits. So they found amazing results with things like major depressive disorder, with Alzheimer's disease. It's been used in stroke rehabilitation. in Parkinson's disease. And so we know with our traumatic brain injuries as well like our concussions, our CTE, that's another area that's been investigated. So we've got things like mood, we've got neurodegenerative disorders, we have the traumatic brain injuries, and then we also have childhood disorders like autism and ADHD. And most of those, or I should say all of those studies have used near infrared light. Some of them have used near infrared light exclusively and then sometimes it's combined. It's important, there's a lot of arguing that goes on in the scientific community about the light penetration into the brain and how could this be working. It is so clear that the light is doing something very powerful when it's applied to the head. Is it? penetrating through the skull into the brain, we don't actually know that but what we do know is that it works and we also know that in the living organism not in a cadaver we have this interconnectedness of structures and Genevieve: Fluid right so if you shine light onto the forehead for example And you are radiate the blood in that area, and then you get it into the lymphatic vessels that are draining in the head You are you are potentially? Using that as a conduit to get light into the deeper structures of the head It's not going to be the photons of light, but it'll be the change that has happened in that Carrying medium right and especially if we find out that water is something that is particularly affected by light, which I suspect it is, but it's never a part of these brain conversations. The brain is full of water. So all that to be said is that near-infrared, its claim for exclusive independent use is brain. But we also have a body of research that uses red combined with near infrared. And so for our purposes, we chose to combine them both. Then we can get the additional hair benefits. We can get the superficial vasculature and everything. And there's the scientific clinical research that supports what we've done. So there's that. If we look at the musculoskeletal research or the research on nerve health, usually that's a combination. Well, the musculoskeletal especially, it's really always a combination of the near infrared and the red, right? You want to get deep into that tissue and you also want to deal often with some superficial stuff going on. I have seen some nerve studies that, you know, if they were talking about really superficial nerves, they used red only, but that can, you know, depends on where you're trying, where you're trying to target. In theory, if you were trying to get to a deeper nervous locate, like a nerve in a deeper location, you might not want to use red at all. might just want to use near-infrared, but that's certainly, there's no downside to using the red as well. So that's really how that research plays out. For the pelvic health, there are... Genevieve: It's kind of split. are definitely some studies that use only red and that's going to be really good for like vaginal atrophy or vaginal dryness. But if you're trying to get the light into the deeper region of the pelvis, like if you're trying to the ovaries, trying to get the, you know, the uterus, you need that near infrared light. It's just, and the pelvic musculature. Alyson: Yup. Alyson: Which is interesting because when we were going to make the pelvic wand, if you recall in the beginning, it's like the first thing you do is just pull all the studies and see what are people doing, what kind of, and there was, and then look at what are, what do people have in the market? And there was a lot of wands with just red in them. And I was like, I feel like all the things we're going to be talking about, people would have tremendous benefit from the near infrared light. Just really, you know, when you're talking about Genevieve: Thank Alyson: pelvic pain and medical conditions and inflammation and not just a stage of life, you know, sort of changes. People are using the pelvic wand for very significant, you know, medical problems that they have and it's helping them. And I'm very happy we put the NeuroInfraRed light in that wand. Genevieve: Yeah, I should also mention, I didn't talk about this when you, when I was talking about the brain health research, is that even though it's predominantly near-infrared in the like 800 nanometer range, there are some... studies and some products that include that longer wavelength. And so when we looked at the literature, the decision was made to actually include two wavelengths of near infrared light. So that shorter 850 and then that longer 1050 nanometer range. And so I think people can probably hear that we've been very, very intentional in the design of our products. They're not all the same. And so, for example, we often get asked by people, well, can I use the regular wrap on my face and absolutely you can however you need to understand that there are less red wavelengths in that one it's a ratio of two to one rather than one to one so subtle differences across our products but very very intentional by design Alyson: Yeah, yeah. Alyson: Yep. Yep. Alyson: Yes. And we've been, so honest when we answer those things, because at the end of the day, it's red light and it's near infrared light. And are there going to be some benefits? We just had a question come in this morning of, you know, I got the full body mat and I'm using that now. And can that replace using the wrap? And at the end of the day, you know, on some level, it probably can just depends, you know, where you're getting contact, how long is the session, those sorts of things. So. Genevieve: Mmm. Alyson: Yeah, it's, I think at one point we sort of arrived at this point where we made a full body mat because I use our head wrap every day as my session and then just our regular wrap every day. And then I cycle through all the other things and kind of got to a point where I was like, I just kind of want to lay on some red and near infrared light for, for a part of my day, you know, and be able to receive that light in a session and, and know that I've been some really good ranges and are they perfect? Meaning is it, do I have the perfect wavelength for, you know, maybe the eczema on my, you know, hand? Maybe not, but I'm still getting benefit from it because I'm in a range of wavelengths that are still going to be beneficial because you, like I said, you can't laser in on a wavelength doing a specific, you know, thing. All the wavelengths have these general. Genevieve: and Alyson: you know, same mechanisms with some nuance to the effectiveness, I guess you could say, of them. So, okay, well, what else? Red and near-infrared light, lots of similarities, definite differences. I think we've highlighted that the depth of penetration is different between the two. And for those reasons, Genevieve: Yep. I agree. Alyson: very common sense, our skin and transvaginal pelvic wand products offer a red only option for superficial uses. But everything else we make does have double the amount of near infrared in it because of that ability to have a deeper penetration, an effect on blood flow in the area, blood and lymphatics affecting our water structure and Yeah, really the depth of penetration with that light being a bigger one. think something you and I have discussed to kind of conclude this is we're very interested right now in talking about brain health. We've been, it means so much to me that we continue to learn about it and teach about it and provide answers for people. Cause I think people are very concerned when they're coming to us and saying, Hey, I'm I'm considering using this for concussion or dementia or Alzheimer's or Parkinson's, they should be. And we go down this road of like, you know, how do we describe these bigger near infrared wavelengths that we're using? It's not necessarily true that they penetrate deeper. It's maybe more accurate to say that they have a more vast penetration or vast distribution of light. Genevieve: Yeah, yeah, I agree. I don't think we have an answer to that right now, but I'm comfortable saying that by having the two wavelengths in there, we're going to have broader benefits than if we just had the single. Alyson: Right, exactly. So, okay. Genevieve: And of course, I do need to clarify there for everybody. you know, Ali, I actually think we really need to start changing the way that we describe our products to list the full spectrum of wavelengths, because people are under an impression that like a laser therapy, there is a single wavelength in your red light therapy device, but it's not. is a. Genevieve: range of wavelengths with in which there is a peak wavelength that gets reported as the wavelength. And so if you're anybody listening that that has heard marketing around a magic wavelength and if your wave if your red light therapy doesn't include 630 nanometers, it's not going to work. It's not at all true. Genevieve: It's not true and it's not the way that science works and it's not the way that biology works. So LED lights emit a range of wavelengths of about plus or minus 30 nanometers or so. So if it says it's 650 nanometers, it'll actually contain light that's around 620 to 680. And so important take-home message, there's no magic wavelengths, red light therapy. with red light, with near infrared light, does a lot of different things, but they cross over. There's so many shared commonalities between a specific product that has a certain. wavelength that's stated or certain type of light. And that's why, know, we're never going to be a company that goes out there and says, you have to buy our products because they are the only ones that do this. That's not at all true. There are a lot of products on the market that, you know, can be beneficial. And it's just important that people understand what they're using and why they're using it. And we want to educate people as to why we designed our products the way that we did. Alyson: Yeah, for sure. So we'll put that on our to-do list because we'd be one of the first to be going into, we're not just changing how our wavelengths are listed, but we're taking this as an opportunity for people to understand wavelengths, you know, which is dropping down 10 levels in detail, which is fine. And I agree with you. I absolutely agree with you. And if the wavelengths change, which let me... Alyson: tell you everything around here seems to change very regularly every year. It's like, just learned that now we got to change this. And it's not the easiest thing when it comes to making product to make those changes, but it is the right thing to keep it progressing to, you know, being the best that we can make. yeah, so we will put that on our to-do list. Okay, thanks everybody. We'll talk to you again soon.

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June 24, 2026

Better Sleep, Less Soreness, More Energy: Let's Talk Magnesium

Dr. Abby Kramer and Dr. Genevieve Newton break down everything you need to know about magnesium — one of the most essential and most overlooked minerals in the human body. From its role in over 800 biochemical reactions (energy metabolism, DNA synthesis, cardiovascular function, neuromuscular signaling) to the growing crisis of soil depletion that makes deficiency nearly universal, this episode is a thorough deep-dive into why almost everyone should be supplementing. Dr. Abby walks through the specific conditions where magnesium supplementation makes the biggest difference: chronic headaches, muscle cramping, sleep trouble, anxiety, cardiovascular issues, and menstrual cramps. Dr. Gen contextualizes the science — including why the commonly cited RDA of 310–420mg is probably far below optimal, and why dietary tracking apps are unreliable guides for actual magnesium intake. The episode also covers Fringe's magnesium blend (glycinate for stress and sleep, malate for muscle recovery, orotate for heart and gut health), dosing guidance (starting at 200mg and titrating up), and what makes the powdered supplement market a "dumpster fire" — and how to read a label to avoid it. Whether you're already taking magnesium or have never tried it, this episode gives you the tools to do it right.   Listen on the go — The Fringe podcast is available on Spotify and YouTube. Subscribe so you never miss an episode.   Transcript Dr. Abby: Hi everyone, Dr. Abby Kramer here on the fringe and I'm here with Dr. Genevieve Newton and we are going to chat all about magnesium today. It's gonna be like a magnesium 101 school. So Jen, can you tell us a bit like a broad definition, what exactly is magnesium? Everyone hears about it constantly, but what is it and what like actions does it have in the body? Genevieve: Yeah, okay, so starting place, it is a mineral. Specifically, it's a macromineral, meaning you need relatively large amounts of it compared to some of the other minerals. So that being said, it's really an abundant mineral in terms of its distribution in our bodies and also in the earth. So if you were to go and sample rocks around the entire globe, you'll find magnesium all over the place. So it's... essential because of the fact that it is a micronutrient that we need in order to survive and to thrive and to be healthy. So we can get it from our diet and it's actually very, very, very widely distributed in food. like some really good sources would be things like your leafy green vegetables, your legumes, your nuts, your seeds, those types of things. But we also find it kind of as we move in through the food chain, right? So if it's in the soil, it gets incorporated into plants. We eat those plant foods. It has magnesium in it. The animals eat the plants. We the animals, they have magnesium in them. So it's really distributed everywhere. But we have, as you you and I have talked about so many times over the last few years, this really pervasive issue of deficiency in terms of our soil. And I know we'll get to that when we kind of look at the issue of deficiency and how prevalent it is. But going back to just this starting place, Genevieve: So we have this very, very wide distribution. We're supposed to be getting it really abundantly in our diet and then we distribute it all throughout our body. But one of the things that's challenging about magnesium is in terms of us being able to identify. of what someone's magnesium status is, is that it isn't found in high concentrations in our blood. So we see it as it gets into the body, it's used for so many different things, which I'm going to go through in a moment, but it's found really like inside the cells. It's intracellular, so we don't have a good way of assessing really like we do for vitamin D. You know, it's a simple at-home blood test for a lot of people. It's very, very easy to do and very accessible. So this whole conversation about magnesium is Genevieve: by a couple, actually more than a couple, of really sort of silent variables that we don't have much control over. And one of those is how much is now in our food, and then another is how much is in our body. And when it comes to our body, when I was initially writing our big blog about magnesium, I chose to use the biggest number that I could find so that we could get the best Genevieve: understanding of how many things in the body magnesium is involved in. Because when you read about it, the number that you usually see is that magnesium is involved in over 300 chemical reactions of the body. But that's related to its really more direct role as being bound to an enzyme and regulating how that enzyme functions. If we extrapolate that to just look at everything that it's all of the reactions that it participates in to some extent, that goes up to over 800. So we have Genevieve: over physiological reactions in which magnesium is either going to be bound to that enzyme or it's going to need to be present in some way in the medium to make it essentially happen. So it plays a role in so many different things. One of the big ones is energy metabolism. Like if you look at ATP, we see that the ATP molecule actually has a magnesium. Genevieve: I'm bound to it, which is like so wild. So it's involved in that. And then when we look at all of these metabolic reactions like the Krebs cycle and different reactions of glycolysis and just all of these metabolic processes where we're making energy, it's very, very, very integral to that. Another big thing that it's involved in is DNA synthesis, RNA synthesis, protein synthesis. So all of these things that we need to build the substrates of our body. It's also really important for bone health, right? If we look inside of a bone, sometimes people think, bones are just calcium. No, you're going to see a lot of different minerals in there and magnesium is a really, really important one. Cardiovascular function and the way that our nerves and communicate with our muscles, that neuromuscular connection signaling, that is another place where magnesium plays a very important role. And then the last one I'd say is really in our insulin, sugar signaling. So you can see like that's just an absolutely massive list. So it's really, really, really, you know, widespread in terms of its importance, widespread in terms of its roles in the body. And it should be very widespread in our environment, but we do have some limitations. Genevieve: due to our modern world. One of the other places that I didn't mention that we do find magnesium, and this is something that a lot of people don't know about, is that it's not only found in our foods, so in our plant foods, those really supposedly very high concentrations, and then, you the animal sources as well, but it's also really supposed to be found in our water. So depending on where you are geographically, this really does vary by location, because it all has to do with the distribution in the rocks. Genevieve: And as the water passes through it picks up these minerals. But historically speaking water has also been a reasonable source of magnesium in some populations. It's one of those things that when we talk about hard water, you know, people have in their houses and it builds up in their pipes and stuff that will usually be a combination of magnesium and calcium. So yeah, I mean it's one of my favourite supplements to use and I know it's one of your favourite supplements to use in practice. Genevieve: who how do you go about recommending magnesium to to your patients who do you recommend it to? Dr. Abby: So the short answer is everyone, because find me someone that's getting enough magnesium through their lifestyle, through food and water these days, right? Like, you know, there's a handful of supplements, which if you guys have listened or followed us, you know we have the essentials line for a reason, because those are the supplements we believe that everyone pretty much should be taking every single day. So magnesium falls into that category, much like all the other minerals, Dr. Abby: minerals, vitamin D we've just talked about super recently. So Most people, if not everyone, could benefit from magnesium supplementation. But I think the easier route is like, if I kind of go into the main symptom pictures people struggle with where I'm like, my gosh, you need magnesium right now. Right? Because just like vitamin D deficiency, there's kind of a spectrum, right? There's people that have glaring like daily symptoms that are screaming magnesium deficiency. And there's other people who really feel pretty good, but they still could use that daily boost because they're likely not getting enough. But magnesium is one of the number one supplements in my practice where you get people on a good quality magnesium at a therapeutic dose and they feel it. And it's like, it's such a low lift, like not enough people take magnesium. I've said this, I will keep saying this forever, arguably, at least this is where I stand right now. We all learn more in Dr. Abby: change, but if you're gonna take one supplement a day, I would probably make it magnesium. This is what I'm saying right now on April 10th, 2026. We'll see if in five years I'm saying the same thing, but very important. Yeah, totally. Maybe I'll say mushrooms in a year. Who knows? But magnesium. Okay, so main things people with muscle cramping or tension. If people get charley horses at night, if they feel like they're always having muscle cramps and issues, magnesium. Dr. Abby: Definitely start taking. People that get chronic headaches, that's a massive one for magnesium, whether they be tension, migraine, whatever. People that have trouble falling asleep and staying asleep, magnesium is a great one to give that a go and then take it before bed, if that's you. People with any sort of heart condition, cardiovascular issues, should definitely take magnesium. or stress should definitely take magnesium and people with like joint pain inflammation arthritis that sort of thing should take magnesium I feel like that's the main buckets where I'm like immediately like let's get you on a magnesium supplement Genevieve: Yeah, yeah, I agree. Do you recommend it to, in like higher doses to people who are dealing with diabetes, anything like that? Or do you find that kind of like your typical supplementation regimen is enough? Dr. Abby: That so depends on the person because the other one I forgot to mention was digestive issues, especially if people tend towards constipation. Even not getting on like a laxative form of magnesium, just getting their like elemental magnesium levels good in their body can straighten that out real fast. Um, it it so depends on the person. say the average adult, I probably put on somewhere in the range of 200 to 600 milligrams per day. And that's why we started our magnesium product is 200 per scoop per serving because for a lot of people, that's a great dose. And I always like my patients to be at the lowest effective dose. If you take 200 milligrams a day and your headaches go away and you sleep awesome, great you don't need 400. But some people really need to be closer to that 600 range for whatever reason right and there we could go down the rabbit hole of this the people with gut issues are you absorbing it well are you taking a poor quality magnesium that's really gonna affect absorption. So I've seen people before that are taking like a thousand milligrams a night but they're taking a crappy form of magnesium right so you get them on a high quality one you shouldn't quite need that much. Genevieve: Yeah, yeah, no, for sure. And I think that what you're saying, like, that's entirely consistent with what I see in the scientific literature. But that being said, the scientific literature in this area, I really don't trust it. think we have a few issues, as I mentioned before, that are layered on top of each other. one is that, as I said, it's hard to measure magnesium status in the body. So what we do is we tend to depend on dietary intake records. And so whether that be a food frequency questionnaire, a dietary recall, a three-day food record, a seven-day food record, whatever. We've got all these tools that are used whereby people remember the food that they eat. Genevieve: down the food that they eat and then you put that into a nutrition database and it spits out numbers for you based on these analyses that were done a long time ago and they're not accurate and there's been literally it's radio silence in the in the scientific literature about this no one's raising any alarms whatsoever and we've seen that there are you know Dr. Abby: Yeah, so those aren't even accurate. Genevieve: studies that have come out where they've taken samples of vegetables and fruits and grains and different products from different geographical locations and there's a level of depletion of magnesium that ranges from you know maybe as low as 20 percent but all the way up to 80 to 90 percent so it so that being said it does make actually getting an accurate measurement of what's in food really difficult because it depends on the geographical location but then we don't have Genevieve: On the other hand, we don't have the ability to just go in and do a really good biochemical sample of people easily where we can say, okay, this is what people's magnesium status is. And even considering those two really big limitations, we still see that numbers show up in the literature that range from like 45 to 60 % of people are deficient in their intake, right? Dr. Abby: Alright. Yeah. Genevieve: And so when you're looking at that, I think you can really safely say, okay, pretty much everybody is deficient. And then on top of that, we have another issue, is, and this is true for really all of our... Dr. Abby: Right? Yeah. Genevieve: micronutrients, what we do when we determine what the recommended nutrient intake is, right, which will be either an adequate intake or an RDA, that recommended daily allowance. We look at how much does it take to, and this has been done, this isn't like, you know, the 1900s, early to mid sort of thing. What is, how much does it take to prevent a deficiency disease? That doesn't tell you how much you need for optimal health. And there's very little research Genevieve: that you know is accurate on what our ancestors would have consumed but the estimates for magnesium are that our ancestors consumed about 600 milligrams of elemental magnesium a day. Our RDA is set between 310 and 420 depending on your age and your sex. So there's a disconnect there just to begin with and then we have yet our last layer which is that Dr. Abby: There's a gap. Genevieve: Body sizes have increased a lot over the last several decades. And as our body size increases, our magnesium requirements increase. So there have been estimates that that can be up to 200 milligrams a day. or more compared to what that RDA was set at, which we already just said was not necessarily optimal for health, but to prevent disease. So it's just layer upon layer upon layer upon layer of issues related to our understanding of both the extent of the deficiency problem, but really also how much to use and how to go about fixing it that. Genevieve: becomes a problem as well when we look at it in these terms, because there's just so many things that we don't know. You're going to recommend to people, well, you so often hear, because this is the dietetics response, go to food first, go to food first, go to food first, right? Well, you can't go to food first with this. And even if you are lucky enough to eat a very high quality diet, the amount that you're consuming is probably very low, but you're not going to know what it is, because you don't really Dr. Abby: Yep. Yep. Right. Dr. Abby: still isn't there. Genevieve: know where it came from and the geographical soil depletion extent. So yeah, it's a huge issue. So you kind of mentioned, yeah, go ahead. Dr. Abby: Well, it's like, I was just gonna say like back to the soil conversation, right? So unless you're, if you're getting everything from like a regenerative farm, you might be able to do it, right? But it's like, who can do that on every single food they're consuming, right? So it's, the bottom line is our soil just is like mostly dead now. So. Genevieve: You might, yeah. Genevieve: Yeah, and our water too. And it depends on, know, if you're dealing with a, if you're buying a more inexpensive food base, which unfortunately many people need to consume, you know, those farming practices tend to deplete the soil to an even greater extent, right? Yeah. So what do you see as far as like clinical responses in your practice when you supplement people with magnesium? Dr. Abby: Yeah, correct. Yeah. Dr. Abby: I mean, Magnesium's amazing. Almost you name it because like you spoke to so well earlier, like give me a system of the body that isn't affected by magnesium by like being low in magnesium that needs magnesium to thrive. Right. But all of the things I spoke about before, like problems people might have, I've seen. Cramping go away, like overnight people that get nightly Charlie horses. I've seen headaches reduced significantly in some people completely. I've seen. digestive balance restored and I am I find with magnesium most people feel a difference fairly quickly. It's not like it takes you know three months to see a difference. It usually is pretty fast people notice especially if they're at the right dose. So I would encourage people if you're like I've taken magnesium for so long and it hasn't affected my headaches try upping your dose especially if you're taking a high quality one like what we make one that isn't gonna like disrupt your GI. I've seen it really help people with like brain Dr. Abby: fog and stuff like that even like cognition it helps with anxiety. I always make sure people are on magnesium for like you spoke about earlier bone health like if you're taking a great vitamin D and K make sure you're also taking magnesium because that's also really important there. It's just such a such a great product like whatever issue you have basically magnesium could support that and so it's worth Genevieve: Thank Dr. Abby: adding it to your daily supplement stack if you haven't yet and see what you notice. But I'd say those are the biggest heaviest hitters. Genevieve: Yeah, I've definitely seen most of those in the scientific literature. magnesium has been relatively well researched, certainly as far as supplements go. And it hits across a lot of different clinical outcomes. So as you said, things like sleep and things like cognition and migraines. One of the issues that is interesting in the literature with respect to supplementation is that, and I think this is what we would call just a historical artifact, is that a lot of these studies use really crappy forms of magnesium to supplement with. They really did. So they're using magnesium oxide and they're using magnesium citrate. So I guess I didn't really talk about this when we were talking about what magnesium is because it is an important Dr. Abby: Yeah. Like oxide, probably. Genevieve: component of the discussion and that's that it is found in these different supplemental forms, right? So when we're talking about magnesium itself, we're just talking about the element, but when we find that element in nature, it's reacted to something else. And so we have these inorganic forms and we have these organic forms. It just depends on what it's bonded to. So magnesium oxide, for example, is like a super common inorganic form of magnesium. And these inorganic forms tend to be really poorly absorbed, whereas the organic forms are more highly bioavailable. They get into our body to a much greater extent, but even that really varies across forms. So if we look at these studies that are maybe using like 600 milligrams of supplementation of magnesium oxide, well, that could be the equivalent of, you know, 400 milligrams of supplementation of a more bioavailable form. So it's something that does kind of make it complicated. Genevieve: when you're saying, I'm look at the scientific literature, I'm going to look at the doses they use, and I'm going to replicate that. Because we, yeah, it can definitely be different. But even that being like a confounding variable in the scientific literature, we still see some really dramatic results across a lot of these outcomes. Like, yeah. Dr. Abby: different. Dr. Abby: Mm-hmm. Well, that's what I gonna say. Even despite being like a cheap, poorly absorbed form, you still see crazy results. So it's like, you know, with an even better form. Genevieve: You do, absolutely. But that's when you start seeing, yeah, you start seeing more of the side effects and that's one of the things that people worry about, right? They're like, I can't take magnesium because it's going to give me diarrhea. Well, if you take magnesium oxide, is potentially, if you take a higher dose, it's going to give you diarrhea for sure. But that's not necessarily the case with these more bioavailable. they're much more GI friendly. I was just reading, there was a really interesting systematic review of all of the sleep studies and trying to remember the numbers. was something like people fell asleep 17 minutes faster in all of these controlled studies and then they slept like 16 minutes longer. So it really does have, you Dr. Abby: That's amazing. Genevieve: That's a very dramatic effect on sleep. The other one that you've mentioned is people seeing really good benefits with our headaches. And most of the studies have looked at migraine headaches specifically, and they've been like really, really consistently demonstrating a positive, very positive response to it. Blood pressure, that's another one that's been researched. And, you know, it was just reading like a series of articles that were written Genevieve: in SUPCO and so they did like this series on magnesium over the last few weeks and it was interesting but I think they downplayed the importance of magnesium to some extent kind of talking about some of the negative or not negative results but some of the studies that don't find positive results and so the conclusion was really important mineral but Genevieve: They called it, the term that they used was like physiologically upstream, which absolutely it is. We just talked about how it's really important in it fundamentally in a lot of processes, right? So that being said though, you and I have just talked about all of these limitations in terms of interpreting that research, right? So issues with bioavailability and absorption and dosing and measurement of Genevieve: body status of magnesium. I definitely think that when you look at the scientific literature as a whole, you really see that it's a very, very consistently beneficial supplement to use. Yeah, yeah, so I would say that. Very low risk. Dr. Abby: Yeah, correct. And low risk. The other research one I wanted... The other research one I wanted to mention was, I can't believe I forgot to say this earlier, the menstrual cramp one, which I'm very excited about still. Menstrual cramps taking one group, well, one group was placebo. One group took 150 milligrams a night. The other group took 300 milligrams night or day, whatever. And they, the women, they were all younger women who experienced menstrual cramping with their cycle. They just had them Genevieve: yes, Yeah. Dr. Abby: take it during their luteal phase. For like the 10 to 14 days before their period, it wasn't even the entire month long. And like crazy positive results. So anyone that experiences that, definitely. Genevieve: Yes, yeah, definitely. Yeah, yeah, and that probably, you know, has to do with that neuromuscular action, right? The relaxation, you have those prostaglandins that are made and they cause the cramping and the tightening. And if you can counteract that with magnesium, like, yeah, it's absolutely, it's amazing. So you've mentioned the doses at night and day, like how do you typically recommend to people that they supplement when you're giving them these protocols? Like, what do you, do you recommend that they divide doses during the day? Genevieve: How much do you recommend people take? Dr. Abby: I don't recommend they divide it if they're taking a good quality magnesium because it shouldn't mess up their gut. it's more, mean, A, the first thing for me is always, because magnesium is such a daily essential supplement, it's whenever you're going to be consistent is my answer. Because a lot of people, take all their stuff in the morning, they forget to take it at night, and then they come back to me and it's like, three days out of the week I took it. So it's like, just take it in the morning then. But if sleep is your concern, you really should be Dr. Abby: taking it at bedtime to get that like positive effect. But the name of the game with supplements like this, like our essentials and whenever you can be consistent, if you take everything at lunchtime, go for it. If you're a nighttime person, go for it. Magnesium, I haven't found, um, is going to make you like sleepy during the day. It just like really supports like deep restful sleep. If you take it at night, that's at, by the way, I need you to send me that sleep study, the review. We need to do. Genevieve: Mm-hmm. Absolutely. Yes. Dr. Abby: post on that. That's an extra 30 minutes of sleep. That's a lot. Genevieve: Yeah, yeah, no, I agree. And I think your point about... make it so that it fits into people's routine. That's like the top recommendation. And then second, if it's not going to be an issue with remembering for you, then definitely take it at night because that's when you're going to potentially see the most benefit. That being said, if you're somebody that does deal with anxiety, then that maybe dividing and having that morning dose is also a good one. Dr. Abby: Yeah. Yeah. Genevieve: Yeah, particularly if you're going to be taking something that has magnesium glacinate in it. That's one of the things that we haven't really talked about are the different forms of magnesium. Do you want to talk about how our magnesium is formulated and how it's kind of unique to other products on the market? Dr. Abby: Mm-hmm. Yeah, so ours is quite unique. I'd say the majority of magnesium supplements on the market are one form, which nothing wrong with that. So each form kind of has its own little personality and benefit. And I really wanted to do a blend and then so you get multiple different benefits in one supplement. But I feel like some of the other blends on the market are almost too many forms. And then it's like therapeutically, are you actually getting enough? Dr. Abby: malate for like muscle recovery, right? If it's just like a sprinkle of eight different forms. You're still getting the elemental magnesium, so you're still gonna have a lot of benefit. But we really wanted to hit that sweet spot where people are getting enough to have that specific benefit and then enough overall. magnesium on a daily basis. So we chose to have magnesium glycinate, which is probably my favorite form of magnesium. It's great for stress, anxiety and sleep. people like if you have a busy brain, magnesium glycinate will be your best friend. So I really like it. It's a nice gentle calming effect. Magnesium malate, which is great for muscle cramping, exercise recovery, joint pain and inflammation, that kind of family of things. And then magnesium orotate, which I kind of fell in love with just from researching, I'd never used it before or really heard of it. And it's pretty cool. It's great for heart health. And there's some studies even on it supporting gut health, which was super cool to me. And I just had not seen like almost anyone use it in their products. And I was like, this is so undervalued. Genevieve: Yeah, I agree. So the research that there is on magnesium orotate is very positive. The flip side of that is there isn't a lot of. research because it is a higher quality, more expensive form. And it's a newer form. Definitely the research shows that magnesium glycinate is like, it's the one that everybody goes to when they switch into like a higher quality magnesium supplement. Anybody who is taking sort of that cheaper was usually at this point taking magnesium citrate, maybe magnesium oxide. But then if you start kind of upping your, Genevieve: your game and going to something people are always like take magnesium glycinate which you'll also see on the bottle it'll say magnesium bisglycinate it's just related to the molecular structure and there is a lot of research on that then in terms of Genevieve: you know, benefits. And I think it has been difficult and it's always difficult to measure effects on anxiety. They're just sort of traditionally anything related to mood and cognition is harder to study. So the studies, you know, straight up, they are not all consistent in terms of showing benefits, but they used widely different ranges. They use different populations. A lot of the research is Genevieve: Unfortunately. didn't select for people who had a lower magnesium intake to begin with, right? So that's something that you really want to do when you're measuring, you know, trying to measure effects with supplementation is, of course, you want to know what happens in a more healthier population, but also you want to know what happens in a deficient population. We really haven't unpacked that. Yeah. Yeah. So what about our dosing? How do you feel about recommending to people and where do they start and, you know, how should they use? Genevieve: that. Dr. Abby: Yep. I would recommend people when you start, you're talking about... If we're talking about our magnesium mix supplement, you start with one scoop a day, which is 200 milligrams and plan on doing that for 30 days. But I would say within a week or two, if you don't notice the result you're looking for to go up to two scoops, have, I would say the majority of my patients are on 400 to 600 milligrams a day. Now that doesn't mean people can't get great results at 200. So it just, it's so depends on the person. Genevieve: Thank Dr. Abby: But I don't think many people need to go straight to like 600 unless maybe that's what you were taking before with a different product or something like that and you find your sweet spot on what gets you sleeping better feeling better less anxiety Etc. Everyone can be a little bit different, but I would stay start with one scoop a day Give that a week or two then up it as needed. Some people might do great at a scoop and a half Which would be right around 300 So that's what's nice with it being in a powder form Dr. Abby: is you can play around with the dosage rather easily or like you were saying to some people, find it really nice to do a scoop in the morning and a scoop at night when you're supporting anxiety and stress levels during the day. A lot of people really notice that's a positive benefit and then sleep at night. Genevieve: And then how would you differentiate our product with respect to the other ingredients in it compared to what's on the market? Dr. Abby: my goodness, well the powdered magnesium market is a dumpster fire. So that is the same story as our electrolytes, like our powdered products is almost all of them. If not all of them, probably all the ones I've seen are going to have natural flavors. They're going to be like half citric acid. have actually, I should do this again because I have a tub of a competitor's powdered magnesium and our tub. They're around the same dosage per scoop. And the tub and the scooper is about double the size in the competitors as ours, right? So then you've got to ask yourself, what is that? What's all that extra white powder? Right? It's probably a bunch of maltodextrin citric acid. So. Dr. Abby: You want to, you always want to look at, and I feel like people are out of the habit of this when you're looking at labels, there's the supplement facts label, which is like the different forms of magnesium. There's 200 milligrams and a scoop in here, but underneath there in very tiny print is other ingredients or additional ingredients. And that's where you're going to find the sweeteners, the gums, the preservatives, the flow agents, the flavorings, all of that stuff. You want that to be as minimal as possible. And ideally it's ingredients you recognize. You're like, I know what that is or I've heard of that before Obviously with our powdered magnesium we added a bit of Thalmatin spoiler alert magnesium tastes terrible you guys So if you open up a magnesium capsule and put it in your mouth, you will understand why we put that in there So it's just slightly sweet. I could put it in like my whole water bottle and I probably wouldn't taste much but It's very easy to mix into a smoothie a little bit of water, some juice, you could put it in your kid's yogurt. To add to things is quite simple. I usually just put it with our electrolytes and then done. Genevieve: Mm-hmm, it is important for people to understand that there can be, you know, if it's in a water bottle there can be a little bit of sediment at the bottom, right? Because it's a mineral, it's inorganic, it can precipitate to the bottom. That's totally, totally normal. Yeah. What about for kids? What do you recommend for kids? Dr. Abby: normal. Dr. Abby: For kids, I love magnesium as well. Very similar story. They're deficient just as our adults. And so we have that, well, it's in our FAQ. I don't think it's on the actual packaging, but according to children's age, we just titrate up. So kids that are closer to adult size, like, you know, 13 and up, they can do a full scoop just like adults can. I think people get scared with like kids in like middle school, high school range. They're like, can they take an adult product? I'm like, you're... Dr. Abby: kids a foot taller than me, they sure can, right? Once they're like full grown, it's magnesium, it's very safe. So we should actually post that maybe in these show notes. Evan, I'll say that to our producer listening in, that we can post the kids dosing according to age on what we recommend. But again, magnesium is a very, very safe supplement. If your kids struggle with sleep, that is probably the first thing I would start adding for them because it's so safe. It's so Genevieve: Thank Dr. Abby: gentle and can really help the kids that wake up a lot or have a problem winding down at night. That would be a great way to support them. Genevieve: Yeah, it's um, now that you're talking about, um, that it just brought something to mind, and that's that some people, when they look at kind of the the mainstream literature about magnesium supplementation, is they might see that there's a recommended upper limit on supplementation, and I can't remember what the number is right now. I think it's 350 milligrams. However, that is Dr. Abby: That's the upper limit? Genevieve: offer supplementation, but that's not the upper limit for intake. It's for what the recommendation is for supplementation, but it's based on GI upset. That's what it's based on. So I wanted to just kind of put it in there that, you know, again, I said that there is this historical precedent of using these poorly bioavailable GI upsetting forms of magnesium. And so when... Dr. Abby: Yeah. Right. Genevieve: you know, the Institute of Medicine and the governments look at their literature that's been done with supplementation and they see that there's a side effect of, you know, GI upset. That's when they say, we're going to put a recommended upper limit on it when really we now have these much more gut friendly that really don't cause GI issues. And the other part of it is that it's very easy to get around that by if you do find that you have a sensitive gut, even despite using a more bioavailability. Genevieve: form, you just separate it into a morning and an evening dose, right? You have two doses. And then the other thing that it made me think about was that there can still be some confusion in terms of how much elemental magnesium is in an ingredient. So you might find a capsule that says 500 milligrams of magnesium glycinate. But then when you look and you see the elemental magnesium in magnesium Dr. Abby: Yep. Yes. Genevieve: glycinate it could be I'm trying to think of what that actually would be it's like 70 milligrams I think for magnesium glycinate. So that would be the equivalent. So if the bottle says 500 milligrams of magnesium and you're like this is great I can just take one pill it's that's all it is you've got to make sure that you you look and on that label and see what's the actual amount of magnesium elementally and that will be 70 or so for a good yeah. Dr. Abby: Yes. Yes. And I remember that was like so confusing for us when we first started researching this. We're like, what is going on? Yes. Genevieve: Yeah, because just because of the way that it's reported, right? It's the molecular weight versus the elemental amount. Dr. Abby: Well, and on labels, you can label it so many different ways. We've seen that, like our manufacturer will send us like five different options for a label and it's like, pick one. So it can be kind of misleading based on however people are choosing to label it. Genevieve: Yeah. Yeah. Genevieve: Yeah, there are guaranteed there are many, many people out there who are supplementing far less magnesium than they think they are because they're looking at that full amount of the magnesium element complexed with whatever it's mixed with. So that's kind of a last thing. Yeah, I mean, is there anything else kind of in closing that you think we've missed today or I think we've covered most of the magnesium 101 issues? Dr. Abby: Yep. Yep. Genevieve: It's a very, very important mineral. Obviously, that's why we included it in our fringe essentials. And it's great to be able to talk about some of the issues that no one is talking about in this space, like underestimating your magnesium intake if you're using a dietary tracking app, for example. Like if you use chronometer or you use, you know, my fitness pal or whatever, you are getting a number from there that's probably not at all. Genevieve: what you're actually consuming. Dr. Abby: Right. So what would you say people should assume then that like say they're doing that? Is it like you should assume you're like getting half the amount it actually says? It's hard to say. Genevieve: It's, this is the thing, we don't even know. We really don't know. I think that at this point, it's safe to say that everybody is, everybody is as consuming. less than they think they are if they're being very careful about their consumption and it's only coming from food. Certainly if you're consuming a supplement and you know what the amount of elemental magnesium is in there, that's going to give you a much more accurate, at least one accurate intake source, but if it's just coming from food, it's not accurate and it's, and as you said, could it be half as much? Yeah, it could be half as much. It might be more, it might be less. It really, it really depends and until those studies are done, we're not going to know. Dr. Abby: Yeah. Yeah. Genevieve: And all we see so far are just a handful of studies that have taken food products. natural food products and analyze their magnesium content and have found this massive range, you know, going from like 20 % to 90 % depletion over the last several decades. So it's a bit of a mess out there. And as you've said many times in this podcast, it's a very safe supplement. So it it goes on both of our number one lists in terms of what we both recommend for sure. Dr. Abby: Yeah, so the take home of this episode is get on magnesium if you haven't, or get on a better one if you have struggled in the past with symptoms. It likely was the form or all of the other whatever ingredients were in there because it's an important one. Genevieve: Yep, agreed.

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June 24, 2026

Exploring Nutritional Gaps in Modern Day Kids

Dr. Genevieve Newton and Dr. Abby Kramer introduce the newest addition to the Fringe lineup: the Kids Mighty Multivitamin. This episode is equal parts product deep-dive and nutritional science lesson, covering why kids today face real and measurable nutrient gaps — even those eating well-rounded diets. Soil depletion, food processing, and the reality of picky eaters all contribute to a landscape where supplementation isn't optional, it's essential. The Fringe kids' multi is built from organic fruits, vegetables, and mushrooms — a food-based foundation that prioritizes bioavailability and safety. Dr. Gen and Dr. Abby walk through the standout ingredients: choline for brain development, algae-based calcium, extra magnesium, and a plant-sourced D2/K1 combination. They also address one of the trickier challenges in food-based supplementation — Proposition 65 heavy metal disclosures — and explain why naturally occurring trace metals in whole-food ingredients are fundamentally different from contamination. From the thaumatin-based raspberry-strawberry flavor (developed with picky eaters in mind) to the $48 price point and dosing by age, this conversation gives parents a clear picture of what to look for in a children's supplement and why most options on the market fall short.   Listen on the go — The Fringe podcast is available on Spotify and YouTube. Subscribe so you never miss an episode.   Transcript Genevieve: Hi everyone, welcome back to the Fringe Podcast. I am here with Dr. Abby Kramer, who is the medical director at Fringe. And I'm Dr. Genevieve Newton. I am the scientific director. And we are really excited to talk to you today because we have a new product that's launching. It is a food-based kids multivitamin that we've called the Fringe Kids Mighty Multivitamin. And there's a lot of really unique and amazing characteristics. that Abby's going to tell us about today. So let's just dive right in, Abby. First of all, why? There are so many multivitamins on the market. Why did you feel so passionately about developing a kid's multivitamin? Abby: Yeah, this is really... A very similar story to other products we've made is even though there are so many multivitamins out there, especially for children, there's almost too many. If you're, you know, researching or looking on the shelves at the grocery store or the pharmacy, it's like, where do I begin? And there also wasn't one I could point to that I absolutely loved. There wasn't one where I felt like I wasn't compromising something where maybe I'd seen it really work or it tastes really great. So kids will actually take it, but I don't love these two or three ingredients in it, right? So I feel like it's a very similar story to our electrolytes that I know it's needed and we're going to talk about why. And there wasn't one I really loved that I really trusted that, you know, from the ground up, I could like stand behind 100 % of it. Genevieve: Yeah, no, I agree. My kids are past the point of taking a kid's multivitamin, but I remember at the time it was. It was challenging to find one that really wasn't just a candy that they would eat. Yeah, definitely. do you think, you know, when you look at the science of the nutrient intakes and dietary deficiencies, are these nutrient deficiencies really widespread in kids today? And what about the ones who eat well? I mean, I have picky eaters, so my kids never fell into that category, but there are definitely some that do. So do you think that that multi Abby: You know, I really do think it's necessary. And if you would have asked me this 10 years ago, I would have said it's not necessary. kids focus on real food, if kids eat clean, if they're not eating the typical kid diet, you know, it's like hilarious. You go to restaurants and the kids menu is like chicken nuggets and macaroni. Like they can't eat, you know, chicken. Come on. It's like such a systemic issue. Um, but I would have said there's no need for a multivitamin. Genevieve: Yeah. Yeah. Abby: it's synthetic anyway, you should be getting your nutrients from food, focus on that. You're overshooting a lot of stuff you don't need. It's in a lot of forms that you don't absorb well anyway, and it's got a bunch of other garbage ingredients in there that you don't need every single day. But however, the last few years, I've really changed my tune because We've really learned how intensely depleted our food is. So that even if you are eating a really good organic whole food base, you're going to the farmers market. Abby: and getting local produce and doing all those things, which we all should absolutely do, we still tend to fall short in a lot of nutrients because of that fact, right? And then let alone, like you're saying, if your kid's a picky eater and goes through a phase where they don't want to touch animal protein, right? So they're losing a lot of their B vitamins or something like that. So I really do believe now that a multivitamin for kids and adults really is becoming more and more essential. Genevieve: Yeah, I've come to the same conclusions. And I think what most of our listeners and really, you know, even very few people who are really well educated in nutrition are aware of is that if you look at the studies that compare the nutrient content of foods today, the micronutrient contents are our vitamins, our minerals. If you look at them compared to 50 years ago, 100 years ago, the nutrient content for some nutrients, not all of them, but several of them has fallen. dramatically. And so even when you're eating healthy food that should in theory contain adequate amounts of nutrients, they don't. And so this confounds the use of things like you know chronometer and these nutrition measuring tools that people are using that you you put in your food across the day and it spits out the numbers that you consumed. Those numbers came from many many many analyses done many years ago. If we were to do those analyses today we Genevieve: would see very different things, particularly for things like magnesium. Vitamin C content of food has changed dramatically, so it's definitely an issue. So this is really, I mean I guess you're in your eyes then you would describe this as another one of our essential supplements, is that correct? Abby: Yeah, for sure. Because like, you know, we've discussed in previous episodes, guys go back and listen to that. But, you know, Essential to us means that in our modern world. we cannot get enough of X, Y, or Z through our lifestyle, through our diets, so this type of supplementation has become essential. It really should be in everyone's kind of daily stack. And then you're personalizing from there based on your needs, but it's just so hard for us to get these basic nutrients from food only. Genevieve: Yeah, and I think you would agree with me that it's absolutely tragic that we've gotten to this place because when I went through my nutrition education and absolutely, you know, the point that was always being made is you need to get nutrients from food. It's only really supposed to be a handful of people that when I was educated were taught that, okay, you need to fill gaps with some individuals, but for the average person, if you're going to eat a healthy diet, you should be okay. And that's just not. Genevieve: the case anymore and it is it's it's very very tragic. So tell us about the kids multivitamin. What what is it? Abby: So our approach with the kids' multivitamin has been, and you know what, I'm glad we waited to make this until now, until our values were really set, because we've landed on, we've really, as you guys know, sourced our things, make our things as close to from the earth and from food as possible. So we decided to go very different than the vast majority of multivitamins out there on the market and source almost all of the nutrients from food. So it's a powder-based supplement. It's not a gummy. It's not a tablet. You can mix it in water, your beverage of choice. You could even mix it in applesauce or yogurt, something like that. And the foundation of the nutrients come from organically grown fruits, vegetables, and mushrooms, which is very, very unique in the market. But to us, it's like, that's where we should, in a perfect world, like we just said, we're getting all of this stuff from our diet. So this is the forms of those nutrients. that's how our bodies should be consuming them. And the shocking thing to me and you, I know, as we, you know, dug started doing this, what, a couple years ago now? Was that how many multivitamins out there are all synthetic? Genevieve: All synthetic. Yeah, almost all synthetic. there are, yeah, it was very wild. We had the option though of we could just buy this fruit and vegetable blend and, that was something that we could have done and we could have used that as our product. A lot of people do that. A lot of companies do that, but we didn't. We chose to formulate it primarily using this fruit, vegetable, mushroom blend. Abby: It's pretty wild. Genevieve: But then we did some stuff to it. Can you tell us about that? Abby: Mm-hmm. Yeah, well, we added a couple other things that we felt like was very important. So I'm really big on choline. We could probably do a whole podcast episode on choline and how important it is. And I mean, we tried to source it from food, but that would be like egg yolk. or liver, it would taste terrible, just trust us on that. So you're welcome. That's the one synthetic add-on nutrient, but choline is so important for brain health, primarily. Really important, you'll see in a lot of high quality prenatal vitamins, for example, people are starting to realize a lot of choline should be in there. And so many people are nutrient deficient because it's in like organ meats and eggs. Genevieve: Yeah, know it's really, the choline is one of those nutrients where when you look at the deficiency statistics, it's very significant for many different age groups. I know personally that's one of the supplements that I use specifically as a choline supplement because of concern with respect to brain health and recognizing that I am not getting enough in my diet. Almost nobody is. And so as you say, we made the decision to add choline and when we looked at sourcing it, we couldn't find a food-based source of choline that was readily available. we made based on our values, which are to put as a priority using ingredients that come directly from nature at the top, but yet weighing that and balancing it out with the need to like the recognition that this supplement needed to contain choline and the only way that we could do it was to use this one single synthetic ingredient. So we did that. What else can tell people about the other things that we decided to add a little bit more of to our multivitamin? Abby: Yep. So we added a bit more calcium. from algae, calcium obviously is probably the most important at any stage of life, you know, for kids, for bone health, bone development, a lot of kids for various reasons cannot have dairy, which is one of the biggest dietary sources of calcium. I see a lot of kids that need to be dairy free for whatever reason. And so then your option is like green leafy vegetables, which we all know how often kids really want to consume that all of the time. So calcium, but algae-based, not, you know, synthetic. And then the other one was some additional magnesium because, like we talked about, magnesium is so depleted in our soils and it's also really, really important for hundreds and hundreds of processes in the body. So we wanted to beef that up a bit as well. Genevieve: Mm-hmm. Yeah, absolutely. And so we looked really carefully at what the intake and deficiency data said, what we could get from the fruit and vegetable and mushroom. food blend and then looked at, okay, we need to add a little bit more for our magnesium and then for the calcium and for the choline. So, okay, we talk about synthetic vitamins and obviously it's a really big value of ours that we avoid those if we can. Can you talk a little bit about why you feel so passionately about that using food, natural ingredients as much as possible? Abby: I mean, I think it just mostly goes down to like biologically. That's how we're supposed to get our nutrients from a food based diet. Right. It's like, wow, how did humans survive for, you know, hundreds and thousands of years without their Flintstone vitamins. Right. Like we got that stuff from food. Like that's naturally how it's supposed to be. And I'm not saying there's not a time or a place for synthetic supplementation. Right. We have kind of talked about this on other podcasts a bit. If you've got a severe deficiency, you Genevieve: Damn. Abby: might need to go that route for a bit to get your levels up, right? But especially for children, you know, why not go food based when we can, but I think a lot of people don't because it's a lot harder and it's a lot more expensive. So it's not as easy. Genevieve: Yeah, no, absolutely. No, no, and we've we've certainly run into that is I mean, we could have made it. We could have made even this just off the shelf picking something, right? And that would be much, much easier. And you can certainly understand the temptation to companies, but it's so worth it. And we're both moms, right? We wanna make that. Well, we're not, and it's not just you and I, there's everybody at Fringe, almost everybody has kids, and it's really important to us to get good quality products into the market. So, okay. Genevieve: When we look at the ingredient list, we see vitamin D2 instead of vitamin D3 and vitamin K1 instead of vitamin K2. Can you talk about that? Why did we have those instead of D3 and K2, which we have in our vitamin D supplement? Abby: Correct. It's because that is the form of those vitamins that is in the fruit-veggie-mushroom blend. So when you consume those vitamins from those plant foods, they're in that form. Right? so that is, you know, unless we added a separate form of that on top of it, that's how you would get those vitamins from those plant foods. And then if people want to add additional, you know, D3K2, like that's why we have that as an extra supplement. So we just wanted to kind of hit that really nice food-based baseline. And then you can always add additional on top of that if you need. Genevieve: Yeah, and most people, as we talked about in our last podcast, most people will need to add additional vitamin D. because it's important to consume vitamin D alongside vitamin K to make sure that any absorbed calcium gets to the bones and the teeth, you want to make sure that you're taking those two together. certainly there's a great synergy between the kids multivitamin and our vitamin D 3K2 supplement. There's no question about that. Yeah. Abby: Yes, and really all of them, right? Even magnesium. Some kids certainly might benefit for more. But that's where we didn't want the multi to have too much D for some kids, right? Or too much magnesium. And that's especially with vitamin D, that's such like a custom need dependent on the person and their biology. So then you can add or not as needed based on what your kid needs. Genevieve: Yeah, well you bring up a really good point there because when people look at our supplement facts table, they're going to see that there's what's called a percent DV, which is a percent daily value. So that is if you're taking this as a supplement as directed, what percentage of the recommended nutrients will it be giving you? And you'll see that for almost all of them, we don't have 100 % of the daily values. Some of them are, you know, they're kind of more coming in at around 50%. Genevieve: Can you explain why we chose not to double it up and hit a hundred on everything? Abby: Yep. And this is, feel like, a big difference and a good thing to specify because people might look at that and be like, am I getting less for my money from, you know, a lot of these synthetic-based multivitamins, for example, overshoot everything, right? You'll see like B12 is 10,000 % of your daily value. And I just don't think that's necessary. Frankly, you're just peeing out most of that. Abby: But for us, we didn't want to completely fill everything. We wanted to leave room for that with a whole food, healthy, nutrient-dense diet, right? So you don't need to overshoot everything so much when you are also... eating these types of foods, protein, fruits, vegetables, healthy fats, right? So I feel like the multivitamin world especially has got swung so far into we're just really overshooting everything and people are just taking a lot more than they actually need. Genevieve: Absolutely, and we really just are, I think if you had to describe our value, I'd... main values at Fringe would be to go live the way nature intended, right? And so nature did not intend for us to consume 500 % of the daily value of nutrients in a single sitting. And so by giving people the option to have having a powder, it's easy if you feel like, you if you feel like your kid has had, you've been on vacation and they've eaten terribly for a week, well, you can bump that scoop up a little bit, right? That's a very easy thing to So parents have a lot of flexibility there and they can definitely be assured that there's no risk of toxicity with the product. One of the things that, you know, we haven't really talked too much about this when we talk about these synthetically made nutrients that come usually from China. It's really important when you're buying those products, we've certainly specified that from some people, some of the time, there's really a time and a place where you may need to take something that is synthetically sourced, but make sure that the company that you're buying it from does extensive third-party testing on the ingredients because heavy metal contamination from other countries isn't, is not an uncommon thing to see. Genevieve: also see contamination from things like residual solvents and pesticides and a lot of things that you don't want to have in that. So can you talk a little bit about how we test for our safety of our products at Fringe? Abby: Yes. do we test? So, yes, first of all, like while we're formulating stuff, we test ingredients because so for example, with this, this product is a great example, right before we even moved forward. We sent the fruit, veggie, mushroom blend out for testing to make sure it's super clean before we go through the work of flavoring it and swining it. We want to make sure this is a really clean source product. And so what we do is we test at different points throughout the production process. We always know where our stuff comes from, what testing the vendor, the company themselves might be doing. So we get our eyes on that, make up a sample, send that out. We test every single batch before and after for heavy metals, pesticides, and mold. And we test for everything you can possibly test for. You can save a lot of money and just test for a couple of pesticides instead of all of them. We test for all of them. And so we do that before. our factory gets all the ingredients, mixes together a sample, they send it out for third party testing. So we wait a couple weeks for that. It comes back, we come over it, do a lot of math, approve it, then it goes through production, then we hold it and do the same thing again. And so we know before it's super clean and after that nothing weird happened. And then we sell it and we do that on every single batch. A lot of people don't do that, unfortunately, like a couple Abby: If you're lucky enough that they would even send you their test results, sometimes you get them and they're like three years old. So that's not even on what you currently are ingesting. And so it's important to us to do that on every single batch. Every time we publish the testing results right on our website so you guys can have access to that. It's important for everything, but especially for kids' products that that's happening and you have access to that information. Because the truth is you just really don't know unless you do. Genevieve: No, you have no idea. You've worked with supplement companies and some really good quality supplement companies. What percentage, I mean, I this is a ballpark, but what percentage would you say are doing extensive safety testing like we are? Abby: I don't even know because they don't even, it's not on their website, right? So I mean, what you would have to do is probably contact the company, the customer service, ask for the testing results. A lot of the really, really big companies do their testing in-house, which I personally don't like. I don't know why you wouldn't send it out for third party. Genevieve: Maybe not. No. Abby: and I think a lot of them just probably do it every few years. Like how up-to-date and current is it? And most of them won't share the COAs, if you ask. So it's really kind of scary, honestly. Genevieve: Yeah, and I think this speaks to, we're seeing a shift in customer education base, obviously, and the more people know about what's going on in the background of the things that they're buying and consuming. Genevieve: the more they need to step up and ask for this information from people because that's the only way it's going to change. Because it should be a standard across the industry because a company that cares about the product that they're making will do this, right? And will stand behind it. So... Abby: Yep. I agree. Abby: Yep. Yep. And some of them will. I've reached out to some and they're like, yeah, we'll gladly send it. And it's totally fine. So I would encourage people if they're thinking like, man, I really want to know what's in, you know, this product or how clean or not clean it is. Just reach out to the company and see what they say. And it'll kind of show you their true colors. Genevieve: Yeah, absolutely. Do you, what is the situation with heavy metals when you're looking at a product like this that is food based? So what most people don't understand is that heavy metals are elements that are found in the earth. So it's actually a very normal thing for them to be present to some extent in things like fruits and vegetables. So how does that play into our products? Abby: Yes, so how that plays into any time you are consuming a food based product or mineral rich product, salt falls into this category, right? You guys might've seen on social media, people leave like putting salt companies on blast because they have, you know, metals in their salt. It's like, well, they come from the ground. So that's going to happen. So it's important to know like dose matters. Abby: And this stuff is cumulative, right? So you want to just make sure the levels are at the lower end, but you usually are going to have these metals in food-based products. If you went to the grocery store and bought a bunch of fruits, veggies, and mushrooms and sent them out to a lab to have tested, there would be some of those heavy metals present in those foods because it's in the soil. You know, the food grows there. Genevieve: It's in the rocks. It's in the water. Abby: Correct, like leaches that and then it's in your final product. Now, certainly, there can be problems with contamination if something is not organically grown or whatever that might be. You know, There's been scary things coming out about like poor quality protein powders being super high in lead, right? So you want to look out for that stuff. But it's important for people to understand people think metal and freak out. And a lot of that is like fear based clickbait on the internet for people that don't understand. that stuff is natural, it is in the earth, it is in our foods. Like the dinner you ate last night in your salad could have had more metals than the multivitamin your kid is consuming, right? So that's an important delineation to make because we also will have like a Prop 65 warning label on this product, not even because we violate it, but just because that's for that reason with the metal levels can show up in things like chocolate, fruit, vegetables, mushrooms, because they come from the earth. Genevieve: So where does that range come from that we use to say, okay, this is acceptable versus this isn't? What's the basis of that? Abby: There's several different ranges out there you can look at and go by. Probably the cleanest one is something called the Clean Label Project. So they're even stricter than Prop 65. Prop 65 is really incredibly strict. So that is like a standard to go by. However, I kind of feel like the Prop 65 stuff really unfairly targets the supplement world, specifically like food-based supplement world. right? So some products will violate it and it's like your sweet potato at the grocery store has more metals than this product does, right? So I mean, if you're below Prop 65, you're very clean. A lot of products have to put that label on and I would still feel comfortable personally ingesting them or giving them to my kid. And so there's a few different organizations that have their standards for heavy metals. They're all a little different, but Prop 65 Genevieve: Mm-hmm. Yeah. Abby: super strict clean label project even more strict. Genevieve: Yeah, so I think what people need to understand is that certainly you could go and buy a fully synthetic multivitamin and it would have potentially no, as long as it wasn't contaminated somewhere, it would have no heavy metals in it. But if it is something that's food-based, even if it's derived from an organic blend of fruits, vegetables, and mushrooms like ours is, because of the fact that it comes from the earth where these metals originate, there will be low levels, but we ensure that the levels are low enough that they're consistent with the accepted standards. I guess, and rigorous standards. Abby: Yep. Yep. Yep. Genevieve: of different industries. Yeah. Yes. Yes, they have different standards. Yeah, yeah, yeah, for sure. So how did you decide to flavor this thing? Like, what does it taste like and where do the sweeteners come from? it tasty? Abby: Correct. And for children, right? That's a very different story than adults. Abby: It's very tasty, it's berry flavored, it really worked to our favor that we had done the electrolyte before this product. because we basically took that flavor profile and shifted it over to the kids' multi. The difference is that this one is raspberry and strawberry, so it's kind of like a mixed berry flavor. And then we used the same sweetener as we do with our electrolyte, which is thalmatin, which is from fruit, kind of similar to monk fruit. And yeah, that part was actually knock on wood easier than previously because we already kind of knew the raspberry tasted really good and we could bump up the sweetness with some more strawberry. And so that luckily, you know, we were already 50 % of the way there. Genevieve: Yeah, Noah, I've had it. I think it tastes great. What sort of feedback have you had from kids who've tried it? Abby: So we've had many kids sample it. gave it to, I see like well over 50 % of my patient bases, pediatrics and clinics. So I gave it to a handful of patient families to try. My daughter's been taste testing it this whole time. I know Alison gave it to a handful of kids and it was like 90 % of the kids loved it. know, there's always gonna be a kid that like doesn't like berries or whatever, but it's really versatile. think. how I will probably use this with my daughters most mornings. She has a smoothie protein shake. It pairs super well in a shake or smoothie. It's really good straight up on its own in water though to be honest. Tastes similar to our electrolytes. I need to try it. I want to try it in plain yogurt because I feel like that actually probably will be pretty good. Make it like a berry flavored yogurt. I think an applesauce would be great and a juice it would be great. So it's super versatile. Genevieve: It is. Yeah. Genevieve: Mm-hmm. Yeah, I agree. And I've been enjoying it, but would you recommend that adults can take it as well as an option? Abby: Absolutely. It's a superfood multivitamin, right? So there's no reason that adults couldn't put even one scoop would give you a nice boost, but a couple scoops in your smoothie. You know, it's that's the beautiful thing about it being food based is your body's gonna utilize those nutrients. Like you just ate some fruits, vegetables and mushrooms. So if you're on the go, you need a lunch, a quick breakfast. That's a super easy add on. Genevieve: Yeah, no, I agree. Okay, so I'm so excited about this. can we expect to see it hit the market? Abby: Me too. Abby: So this will be live on our website mid-March, I'm assuming when this podcast goes out, it'll be live. And that'll be available for pre-order. We'll be just on the tail end of finishing up the testing, all that stuff we talked about, waiting for that to come back. And then it should be shipping in April to people. Genevieve: Okay, and what's the approximate price point going to be? Abby: It's going to be a very, the plan is the same price point as our current products. So 48 bucks. And then if you put it on subscription, like our other products, it even goes down from there. Genevieve: Amazing, amazing. And so, do you have any any additional thoughts or points that you wanted to share about the product that I haven't asked you about? Abby: I think the main parting words with this is that if you have not tried a high quality kids multivitamin with your children yet, I would highly encourage people to give it a try for 30 days and see the difference you notice in your kids because you know, a multivitamin doesn't sound very sexy or like it's going to fix anything. But I'm telling you when you get kids nutrients up, like we've talked about on our other podcasts, right? When you get your minerals up, your hydration up, like the foundational stuff. I've seen stuff, and this is on like more synthetic multivitamins, right? This is going to be even better, but I've seen kids with attention issues improve, sleep improve, energy improve, digestion improve, brain fog, like, so behavior is huge. The body... is going to exhibit symptoms when it's lacking core foundational nutrients for every process in your body to run, right? So this is another one of those foundational things, no matter what your child might be struggling with with their health or not, this is definitely something to give it a try and report back. Genevieve: Yeah, no, I agree. I think it's really exciting and looking forward to what happens over the next few months with this. So thank you for talking today about our new Kids Mighty Multivitamin. And thanks everybody for joining us. And we will see you next time on the Fringe Podcast.

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June 24, 2026

Red Light Therapy 101

Alyson and Dr. Abby Kramer offer the clearest, most accessible introduction to red light therapy you’ll find. Starting from first principles — what photobiomodulation actually means, how it differs from heat therapy, and why light is not a new biohack but something our biology has depended on since the beginning of human existence — this episode answers the most common questions people have when they first encounter red and near-infrared light therapy. The conversation covers how LED devices differ from lasers (and why that’s mostly a good thing for home use), the Goldilocks principle of intensity (too little doesn’t work, too much causes photo inhibition, and the sweet spot is closer to what the sun actually produces than what most brands market), and the cascade of benefits that flow from cellular energy: improved circulation, collagen and elastin production, and modulated inflammation. Alyson’s framing is practical — these are the building blocks of your body’s natural healing environment, which is why red light therapy has published research on conditions as varied as Parkinson’s, thyroid health, skin aging, and blood sugar regulation. Dosing guidance is clear: 10–20 minute sessions, three to five times per week, with effects lasting 24–48 hours post-session. The episode also covers where to use it (head, face, gut, reproductive health), safety for kids and pets, and what contraindications actually matter. If you’re new to red light therapy or trying to explain it to someone else, start here.   Listen on the go — The Fringe podcast is available on Spotify and YouTube. Subscribe so you never miss an episode.   Transcript Alyson: Hi, everybody. I'm Alyson, owner and co-founder of Fringe, and I'm here today with Abby, our medical director. We both have a background as medical providers and somehow have found ourselves working together every day, in an absolute out-of-necessity attempt to help people navigate feeling better. In our journey doing so, we've found ourselves making all sorts of cool products that we wish existed and didn't. Today we're talking about red light therapy — and I'm pretty sure Abby's going to ask me all sorts of questions. I'm not in clinical practice anymore, but Abby still is and gets lots of feedback utilizing our products with her patients throughout the week. So here we are, a couple of people on the medical team at Fringe talking about red light. Abby Kramer: A good place to start is: most people have heard of red light therapy, it's a buzz term. But the next question is always — what is it? People are like, I've heard of that, I've seen people with those big panels on Instagram, but what actually is red light therapy? Alyson: Red light therapy specifically is the use of both red and near-infrared light to affect our biology. That's what it is. It's not a heat therapy — which some people think it is — it's actually a light therapy used to affect our biology. In the science world, the term is photobiomodulation: photo means light, bio means biology, and modulation means making changes. The interesting thing about light therapy is that there are so many different forms of light we receive from the sun, and we're really just now learning about all the different types and their health benefits. For the past 50 years we mostly focused on damage from the sun. We didn't really understand that all these different types of light are critical — literally critical to our survival. Plants, animals, and humans require the sun. There is no replacement for it. You can't go to the gym more or eat more vegetables to replace the lack of light you're getting. Red light therapy is popular right now and it will continue to be popular — but what people don't know is it's really not new. It's been around for decades, 50 or 60 years of published research. It's just that only in the past five, six, seven years have consumers had access to use red light therapy at home. Before that, you had to go into a clinic — a physical therapist, chiropractor, or medical spa — where you'd receive red and near-infrared light via laser for hundreds of dollars a session. Now technology has advanced and we have access in our homes. Everything we make at Fringe is trying to make it accessible, help people understand why they would use it — and light is not something we need once a month at a doctor's office. It's something we need. Abby Kramer: Can you talk about the difference between what Fringe produces — the panels, the wraps — and laser? There's still so much confusion. People assume laser is better, more effective. What does that actually mean? Alyson: Light travels to us on wavelengths — think of them as tiny balls of energy traveling on these pathways. Short wavelengths produce some of the colors of light we see from the sun, like blues and purples. As you move up the rainbow, you get into longer wavelengths. Red is a moderate wavelength; near-infrared is bigger still; and then far infrared beyond that. A laser is very narrow — literally like a laser pointer — very specific, very high powered, higher penetration, used in short periods of time. LED lights are much more similar to how the sun produces a wavelength: a range, not one specific point. This is where it gets frustrating in the industry. People say you have to use a specific wavelength for a specific condition, but that is not how the sun works. On our products, we list a peak wavelength, but the actual range is broader — and that's what's natural and effective. Near-infrared light is even more confusing because you can't see it. If you turned on near-infrared only, you'd see nothing but feel a gentle warmth. Red and near-infrared have very similar effects in the body — red is more superficial, near-infrared penetrates deeper. Laser is high intensity, specific wavelength, short sessions, used clinically. LED is a range of wavelengths, longer sessions, used frequently — every day is fine, very safe at home. Our philosophy at Fringe is to make it like the sun. About half of the sun's light is in the red and near-infrared category, and our approach to intensity reflects that. More is not better here. Abby Kramer: That intensity conversation is so important. A lot of competitors push high intensity heavily — medical strength, medical grade. That plays to the American instinct that more is better. People assume high intensity means higher quality. But our message is different. Alyson: With light, there is a Goldilocks window. Too low of an intensity won't have an effect. The medium, just-right intensity will have the best effect. And too high of an intensity results in photo inhibition — the effect is negated. So going out and buying the highest-powered device is not how your body responds, which should actually make intuitive sense. It's like exercise: a mile walk is great, two miles, three miles, but you can't just run a marathon on day one. The high-intensity marketing is also largely inaccurate — when you actually test many products at the device face or at proper distance with the right tools and third-party validation, they come in at a fraction of what's claimed. Our intensity is 20 to 40 milliwatts per centimeter squared, because that's roughly what the sun produces throughout the day — and that's what the evidence shows people respond best to. We publish our third-party testing, which is still rare in the industry. At the end of the day, we want people using a really safe and effective product. Alyson: There was also a period where everyone was standing in front of these giant panels naked and they were hanging on the back of their doors for $2,000. I bought one and stood there and thought, this isn't it. Because here's the thing: all the science says the best way to absorb light is for it to be in direct contact with your skin. With a mega panel at a distance, somewhere between 60 and 80% of the light has nothing to do with you — it's traveling through the atmosphere. What you're actually receiving at your skin is still around 20 to 40 milliwatts, same as a wrap. That's what made us start building affordable direct-contact products. A big panel is still amazing — you get a large area of the body, it lights up the room, it's great — but direct contact delivers the same dosage at lower intensity more efficiently. Abby Kramer: Okay, we need to talk about how red light therapy actually works. You have the wrap on your body, direct skin contact, you're absorbing it — what's going on? Alyson: To summarize: red light therapy — which is basically half the sun — energizes the cells in our body, and all we are is a walking bag of cells. Cells make up my hair, my skin, all of my organs, my blood vessels, my nervous system, my ligaments, tendons, muscles — everything. When light comes into our body and is absorbed through the skin, it energizes the cell by being absorbed into a compound inside the cell called the mitochondria. And that cell is then energized. The cool part is the cascade of events that follows. When our cells are energized, they do their jobs better. I have cells in my skin called fibroblasts whose job is to make and repair skin and build collagen. Osteoblasts in my bones build bone. When we energize these cells, they just function better. One amazing, well-documented outcome is improved blood flow — increased circulation to an area. Blood is necessary for anything you're trying to heal or restore. Another outcome is that energized cells rebuild and repair, so you see increased collagen and elastin production — which is incredible for skin, but also for joints, and really everywhere in the body, because all tissue needs collagen and elastin for integrity and strength. And the third major outcome is modulation of inflammation — for most people, that's an anti-inflammatory effect, which is absolutely incredible. So when someone asks me whether red light therapy could help X, my answer is always: does X improve with cellular energy, blood flow, reduced inflammation, and rebuilding and repairing? And the answer is almost always yes. That's why we have published research on conditions from Parkinson's to crow's feet to thyroid health to heart disease to blood sugar regulation. After a session, those effects last 24 to 48 hours — markers like nitric oxide can peak six to eight hours afterward. So you don't want to do back-to-back sessions all day. Think of it like exercise: give your body time to respond. Abby Kramer: And it's not only affecting the exact area where you apply the light — the effects are systemic. That's something we're still at the tip of the iceberg on understanding. Alyson: Right. The mitochondria float around in your blood, so the effect is systemic. There are studies where they put light on a rat's shin and blood glucose goes down. That's the bigger picture. We've been taught to take our eyes to an eye doctor, our brain to a brain doctor — to think in parts. But putting light through my brain right now is affecting my gut, my endocrine system, my mood, how I'm going to sleep tonight. It's a whole-system effect. And that's really at the root of why we named the company Fringe — as chiropractors, we were always considered the fringe of the medical community. I decided to take that as a compliment. If you're out here talking about things we don't completely understand yet but that are genuinely helping people, that's where growth happens. The old way isn't working — we're sick and getting sicker. So come to the fringe with us. Abby Kramer: Okay — how to use it. How long, how many times per week? Alyson: Red light therapy is safe to use every day. We recommend three to five times per week as a guideline. After a session — say I put a wrap over my chest for 20 minutes — the cellular activity happening underneath continues for 24 to 48 hours. Nitric oxide peaks at six to eight hours post-session. So you don't want to do it over and over again in one day, because that's where you tip into photo inhibition. Think of light as a stimulus: give your body time to respond, just like exercise. Our products are geared toward 10 to 20 minute sessions — that's the most evidence-based dosage window. If you're doing it a few times a week and feeling the benefit, you don't need more. For acute conditions, you might reduce time and frequency so you're not overwhelming tissue that's already working hard to heal. For most people, it just becomes a part of their daily routine — put the wrap on at night while watching TV, do it on a Zoom call with the head wrap. Three to five times a week, 10 to 20 minutes. That's red light therapy in a nutshell. Alyson: Let's talk about where you can use it. Starting at the top: brain health is incredible — cognition, memory, improved blood flow, reduced neuroinflammation. Neuroinflammation is at the root of many devastating conditions: Parkinson's, MS, Alzheimer's, dementia, concussion, TBI, CTE — and in younger populations, ADHD and autism. Hair growth is a byproduct of using it on the head — it energizes the hair follicles, which are cells, and they respond accordingly. For the face: light through the face promotes the same outcomes any facial or laser spa treatment does — blood flow, oxygen, collagen and elastin stimulation, reduced inflammation — at a fraction of the cost, used regularly at home. And blue light deserves a mention: blue light from phones and computers is problematic, but we receive blue light from the sun every day, and it's antibacterial, antimicrobial, and excellent for acne, certain skin rashes, oil production, and pore size. One note: blue light is energizing — it stimulates a cortisol response — so if you're very sensitive to light before bed, use it earlier in the day. For the neck and chest: amazing for lymphatics, thyroid, circulation. For the gut, Abby, you want to take that one? Abby Kramer: If you're going to pick one area to work on, I would argue it's the gut. Gut health is foundational: how we detox, how we absorb nutrients, where most people struggle, the majority of our immune function, the gut-brain axis. Three to five times a week over the abdomen is a great overall wellness practice. And for reproductive health — whatever stage you're at in that process, there are so many mitochondria in our reproductive systems. Whether it's menstrual cramps, fertility, perimenopause, or menopause, a session over the lower abdomen is incredibly supportive: cellular energy, reduced inflammation, increased circulation. I also find it's a beautiful starting point for patients who are very reactive to supplements or other protocols — it's gentle, it supports healing without overloading the system, and results are measurable. Abby Kramer: Before we wrap up — kids? Alyson: Kids, pets, elderly — everyone has a range. For kids, reduce time: 20 minutes is long, 10 minutes is better, and for toddlers or infants, even a few minutes is fine. We have adjustable light intensity on all our wraps — 100% and 50% modes — which is great for the younger population. For pets, same thing — reduce time, it's safe and effective. It's everything we just talked about. My kids use it regularly and they ask for it when they're sick. Alyson: Contraindications: if you cannot safely be in the sun for 20 minutes, exercise the same caution with red light therapy — start slow, reduce time and intensity, go from there. Photosensitivity from medications or medical conditions is the main individual factor to be aware of. Beyond that, we say don't use it over an active cancer site or over the pregnant abdomen, not because we know it's harmful, but because there hasn't been enough research yet. Once there's more published information, recommendations may change. And knowing that red light therapy promotes blood flow to an area, if there's any reason you should not have increased blood flow — like an open wound — that would be an area to avoid. We always recommend talking to your attending physician, and we ensure people that it is very safe, very gentle, and there are so many ways to ease into and control a session. That's red light 101 from Abby and Alyson on the Fringe.

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June 24, 2026

Light Therapy & Pelvic Health: Inside the Fringe Pelvic Wand

Alyson and Liz Frey, Fringe’s Pelvic Health Medical Director, tell the origin story of the pelvic wand — which started with postpartum women asking whether they could sit on a therapeutic pad. That question launched an 18-month development process that produced a first-of-its-kind device: medical-grade silicone, a 2cm tip diameter, gentle curvature for anatomical comfort, LEDs running the full length of the shaft, and three light modes (red, near-infrared, and blue light). The result is an internal photobiomodulation delivery system designed to reach tissue that no external device can. Liz walks through the three primary populations the wand serves: postpartum women navigating scar tissue, pelvic floor tension, and recovery; those dealing with chronic pelvic pain conditions including vaginismus, vulvodynia, endometriosis, and interstitial cystitis; and menopausal women addressing tissue atrophy, dryness, and incontinence. The mechanism is the same across all three — improved blood flow, reduced inflammation, collagen and elastin support, and cellular energy — but the experience and outcomes vary significantly by presentation. The episode covers protocol details (10-minute recommended sessions, 50% intensity mode for sensitivity, four vibration levels), contraindications (active pelvic cancer, pregnancy, photosensitivity medications), and the important distinction between LED-based home devices and clinical lasers. For anyone curious about whether light therapy belongs in pelvic health — and the answer, increasingly, is yes — this is the episode to start with.   Listen on the go — The Fringe podcast is available on Spotify and YouTube. Subscribe so you never miss an episode.   Transcript Alyson: Hi everybody, welcome to the Fringe. Today I'm joined by Liz Frey, our Pelvic Health Medical Director at Fringe. We both have medical backgrounds, very different though — my background is as a chiropractor, and Liz is a pelvic health physical therapist. Today we're going to start with the story of how Fringe even remotely ended up developing a light therapy product for pelvic health — it was nothing I thought we were going to do. That seems to be the story here at Fringe: at the end of the day, we're trying to help people with light therapy, and a lot of the times our customers are the ones who really help us understand the paths we should be taking forward. Liz, before we get into how it all started — what is a pelvic health physical therapist? Because it's still such an underutilized part of the profession, and I really think most women should be visiting one at some point in their journey through womanhood. Liz: Thanks. So I'm Liz and I'm a pelvic health physio. What it means to be a pelvic health physiotherapist is that I've done specific credentials that allow me to do internal palpation — internal vaginal and rectal work with women. And I think this is super important to note: when we think about our pelvic floor muscles and our deep core muscles, especially as women are transitioning with pregnancies, postpartum, menopause, etc., we really do need to be able to palpate — to touch and feel the muscles we're intending to work on. With the designation of pelvic health physio, you're actually allowed to do internal vaginal and rectal work where we can touch and palpate the muscles we're intending to target and then actually work on them. That's really what it means to be a pelvic health physio. Alyson: As soon as we started launching red light therapy for Fringe — this was a few years ago now — this was our basic red light therapy therapeutic pad with red and double near-infrared. Very quickly after launching it, we had postpartum women reaching out asking if they could sit on it for their tearing during delivery. The very first outreach was women saying: I tore a lot during childbirth, or I had a lot of pain or hemorrhoids, is this okay for me to sit on? And I was like: yes. It's so gentle, it's a very natural way to promote healing to tissues, promote blood flow, tissue repair and regeneration, and reduce inflammation. And they would report back: I've been sitting on this wrap and it's helping so much — you need to tell more women about this. Which led us to reading a lot about red light therapy being utilized for women's health, which very quickly led me to: look at all these studies using red light therapy transvaginally. That's when I reached out to Liz and said, I think you need to come join the Fringe team. Women are asking if they can use this light internally. And so I reached out to several pelvic health physical therapists and said: I'm thinking about doing this, I don't see a lot of options for consumers, and I want to make sure what we design is designed by women pelvic health physical therapists — the shape, the size, the curvature, the materials. I knew from the research what kind of light we needed. But I wanted the design to come from the people who work in this space every day. Liz: When Alyson reached out with the idea of the pelvic wand and asked for feedback, I was so excited. I was a hell yes right from the get go. I wanted to be a part of the team and a part of the development of the product so I could help more women. Looking at the design — the wand has a really gentle curvature to it so that when you insert it vaginally, it slides in quite comfortably. And if you look at the actual size — the circumference of the tip is two centimeters in diameter, which is really comparable to the size of a thumb for those watching. It's not meant to be intimidating at all. Women with pelvic pain can use it externally to start, along the vulva area. They can even just use the tip at the entrance of the vagina — so if you've had an episiotomy or granulation tearing, even just the tip can be really helpful. And then of course you can insert it to affect the deeper pelvic floor muscles. One more important thing: there's light through the entire shaft of the wand — it's not just in one small segment. So even when you're using it externally or just at the tip, you're still receiving all the benefits. I was so excited to be a part of helping with the design. Alyson: I sort of looked at the market and thought: we need professionals to be designing this. Our name is Fringe, and we're not uncomfortable talking about things we should be talking about to make people feel better. Women who've had babies should not be standing around in a circle talking about peeing their pants. That is common, but it is not normal. And I'll note: I treat men, I treat women, I treat everybody in my practice. Plenty of men ask about it too. The light in the wand is important to discuss. We have red, near-infrared, and blue light options. Red and near-infrared are really about energizing the cells in the tissues receiving the light. It doesn't matter if it's our brain, organs, muscles, ligaments, or tendons — the tissue receives the light, the cells become energized, they help bring blood flow to the area, deliver nutrients, help with tissue repair and regeneration, and help with pain and inflammation. The near-infrared is probably one of the most important lights to be delivering transvaginally for a lot of the conditions we'll talk about. The wand also has four levels of vibration — a really low gentle mode of vibration and then ramping up to higher vibration frequencies. Liz, let's start with the top three conditions you treat in your clinic and how you utilize the wand settings for those conditions. Liz: Top three. The first group I see most often are postpartum women. The wand is unbelievably valuable for the postpartum woman. Initially, if there has been trauma — tearing, episiotomy, even C-section scar — the wand actually has a great little curvature to follow the C-section scar. I would recommend women use the wand externally at first. The reason is that I want to increase blood flow to healing tissue, help promote healing and tissue repair and regeneration, increase even the collagen and elastin production — the little structural integrity pieces of our tissues — early on. Then as women progress in their postpartum journey, some will be left with hypertension, a lot of tension in their pelvic floor muscles. That could be from scar tissue that formed during healing, or from where they're holding their tension and stress in their pelvic floor — maybe they're anxious about intimacy. For that, I utilize the lower levels of vibration — the first two of the four vibration levels — in addition to the red light therapy. Low-level vibration helps relax the pelvic floor muscles: soften, soothe, relax. Women just say it feels nice. They actually look forward to doing their pelvic health home stretches because the vibration and the gentle warmth of the near-infrared feel like self-care. On the flip side, some women will have dysfunction where the brain and the pelvic floor muscles aren't connecting well — low tension, inability to contract the muscles the way they once could. A woman might know this if she's having urinary leakage, or feeling a sense of heaviness — what we term prolapse. The muscles just aren't strong and contracting the way they once did. In that case, I use the red and near-infrared light therapy settings and the two higher levels of vibration, so the brain can feel the vibration in the pelvic floor muscles and re-establish that connection — so you can actually do strengthening exercises again. I recommend the red and near-infrared settings unless someone is sensitive to the heat generated by near-infrared, in which case just the red light setting is fine. And I recommend three to five times a week. There are settings on the wand to go to 50% light intensity if someone is sensitive or apprehensive. You don't have to start with 10 minutes either — you could start with five and work your way up. A gentle approach is totally fine. But three to five times a week is what I recommend so women see results within a few weeks. Alyson: That's condition number one: postpartum. Condition two? Liz: Condition number two is pelvic pain, which I'll use as an umbrella term. Within this bracket: endometriosis, interstitial cystitis, vulvodynia, vaginismus — where there's sort of a closing down or connective tissue dysfunction that doesn't allow use of tampons or intercourse. A lot of tension is often one of the underlying issues. If we can use the wand externally or internally, depending on comfort, to increase blood flow to these restricted, tight muscles, we can bring oxygen and nutrients to have a healthier situation. Increasing energy production — what the light therapy does — can reduce inflammation and help reduce pain. We're also affecting the neural pathway: if you have really restricted muscles, all the nerves that pass through and around these muscles are often being compressed, and those nerves are what sends the information to the brain saying ouch, this isn't comfortable. If we can have the muscles relax and increase blood flow, oxygen, nutrients, and energy to both the muscles and the nerves, then we're going to have a whole lot less pelvic pain. I also recommend low-level vibration combined with the light therapy for this population — it's unbelievably relaxing, especially combined with breathing through the diaphragm, mindful meditation, all those things stacked together. With this population, I rarely say start with 10 minutes. I might even start with three minutes, something really low so that someone feels relaxed, feels comfortable, has a positive experience, and then feels encouraged to use the wand more frequently. Building from three to five to seven to ten minutes, adding in vibration only after they feel comfortable with the light. It doesn't have to be all or none. I stack the therapies as women become more comfortable. Alyson: Condition three? Liz: Near and dear to us both — I'm perimenopausal too. The third population is menopausal women who come in with the full host of genitourinary symptoms of menopause. Some women will have tissue dryness and tissue fragility — the tissue thins, it's fragile, sometimes there are even little fissures, like paper cuts within the vaginal tissues. Using light therapy for vaginal dryness is a game changer. The way we increase lubrication to our tissues is by increasing blood flow. Using the wand even externally is going to be so powerful — it brings oxygen, nutrients, and helps with secretions and hydration of the tissues. I do recommend for my menopausal women to use the wand as a warm up pre-intimacy, because if you're going to use it that day anyway, let's use it when we really want to have that increased blood flow. Beyond tissue frailty and dryness, a lot of menopausal women will say they've never had urinary leakage before — they used to be runners, they could cough and sneeze without issue — and now as estrogen decreases, everything is atrophying. They're finding that when they have the urge to go to the bathroom, they just can't stop it. For this population, I always recommend the red and near-infrared light therapy. Red light penetrates at a specific depth, but near-infrared actually penetrates deeper — and that's what we're trying to target with our deep muscular system: bring blood flow, oxygen and nutrients, collagen and elastin production, strength and I'll say plumpness to these muscles. I combine that with the higher levels of vibration to help women connect the brain with the muscles, and then do strengthening exercises. I use a more frequent approach for this population — five times a week. With anything, if you want to develop strong biceps, you can't do one bicep curl and hope for the best. You have to use the device consistently. Usually it's 10 minutes, five times a week. Then when we see results we step back to a maintenance mode of two times a week or whatever works. For menopausal women who have pain with intercourse — from dryness, atrophy, or other reasons — I'll shift to the lower vibration levels instead to help reduce tone. So those are my three populations: postpartum, pelvic pain, and menopausal women — and in all three cases, the wand is used at home as an adjunct to the therapy I'm providing in clinic. That's the intended use: here's the tool, use it at home, and this is how you'll see greater results more quickly. Alyson: Red light therapy for pelvic health isn't new. There's been published research for 10 or more years. A lot of it uses laser, but red light therapy research using laser is still red and near-infrared light — laser is just the delivery mechanism. Laser is high intensity, done in a clinical setting under professional guidance. This wand is LED light, which means it's not as intense as laser, doesn't generate as much heat, and doesn't have to be used under clinical guidance. The safety profile is incredible. You have to use it more regularly and for longer periods of time to deliver similar results to a laser — that's just how you tweak the dosage of light. When I started learning about this, I looked into what parameters the laser treatments were using — what power, what wavelength — and I wanted to bring as close to that as possible in our device, adjusted for LED. So: you can get laser pelvic light in a medical clinic and you'd get incredible benefits. But if you want to use it at home more regularly, LED is definitely the way to go. Liz, should we talk contraindications? Liz: Absolutely. There are very few contraindications to using LED light therapy for all the reasons already mentioned — it's super safe, low intensity. The only people who can't use it are those with active pelvic cancer. And I want to note: if you had cancer somewhere else in your body and wanted to use the wand, that's fine. You can't use it over where there's active cancer. But that's the active cancer site caveat. Similarly, we don't recommend using it over the abdomen or internally during pregnancy. Not enough research has been done, so we exercise caution there. The other consideration is photosensitivity — if you're on a medication that makes you more sensitive to light, or you have an autoimmune condition that makes you more sensitive to light, it's not contraindicated but it is a major caution. That's also a good reason why we have the 50% light mode, so you can start more gradually. Those are our contraindications and major cautions — but otherwise it's really safe and really effective. Alyson: To summarize: light that we receive from the sun has always powered our bodies. It energizes the cells in our tissues and allows them to work better for the area we shine light on. The outcome is pretty universal: cellular energy, blood flow, reduced inflammation, tissue repair and regeneration. It doesn't matter if I just injured my shoulder or I'm going through perimenopause and menopause asking why my tissue is losing elasticity — the changes in estrogen reduce collagen production and reduce blood flow into our tissue. I could be talking about my face, my shoulder, or my pelvic tissues. The physiological effect is similar. So it makes so much sense. We just went there — we made this, and we want to talk about it. I know more terms about pelvic health than I ever thought imaginable at this stage. And I'm so grateful to you, Liz, for teaching our whole team about all of this. People ask us every day: could this help me? I can't find a solution. I'm on hormone replacement therapy, I've tried other therapies, could this help me? And our response is always: it's very safe, it's very comfortable, it's easy to use — why not give it a try? Thank you, Liz. We'll talk to you guys soon. Liz: Thanks, Allie. Bye.

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June 24, 2026

It Takes More Than Hormones to Fix Our Hormones

Dr. Genevieve Newton sits down with Dr. Anna Cabeca — triple board-certified OB/GYN, author of The Hormone Fix and KetoGreen 16, and host of the Girlfriend Doctor podcast — for a rich conversation on what it actually takes to restore hormonal health. Dr. Cabeca shares how years in conventional practice, combined with her own personal health crisis, pushed her toward a functional and integrative approach built around what she calls the “devil’s triad”: chronic inflammation, adrenal dysregulation, and the interplay of hormone imbalance and insulin resistance. The keto-green diet is central to Dr. Cabeca’s framework — a combination of ketosis with alkalinizing greens, fiber, polyphenols, and fermented foods that supports insulin sensitivity, brain function, and hormonal balance simultaneously. She explains the brain fuel shift that occurs during perimenopause, and why approaches that worked in your 30s may no longer apply. The conversation also explores the underappreciated role of oxytocin — not just as a bonding hormone, but as a powerful driver of resilience and wellbeing that can be cultivated through gratitude, prayer, and human connection. A significant portion of the episode focuses on genitourinary syndrome of menopause (GSM) — the constellation of vaginal dryness, atrophy, and urinary symptoms that affects most menopausal women but remains underaddressed. Dr. Cabeca and Dr. Gen walk through a complete pelvic health stack including DHEA cream, water-based lubricant, targeted probiotics, pelvic floor exercises, and the Fringe pelvic wand with vibration. A 74-year-old patient story puts all of it in perspective.   Listen on the go — The Fringe podcast is available on Spotify and YouTube. Subscribe so you never miss an episode.   Transcript Dr. Genevieve Newton: Hi everyone, welcome to the Fringe Podcast. I'm Dr. Genevieve Newton, Scientific Director at Fringe, and I'm here today speaking to Dr. Anna Cabeca. Very excited to have you as our special guest. Dr. Cabeca is the best-selling author of The Hormone Fix, KetoGreen 16, and Menu Pause. She is triple board certified in gynecology and obstetrics, integrative medicine, and anti-aging and regenerative medicine. She holds special certifications in functional medicine, sexual health, and bioidentical hormone replacement therapy. Dr. Anna is also known as the Girlfriend Doctor and hosts the podcast by the same name, where we spoke about a year ago. We're going to pick up our conversation and talk all things menopause. Tell us how you got here — you started off as a more conventional OB/GYN and then shifted into this functional integrative side. How did that happen? Dr. Anna Cabeca: I grew up in a culture of first-generation Americans — a lot of food as medicine. I chose osteopathic medicine because of the philosophy of empowering the body to heal itself: alignment, address the issues, the fascia is connected to everything, can't treat one part of the body without treating the rest. Then I did residency at Emory University, one of the best allopathic institutions for OB/GYN. Early on in private practice, I had a patient who came in — 63 years old, history of ductal carcinoma in situ of the breast, it hurt to have sex, she was dry, no doctor would give her hormones. She loved her husband, couldn't have sex because it was too painful, and she said she'd rather die than live this way. And I was like: my job as a physician is not to say the case of do no harm means do nothing. So I dug into the research. She was the president of a biotech company and we dug in together. We found we could use DHEA, testosterone, vaginal estrogen — no contraindications. I read all the research. We wanted to stay away from progestins for sure. And I started working with her. From there, other clients came in — the women with breast cancer, other GYN cancers, over a certain age, just left to suffer. That was completely unacceptable to me. And I started on this journey creating solutions, understanding that it takes more than hormones to fix our hormones. Always address the underlying issues. When a patient comes in with a diagnosis, what caused that diagnosis? Did we address the underlying issues? For me, this is truly my passion. Dr. Genevieve Newton: You have been a long-time champion for women who are suffering from these issues. What are the root causes you see so often in your practice? Dr. Anna Cabeca: That comes down to three things — I call them the devil's pitchfork. If we can address these three things, we’re going to heal or reverse 99% of the diagnoses that come up. Number one: inflammation. There is no disease without inflammation that exists in an alkaline, non-inflamed body. Number two: adrenal dysregulation. Our foot on the cortisol pedal, the adrenaline pedal — we're firing up our system, which also contributes to inflammation. Number three: hormone imbalance. With that hormone imbalance, I'm going to talk about insulin resistance. As we get older, reproductive hormones decrease but insulin and cortisol increase. We have to become more insulin sensitive. We have to support our bodies' natural ability to make and use hormones more efficiently. There are so many hormone disruptors. The answer isn't piling on more hormones — believe me, I am a hormone prescriber. I've done this for 30 years. I use bioidentical hormones. But it's really important to address the underlying issues first: empower our bodies to use and produce our hormones most effectively, and avoid, remove, and cleanse our systems from things that are disrupting our hormone receptors, production, or acting as hormone mimickers. Dr. Genevieve Newton: If I came into your office suffering from the devil's triad, what would you tell me to do from a dietary perspective? Dr. Anna Cabeca: Foundationally, I call it keto green. A way to get into healthy ketosis — not butter and bacon keto, but getting into ketosis in a healthy way while also focusing on the alkalinizers: the greens, the fiber, low glycemic nutrients, polyphenol-rich foods that feed our gut microbiome. The most important population in the world that I want to protect is the microbiome — the healthy, protective microbiome. So the keto green foundational nutrition: I created medicinal menus that help us get into ketosis and decrease inflammation, improving alkalinization. Each meal has a healthy high-quality protein, good alkalinizing greens or phytonutrients, a healthy fat, and a fermented food. That combination is so empowering and helpful. Food is medicine, or it can be disease-promoting. Dr. Genevieve Newton: You were really far ahead of the curve because with Atkins and early keto, there wasn't this recognition of the need to support the microbiome and provide fiber. Have you had to fight to get this information accepted? Dr. Anna Cabeca: Absolutely. I've collected thousands of clients that have gone through surveys pre and post my Magic Menopause program. I'll publish it someday. In my mid-to-late forties, hitting that perimenopausal spiral — even though my hormones were dialed in, I was experiencing the 5, 10, 20 pound weight gain without doing anything different. The mood swings, irritability, monster within me, intolerance, burnout, disconnect. Even as a hormone specialist with my hormones dialed in, I was experiencing this weight gain and brain fog. I knew the keto or low carb diets could help. But I felt what I called keto crazy — not keto flu, but something wasn't right. Something if men can do keto differently than women. No one had really studied it in women, let alone menopausal women. So I started digging in. I checked my urine pH — as acidic as the paper could read. And think as a gynecologist: acid in your bladder long-term is going to create incontinence, interstitial cystitis, infections, urgency symptoms. We know alkaline urine pH is associated with lesser metabolic disease, diabetes, cancer, bone loss. So I needed to add alkalinizers back. I started thinking about cultures that eat ketogenically — the Inuit people, for example. They make fish bone broth. That's the minerals. The minerals are huge alkalinizers. I started adding more minerals, microgreens, sautéed beet greens, kale soup. The alkalinizers were key. And all of a sudden the weight released and my mood lifted. I had this sense of peace — nothing in my life had changed. Still single mom of all my kids, soul breadwinner, lots of stress and trauma. But I felt that peace. And as a result, my mornings changed completely. And I realized it wasn't just what we eat. Cortisol — you can be eating all that good nutrition but be stressed out and angry, and cortisol creates that acidic environment. Cortisol is the key that unlocks the door to those intact cell membranes. Oxytocin does the opposite. The practice of gratitude, presence, joy, prayer, meditation, getting out in nature — these things increase oxytocin and seal that gate, creating alkaline urine pH. So I took this and called it my Magic Menopause program. I took my most difficult patients through it — the stubborn ones where I couldn't get the needle to move. And every single one of them felt better within a few weeks. That became my Magic Menopause program, launched in 2014. Dr. Genevieve Newton: I love that you have that spirit connection in there because that's been my personal experience too — it's a triad of mind, body, spirit in terms of being healthy, and you really can't have one without the others. Can you speak to the biochemical aspect of the keto-green approach in perimenopause specifically? Dr. Anna Cabeca: In 2015, a research article was published looking at MRIs and SPECT scans of women's brains, examining glucose metabolism. Glucose metabolism or gluconeogenesis in the brain is an estrogen-dependent phenomenon — it flows along the decline of progesterone more so than estrogen, though progesterone is not well studied in the female brain. During the time period when progesterone and estrogen start to decline, your brain is actually starving for fuel. It’s not using glucose as much. So you forget your words, you don't know why you went into a room. It's a very challenging and concerning experience. But the use of ketones for fuel in the brain is not hormone-dependent. When I shifted into ketosis, my memory was there, my clarity was there. And with the alkalinization in that healthy way, really focusing on feeding the gut microbiome, addressing our physiology in a supportive low-inflammatory way — that's key. That period from roughly 35 to 60 is a period of neuroendocrine vulnerability. But through lifestyle and nutrition, we can shift that. And I've proven: through the keto green approach, in as little as ten days, hot flashes can be gone. Because insulin resistance is what's driving the hot flashes — they're symptoms of insulin resistance, not just estrogen insufficiency. If you create insulin sensitivity, you've just improved longevity. Dr. Genevieve Newton: I turned 50 this year and I'm definitely menopausal. It hasn't been a super challenging experience so far — I’m very focused on my diet and my spiritual wellbeing. There's this ongoing conversation among friends about hormones. Today many people think you can't be well through this transition without replacing hormones. What's your take? Dr. Anna Cabeca: It's always about being in alignment with the patient's personal preferences and practices. I will say — I personally will be on my balance cream and my Jolva cream until I die. And probably some testosterone. I want to keep my bladder as healthy as possible. But I also have clients who chose not to use hormones. And nutrition, lifestyle, and nature are really important interventions for them. When I walked the Camino de Santiago, one of the most amazing women I saw was in her late seventies — all smile lines, laugh lines, body like a twenty-year-old, strong, agile, walking fast, energetic. Not on hormones. Not on handfuls of supplements. Not biohacking herself. And I honor that absolutely. I think: if I was hiking the Camino or living in the Amazon, waking up with sunrise, going to sleep with sunset, not exposed to EMFs, not burning the candle at both ends — maybe I wouldn't need hormones or as much. We get so much more from nature and sunshine than just vitamin D. In the Blue Zones, not one of the factors was supplements or hormones. It was connection, all the oxytocin-increasing practices. The most powerful pharmacy in the world is the one in our own body. So tapping into that — that's creating your Blue Zone. It's not a heck yes or a heck no on hormones. It has to be in alignment with our lifestyle and our choices. Dr. Genevieve Newton: At Fringe, our philosophy has always been not about biohacking or super-physiological doses and really high intensities. With supplements: what are we missing that we really can't get from our diet anymore, and can we get that from a food-based supplement? With red light therapy: let's mimic the intensity of the sun to bring in some of what people are missing from their interior-focused lifestyles. If you ask us whether it's better to go out in the sun — absolutely yes. We want you to do that. In the context of menopause and genitourinary syndrome specifically — those urinary and sexual symptoms — how do you see non-pharmacological options, including light-based therapies, fitting in? Dr. Anna Cabeca: I think it's essential. I talk about vulvar topical hormonal therapy, red light therapy, vaginal microbiome support therapy — all of this is critical to vaginal health and wellness. Even my clients in their 80s, I have them using topical hormones in this area because incontinence, urgency, dryness all make a difference. And not just red light — the reason I recommend the Fringe wand is it's red light with vibration. Vibration helps with blood flow and vascularity. It works better in hormonally sensitive tissue, making it more flexible and more elastic and supporting natural glandular secretions. When I recommended the red light vaginal and vibration therapy to my patients, they were on board immediately because they understand how red light is affecting their skin in other areas — helping with aging, helping with healing, it's collagen-promoting. So let's add that down there as well. If we think of the healthy pelvic floor stack, that's definitely included. And there's no negative risk that I know of. I have a 74-year-old patient I love telling this story about. I asked her in the office: how's your sex life going? She said, Dr. Anna, in this last year since we fixed things down there, it has been the best in our marriage. Fifty years married. And she said: we've always loved each other, sex was okay, but over the years it was something we did. We love each other and care about each other. But since addressing everything — using Jolva, adding the vaginal microbes, the Lactobacillus crispatus supplementation, adding red light therapy — they increased the quality of their intimacy and relationship. She said: not just in the bedroom, but in all areas of life, we're laughing more together, having more fun. That's oxytocin. When we create that safety and trust by addressing those issues, by addressing clitoral atrophy, vulvovaginal atrophy, dryness — the body feels safer, has more pleasure, more enjoyment. That's game changing. That's why I champion vulvovaginal care. Dr. Genevieve Newton: I would love for you to get detailed with us about that pelvic stack. If you wrote this down on a prescription pad for a patient, what would it look like? Dr. Anna Cabeca: Number one: I start clients on Jolva. I started compounding hormones with DHEA in the 1990s, and Jolva is the result of that evolution — plant stem cells and DHEA in a very emollient, absorbent base. Typically I tell clients to start every other day for the first one to two weeks, then daily, applied clitoris to anus, the vulvar labial tissue. That naturally helps with moisture. Number two: my new lubricant Velvee — aloe, hyaluronan, clean, water-based, propanediol, no propylene glycol, no parabens. It's a great lubricant during sex and also soothing. Number three: VB probiotic — the vaginal targeted probiotic with high quality strains, including Lactobacillus crispatus. Key. Number four: pelvic floor exercises. Muscle is magic and the most important muscles are in the pelvic floor — keep them strong and healthy. Number five: red light and vibration. The reason I like the Fringe wand over some others is it's a narrower diameter. You also have the blue light option, which for any inflammation, infections, or post-coital tenderness, you can use that blue light and it can really cool things down. For the probiotics: initially, especially if you haven't been on any in a while, I typically have my postmenopausal women on it at least three months — two capsules a day for two to three months, then take a break, but integrate it back in periodically. For younger patients in their 20s, just doing one course of the probiotic should be fine. I think it's one of those things where like the seasons change, do a bottle every quarter just for that preventative repopulating of healthy bacteria. Because as I've been doing vaginal cultures on clients in their twenties, thirties, forties, and beyond, I'm not seeing the healthy bacteria. I see a lot of dysbiotic or just aseptic vaginas from antibiotic use, hormone disruptors, washes. All of that has affected the vaginal microbiome. Adding in a vaginal probiotic — I have patients who've been on my Jolva product for over ten years and then we add in the vaginal probiotic and they're like: my God, even better. Not getting up at all at night to pee. These are the changes I'm hearing from the community. Dr. Genevieve Newton: I love how comprehensive this toolkit is, and it's also not onerous — it's really manageable. It's a very different message than what a lot of women are getting today, which is just go on hormone replacement therapy and use vaginal estrogen. There's a lot more to the story. Is there something you want to add on the hormone side? Dr. Anna Cabeca: Yes. In every prescription vaginal estrogen, unless it's compounded, there are hormone disruptors in it — that's what gives it the shelf stability for years. Those ingredients can actually cause disruption of the vaginal mucosa cells and disruption of the microbiome. So there's a double-edged sword. Yes, estrogen can help the mucosa. But compared to DHEA or testosterone, it's not addressing the deeper layers. I've been following the work of Dr. Ferdinand Labrie out of McGill University for over two decades. Vaginal DHEA increases the strength of the muscle walls. Topical use, together with pelvic floor exercises, improves glandular secretion. According to the published research and my clinical experience, vaginal DHEA and vaginal testosterone work so much better than estrogen alone. So much better. Dr. Genevieve Newton: Thank you for sharing all of that. Where can people find you? Dr. Anna Cabeca: Easy to find me at dranna.com — D-R-A-N-N-A dot com. And on social media at The Girlfriend Doctor. Check out my YouTube channel. My books — The Hormone Fix, KetoGreen 16, and Menu Pause — are available anywhere books are sold. Dr. Genevieve Newton: Amazing. Thank you so much, and thanks everyone for joining us today. We'll look forward to seeing you again.

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