Dr. Josh Shields

Dr. Josh Shields Integrative Wellness Centers, located at 38777 Six Mile Road Suite 401, is Michigan's premier functional and naturopathic health destination.
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TRANSFORMATION → through Better Thoughts | Better Behaviors | Better Biology
Helping you heal from the inside out by addressing the root cause through a systems-based approach. Our expert team of holistic health professionals offers personalized care to help you achieve optimal wellness by addressing the root causes of your health concerns. As a leading wellness center near you, we specialize in

integrative approaches that blend the best of conventional and natural medicine. Discover how our holistic health center can support your journey towards renewed vitality and well-being. Experience the difference with Michigan's best in functional medicine and start your path to healthier living today.

Dr. Paul Lehrer's research at Rutgers on heart rate variability biofeedback has produced some of the most clinically use...
06/08/2026

Dr. Paul Lehrer's research at Rutgers on heart rate variability biofeedback has produced some of the most clinically useful findings in psychophysiology, and I think it deserves more attention than it gets outside of research circles.

The core mechanism works like this. Your cardiovascular and respiratory systems have a natural resonance frequency, typically around 0.1 Hz, which corresponds to approximately 5.5 breaths per minute. When you breathe at this rate, your heart rate oscillations synchronize with your respiratory cycle in a way that maximally stimulates baroreceptors in the aortic arch and carotid sinuses. Those baroreceptors send strong afferent signals up the vagus nerve to the brainstem.

Here is the detail most people miss. The vagus nerve is approximately 80 percent afferent, meaning the majority of its fibers carry signals from the body to the brain rather than the other way around. When you breathe at resonance frequency, you may be sending a powerful safety signal directly into brainstem regulatory centers, which is a very different thing from simply relaxing.

Lehrer's research recommends 20 minutes twice daily as the protocol that produces durable neurological adaptation. Not five minutes occasionally. Twenty minutes, twice. That is the dose that produces clinically measurable changes in baroreflex sensitivity that persist over time and transfer to baseline HRV outside of practice sessions.

For the final five minutes of any breathing practice, deliberately layering a positive emotional state such as gratitude or calm may amplify the nervous system's encoding of safety, based on HeartMath Institute research.

Here is a video I did on HRV training. urlgeni.us/youtube/Lkljed

Research: Lehrer PM, Gevirtz R. "Heart rate variability biofeedback." Front Psychol. 2014;5:756. https://doi.org/10.3389/fpsyg.2014.00756

Most fatigue conversations stop at the thyroid, or cortisol. Those are important starting points, but there is a layer b...
06/08/2026

Most fatigue conversations stop at the thyroid, or cortisol. Those are important starting points, but there is a layer below them that may be driving the problem in ways that standard workups simply do not evaluate.

Your mitochondria produce approximately 90 percent of your cellular energy through oxidative phosphorylation. They also regulate immune signaling, apoptosis, and the management of reactive oxygen species. When mitochondrial function is compromised, virtually every system downstream can be affected, which is part of why mitochondrial dysfunction can look like so many different things depending on which tissues are most affected.

Several factors that impair mitochondrial function are common in chronically ill patients. Oxidative stress from poor diet, toxin exposure, or chronic infection can damage mitochondrial membranes and DNA. Nutrient depletion, particularly CoQ10, magnesium, B vitamins, alpha-lipoic acid, and NAC, may reduce electron transport chain efficiency. Chronic cortisol elevation can alter mitochondrial biogenesis, which is the process of building new mitochondria. And certain environmental toxins including heavy metals and specific pesticides may directly inhibit mitochondrial enzyme complexes.

The compounds with the most research support for mitochondrial function include CoQ10 in ubiquinol form, NAC, PQQ, alpha-lipoic acid, magnesium malate, and acetyl-L-carnitine. This is not a supplement stack recommendation. It is a framework for understanding that cellular energy production may be a root-level target that most standard medicine does not evaluate.

Struggling with unexplained fatigue, brain fog, or chronic illness? Get my Free Balance Toolkit — comment BALANCE.

Research: Picard M, et al. "Mitochondrial dysfunction and lipid accumulation." J Appl Physiol. 2012. https://doi.org/10.1152/japplphysiol.01294.2011

This is not an anti-psychiatry argument. Some people feel better with medication, and that is real and legitimate. But t...
06/07/2026

This is not an anti-psychiatry argument. Some people feel better with medication, and that is real and legitimate. But there is a conversation worth having about what gets lost when we begin pathologizing the full spectrum of human emotional experience.

Grief after loss. Anxiety before genuine uncertainty. Sadness in the face of real suffering. These are not malfunctions. They are appropriate biological responses, signaling systems that evolved to orient us toward what matters. The current diagnostic framework does not always distinguish between appropriate emotional response and clinical disorder.
A four-week window of low mood following a major loss can technically meet criteria for major depressive disorder. Situational anxiety, the kind that lives in your circumstances rather than your neurotransmitters, can look identical on a checklist to generalized anxiety disorder.

And then there is the biology that almost never gets assessed. Low progesterone directly suppresses GABA activity, the brain's primary calming mechanism. Magnesium deficiency, which affects a significant portion of the population, is a direct cofactor in serotonin synthesis. Blood sugar dysregulation produces cortisol and adrenaline surges that can mimic panic attacks. Gut dysbiosis disrupts the production of serotonin, the majority of which is made in the gut, not the brain. Neuroinflammation can cross the blood-brain barrier and alter mood signaling directly.

These are not always the answer. But they are rarely the question. If the biology has not been investigated, the diagnosis may be incomplete.

Struggling with mood, anxiety, or symptoms that don't respond to standard treatment? Get my Free Balance Toolkit — comment BALANCE.

Research: Hidaka BH. "Depression as a disease of modernity." J Affect Disord. 2012;140(3):205-214. https://doi.org/10.1016/j.jad.2011.12.036

Dr. Candace Pert's work at the National Institutes of Health challenged the mind-body divide not through philosophy but ...
06/07/2026

Dr. Candace Pert's work at the National Institutes of Health challenged the mind-body divide not through philosophy but through hard biochemistry, and I think her contributions deserve more attention than they currently get in clinical practice.

Her discovery of the op**te receptor in 1972 opened a door that led to something far more significant: the mapping of neuropeptides and their receptors throughout the entire body. What she found was that the information molecules of emotional experience, including endorphins, substance P, and dozens of other peptides, were not confined to brain tissue. They were present in the gut, the immune system, the endocrine glands, and virtually every organ system.

The clinical implications of this are still being worked out, but a few findings stand out. Immune cells carry receptors for neuropeptides, which means the immune system may be directly influenced by emotional states at the molecular level rather than just indirectly through cortisol and the stress response.
The gut contains a dense concentration of neuropeptide receptors, which provides a possible mechanistic basis for the gut-brain connection that predates the microbiome research by decades. And emotional experience may be stored not just neurologically but in the body's tissues, a hypothesis that has gained renewed attention in trauma research and somatic therapy.

Pert's work suggests that what we call emotional health and what we call physical health may not be separate categories at the biological level. The peptide network connecting brain, gut, and immune system may mean the body is a unified communication system. That changes how we think about chronic illness, trauma, and healing.

Struggling with chronic symptoms, emotional dysregulation, or unexplained illness? Get my Free Balance Toolkit — comment BALANCE.

Research: Pert CB, et al. "Neuropeptides and their receptors: a psychosomatic network." J Immunol. 1985;135(2 Suppl):820s-826s. | Pert CB. Molecules of Emotion. 1997.

The 78 percent statistic gets cited often. The physiology behind it rarely gets explained. Women generally mount stronge...
06/06/2026

The 78 percent statistic gets cited often. The physiology behind it rarely gets explained.

Women generally mount stronger innate and adaptive immune responses than men. Higher antibody production, more robust T-cell activation, faster inflammatory response. In the context of infection, this likely confers a survival advantage. In the context of autoimmunity, that same amplified response may increase the risk of the immune system mistakenly targeting self-tissue.

A few mechanisms appear to be relevant here. The X chromosome carries a disproportionate number of immune-regulatory genes. Women carry two copies, and while one is largely silenced, incomplete inactivation may lead to immune gene overdosage in some cases.
Estrogen directly stimulates B-cell proliferation and antibody production, which may explain why many autoimmune conditions fluctuate with the menstrual cycle, worsen during perimenopause, and can be triggered by postpartum hormonal shifts. Intestinal permeability also appears to be modulated by both estrogen and progesterone, which could create windows of vulnerability when these hormones fluctuate significantly.

Pregnancy involves extraordinary immune tolerance mechanisms, and the breakdown of those mechanisms after delivery may, in some cases, contribute to autoimmune onset. Many of my patients with Hashimoto's or lupus trace their first symptoms to the postpartum period.

This is not a flaw in female physiology. It is a trade-off that evolution made. Understanding it may be the first step toward addressing it more effectively than conventional medicine currently does.

Struggling with autoimmune symptoms, hormonal shifts, or immune dysfunction? Get my Free Balance Toolkit — comment BALANCE.

Research: Ngo ST, et al. "Gender differences in autoimmune disease." Front Neuroendocrinol. 2014;35(3):347-369. https://doi.org/10.1016/j.yfrne.2014.04.004

Coenzyme Q10 sits at the center of your mitochondrial electron transport chain, specifically at complexes I, II, and III...
06/06/2026

Coenzyme Q10 sits at the center of your mitochondrial electron transport chain, specifically at complexes I, II, and III. Without it, your cells cannot efficiently produce ATP. That is not a metaphor. It is biochemistry, and it plays out clinically in ways that do not always get connected to CoQ10 depletion.

The most common scenario I see is a patient on a statin medication who is experiencing fatigue and muscle weakness, and nobody has mentioned CoQ10. Statin medications inhibit the mevalonate pathway, which is required for both cholesterol synthesis and CoQ10 synthesis. Research suggests statin use may significantly reduce plasma CoQ10 levels, which could be contributing to the myopathy and fatigue some patients report. The irony is that statins are prescribed for cardiovascular protection, and CoQ10 is particularly important for cardiac muscle function.

Beyond statins, aging naturally reduces mitochondrial CoQ10 content, and chronic illness combined with ongoing oxidative stress may accelerate depletion faster than the body can synthesize it.

On the form question: ubiquinol, the reduced form, tends to be better absorbed than ubiquinone, particularly in older adults whose conversion capacity may be reduced. If someone is supplementing and not noticing a difference, switching forms is often worth trying before concluding it does not work for them.

If you are fatigued, on a statin, or managing a chronic condition, CoQ10 is a reasonable place to look.

Struggling with fatigue, heart health concerns, or mitochondrial dysfunction? Get my Free Balance Toolkit — comment BALANCE.

Research: Littarru GP, Tiano L. "Bioenergetic and antioxidant properties of coenzyme Q10." Mol Biotechnol. 2007;37(1):31-37. https://doi.org/10.1007/s12033-007-0052-y

Identical twins share virtually the same genome. Yet when one develops an autoimmune condition like lupus or rheumatoid ...
06/05/2026

Identical twins share virtually the same genome. Yet when one develops an autoimmune condition like lupus or rheumatoid arthritis, the other develops it only about 25 to 50 percent of the time depending on the condition. That gap is worth paying attention to, because it's where most of the actionable information lives.

What I look at when a patient comes in with autoimmune disease, or a strong family history of it, is the environment around the genes rather than the genes themselves. Dr. Bruce Richardson's research on epigenetics and autoimmunity at the University of Michigan has been influential in shaping how functional medicine practitioners think about this. The question isn't just what genes you have. It's what's activating them.

Intestinal permeability may allow bacterial fragments into systemic circulation in a way that keeps immune activation running. Estrogen's influence on B-cell function could help explain why roughly 78 percent of autoimmune cases occur in women. Environmental exposures including certain infections, heavy metals, and mold may contribute to molecular mimicry, a process where the immune system could begin reacting to the body's own tissue after targeting something that looks structurally similar. And chronic psychological stress may alter the regulatory T-cell function that normally keeps immune responses from going too far.

Genetics may set the stage. But the accumulation of terrain factors seems to be what determines whether the condition actually develops. This is why looking upstream matters, not just at what the immune system is doing, but at what may have set it in motion.

Struggling with autoimmune symptoms, unexplained inflammation, or immune dysfunction? Get my Free Balance Toolkit — comment BALANCE.

Research: Richardson B. "Epigenetics of autoimmunity." Autoimmunity. 2020. https://doi.org/10.1080/08916934.2020.1777318

When Long COVID started showing up in my practice, one of the first things I noticed was that the patients struggling mo...
06/05/2026

When Long COVID started showing up in my practice, one of the first things I noticed was that the patients struggling most weren't necessarily the sickest during the acute phase. Some of them had relatively mild initial infections. What they shared was a biological environment that may have made recovery harder.

Research published in Nature and Cell has identified several patterns that seem to distinguish people who develop post-acute sequelae from those who don't. Persistent viral material in gut tissue even after respiratory clearance. Reactivation of latent herpesviruses, particularly EBV, in people with impaired immune surveillance. Elevated autoantibodies targeting neurological and cardiovascular tissue. Mitochondrial dysfunction in affected tissues. Pre-existing microbiome disruption that may have limited the body's initial mucosal immune response.

None of this means Long COVID is imaginary or psychological. It means biology explains it, and biology can potentially be addressed. The conversation I have with post-COVID patients is the same one I have with anyone dealing with chronic illness: what does your gut look like, what are your inflammatory markers, what is your nutrient status, and what is your nervous system doing. Those questions get skipped in most post-COVID follow-up care.

If you're still struggling months after an infection, there may be a biological explanation that nobody has looked for yet.

Struggling with post-viral fatigue, brain fog, or immune dysfunction? Get my Free Balance Toolkit — comment BALANCE.

Research: Davis HE, et al. "Characterizing long COVID in an international cohort." eClinicalMedicine. 2021;38:101019. https://doi.org/10.1016/j.eclinm.2021.101019

I want to share something I don't talk about enough publicly. I have been using GlutaClear by Metagenics in my practice ...
06/04/2026

I want to share something I don't talk about enough publicly. I have been using GlutaClear by Metagenics in my practice for about 15 years. If I had to pick one product I consider a clinical superweapon, this is probably it. Let me explain why.

NAC (N-acetylcysteine) is the rate-limiting precursor to glutathione synthesis.
Most people have heard of glutathione at this point, but what does not get explained well is why it matters at the cellular level. Your mitochondria generate ATP through oxidative phosphorylation, and that process produces reactive oxygen species as a byproduct. Under normal conditions, glutathione neutralizes them. When glutathione becomes depleted through chronic stress, environmental toxin exposure, poor sleep, gut infections, or nutrient deficiency, mitochondrial membranes take oxidative damage. Energy production drops. Detox pathways slow. Cellular signaling breaks down.

GlutaClear is formulated specifically to support the body's own glutathione production rather than just delivering glutathione directly, which matters because oral glutathione has significant absorption challenges. Supporting the body's synthesis pathway is a more reliable clinical strategy.

The presentations where I reach for this most consistently are patients with chronic toxic burden, persistent fatigue that doesn't respond to thyroid or adrenal support, and anyone with significant gut inflammation. The liver detoxification support piece is also relevant for patients dealing with hormonal clearance issues, since phase II detox is glutathione dependent.

This is not a supplement I recommend casually. It is one I have watched make a real difference in patients who were stuck.

If you want to try it, check it out: https://shop.iwcenters.com/products/glutaclear
Struggling with fatigue, brain fog, or toxic burden? Get my Free Balance Toolkit — comment BALANCE.

Research: Mokhtari V, et al. "A Review on Various Uses of N-Acetyl Cysteine." Cell J. 2017;19(1):11-17. https://doi.org/10.22074/cellj.2016.4456

If you've spent any time in functional medicine circles, you've probably heard the phrase "the terrain matters." I want ...
06/04/2026

If you've spent any time in functional medicine circles, you've probably heard the phrase "the terrain matters." I want to explain what that actually means in practice, because I think it gets thrown around without enough clinical context.

When two people are exposed to the same pathogen and have completely different outcomes, the instinct in conventional medicine is to look for differences in the pathogen itself. Different strain, different load, different timing. But that explanation doesn't always hold up. Sometimes the exposure is genuinely identical and the outcomes are still worlds apart.

What I look at in those situations is the host. Specifically, things like gut barrier integrity, vitamin D and zinc status, glutathione levels, and the overall inflammatory burden someone is carrying before the exposure ever happens. Dr. Ruslan Medzhitov's research on innate immunity at Yale helps explain why these factors matter. The immune system's first response isn't uniform across people. It's shaped by the biological environment it's operating in, and that environment can vary enormously from one person to the next.

I'm not suggesting antibiotics don't matter when there's an active infection. They do. But in my experience, the patients who stay sick long after the acute phase has passed are often the ones where nobody ever looked at the terrain. The gut never got addressed. The nutrient depletions never got corrected. The stress load never got evaluated. And so the immune system keeps struggling in an environment that was already compromised before the infection arrived.

Struggling with chronic infections, immune dysfunction, or symptoms that won't resolve? Get my Free Balance Toolkit — comment BALANCE.

Research: Medzhitov R. "Inflammation 2010: New Adventures of an Old Flame." Cell. 2010;140(6):771-776. https://doi.org/10.1016/j.cell.2010.03.006

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