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.

Let me be direct: the framing of type 2 diabetes as a progressive, inevitably worsening condition requiring lifelong med...
06/02/2026

Let me be direct: the framing of type 2 diabetes as a progressive, inevitably worsening condition requiring lifelong medication escalation is not supported by the full body of available evidence.

The Diabetes Remission Clinical Trial (DiRECT) — published in The Lancet — demonstrated that intensive dietary intervention produced type 2 diabetes remission (defined as HbA1c below 48 mmol/mol without glucose-lowering medication) in 46% of participants at 12 months and 36% at 24 months. With sustained weight loss of 15kg or more, remission rates approached 86%.

This isn't fringe research. It's a large, randomized controlled trial published in one of medicine's most prestigious journals.

Insulin resistance — the metabolic foundation of type 2 diabetes — is driven by chronic carbohydrate excess, visceral adiposity, gut dysbiosis, sleep deprivation, physical inactivity, and chronic stress-mediated cortisol elevation. These are modifiable. Every single one.

The mechanisms of reversal are well understood: reducing hepatic fat restores insulin sensitivity in the liver; resistance training increases GLUT4 translocation in muscle independently of insulin; gut microbiome restoration reduces systemic inflammation driving insulin resistance; sleep optimization normalizes cortisol-insulin dynamics.

This is not alternative medicine. This is peer-reviewed physiology.

Want a real strategy for metabolic health? Get my Free Balance Toolkit — comment BALANCE.

Research: Lean MEJ, et al. "Primary care-led weight management for remission of type 2 diabetes (DiRECT)." Lancet. 2018;391(10120):541-551. https://doi.org/10.1016/S0140-6736(17)33102-1

I want you to sit with this finding for a moment because it changes how we should think about metabolic health entirely....
06/02/2026

I want you to sit with this finding for a moment because it changes how we should think about metabolic health entirely.

Research from the University of Chicago — published in the Annals of Internal Medicine — demonstrated that sleep restriction to 5.5 hours per night for two weeks, in the context of a calorie-restricted diet, caused fat-free mass (muscle) loss to increase by 60% and fat loss to decrease proportionally, compared to subjects sleeping 8.5 hours on the same caloric restriction.

Separate research from Dr. Matthew Walker's group and colleagues at the University of Pennsylvania showed that just one week of insufficient sleep produced insulin resistance in healthy adults comparable to months of dietary insult.

The mechanism is multi-layered: sleep deprivation elevates evening cortisol, which directly antagonizes insulin signaling. It suppresses growth hormone release (which occurs primarily in slow-wave sleep) — impairing fat mobilization and muscle protein synthesis. It disrupts leptin and ghrelin, driving hunger and reducing satiety. And it impairs glucose transport through mechanisms that are partially independent of cortisol.

The clinical implication is direct: a patient who eats clean, exercises regularly, and manages stress but sleeps 5-6 hours is fighting their metabolic interventions. Sleep is where the metabolic restoration occurs. Without it, the other pieces cannot function optimally.

Sleep hygiene is metabolic medicine.

Struggling with weight, sleep, energy, or blood sugar? Get my Free Balance Toolkit — comment BALANCE.

Research: Nedeltcheva AV, et al. "Insufficient sleep undermines dietary efforts to reduce adiposity." Ann Intern Med. 2010;153(7):435-441. https://doi.org/10.7326/0003-4819-153-7-201010050-00006

Thyroid hormone production and conversion is an enzymatic process — and like all enzymatic processes, it requires specif...
06/01/2026

Thyroid hormone production and conversion is an enzymatic process — and like all enzymatic processes, it requires specific cofactors at every step.

Iodine is the raw material for thyroid hormone synthesis — T4 contains four iodine atoms, T3 contains three. But iodine alone is insufficient without:

Selenium, which is required for the selenoenzyme deiodinases (D1, D2, D3) that convert T4 to active T3 — and for glutathione peroxidase activity that protects the thyroid gland from oxidative damage during hormone synthesis. Selenium deficiency alone can produce hypothyroid symptoms with a normal TSH.

Iron, required for thyroid peroxidase (TPO) function — the enzyme that catalyzes iodine incorporation into thyroid hormone. Iron deficiency impairs thyroid hormone synthesis directly.

Zinc, which supports both thyroid hormone production and receptor sensitivity — meaning even adequate hormone levels don't function properly in a zinc-deficient state.

Vitamin D, which modulates immune tolerance and is consistently low in populations with autoimmune thyroid disease.

Gut integrity, because 20% of T4-to-T3 conversion depends on gut bacteria producing the enzyme sulfatase — meaning gut dysbiosis directly impairs thyroid hormone activation.

When you give someone Levothyroxine without evaluating any of these parameters, you're adding fuel to a system that may not be equipped to use it.

Test everything. Address everything.

Struggling with thyroid symptoms despite medication? Get my Free Balance Toolkit — comment BALANCE.

Research: Ventura M, et al. "Selenium and thyroid disease: from pathophysiology to treatment." Int J Endocrinol. 2017;2017:1297658. https://doi.org/10.1155/2017/1297658

After 20 years in practice, this remains one of the most consistently missed causes of suffering I see — and it's almost...
06/01/2026

After 20 years in practice, this remains one of the most consistently missed causes of suffering I see — and it's almost entirely due to inadequate thyroid testing.

TSH (thyroid stimulating hormone) is produced by the pituitary gland. It rises when the pituitary senses insufficient thyroid hormone signal and falls when it senses adequate signal. That's the extent of what TSH tells you.

What it cannot tell you: whether T4 (the storage form your thyroid primarily produces) is being adequately converted to T3 (the active form that actually enters cells and drives metabolism). This conversion happens primarily in the liver, gut, and peripheral tissues — and is impaired by chronic stress, gut inflammation, selenium deficiency, and elevated cortisol.

A patient can have a perfectly normal TSH, a normal Free T4, and a Free T3 at the very bottom of the reference range — meaning their cells are barely receiving active thyroid hormone. Standard workup declares them normal. They feel exhausted, cold, cognitively foggy, and unable to lose weight despite every effort.

The antibody markers (TPO and TG) identify autoimmune thyroid disease (Hashimoto's) — which can be present for years before TSH shifts out of range, and which has a completely different treatment logic than non-autoimmune hypothyroidism.

This is not controversial. It is basic thyroid physiology that isn't being systematically applied.

Told your thyroid is "normal" but you feel anything but? Get my Free Balance Toolkit — comment BALANCE.

Research: Bianco AC, et al. "Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases." Endocr Rev. 2002;23(1):38-89. https://doi.org/10.1210/edrv.23.1.0455

This is the gap in standard diabetes screening that puts people years behind on addressing one of the most significant m...
05/31/2026

This is the gap in standard diabetes screening that puts people years behind on addressing one of the most significant metabolic problems of our time.

Hemoglobin A1c reflects average blood glucose over approximately 90 days. It's a useful marker — but it captures only one dimension of metabolic dysfunction. And critically, A1c remains in the normal range during the years of developing insulin resistance, when fasting insulin is already significantly elevated.

Here's the sequence: insulin resistance develops first — cells become less responsive to insulin's signal, so the pancreas compensates by producing more. Blood glucose stays controlled through sheer volume of insulin. The A1c looks fine. But the hyperinsulinemia itself is driving chronic inflammation, promoting visceral fat storage, disrupting s*x hormone balance (elevating androgens in women, suppressing testosterone in men), and accelerating cardiovascular disease risk.

By the time A1c elevates into prediabetic range, the underlying dysfunction has typically been present for years — sometimes a decade or more.

Fasting insulin is inexpensive, widely available, and gives you a window into metabolic health that A1c alone cannot provide. Optimal fasting insulin is below 7 µIU/mL — ideally below 5.

If your metabolic screening doesn't include fasting insulin, HOMA-IR, and a full lipid fractionation, you have an incomplete picture.

Want to know what your metabolism is actually doing? Get my Free Balance Toolkit — comment BALANCE.

Research: Kraft JR. "Detection of diabetes mellitus in situ (occult diabetes)." Lab Med. 1975;6(2):10-22. | Reaven GM. "Banting lecture 1988. Role of insulin resistance in human disease." Diabetes. 1988;37:1595-1607.

If you've been treating your mental health and your gut health as separate problems, you've been working with an outdate...
05/31/2026

If you've been treating your mental health and your gut health as separate problems, you've been working with an outdated map.

The enteric nervous system — the neural network embedded in your gastrointestinal tract — contains approximately 500 million neurons. It communicates bidirectionally with the central nervous system through the vagus nerve, inflammatory signaling, hormonal pathways, and microbially-produced neurotransmitter precursors.

Approximately 90-95% of the body's serotonin is synthesized in the gut, not the brain. Gut microbiome composition directly influences serotonin production, GABA receptor expression, BDNF levels, and the integrity of the blood-brain barrier.

Dr. John Cryan and Dr. Ted Dinan at University College Cork have published extensively on the microbiota-gut-brain axis. Their work demonstrates that gut dysbiosis produces neuroinflammation, alters HPA axis reactivity, and measurably shifts mood, cognition, and stress resilience.

This is why I run comprehensive GI-MAP stool analysis on patients presenting with mood disorders, brain fog, and cognitive decline — not just digestive complaints. The gut can frequently be the origin point.

When pathogenic bacteria, fungal overgrowth, or intestinal permeability are present, the downstream neurological consequences are real and measurable. And they will not resolve with antidepressants alone.

Depression isn't a Prozac deficiency. Anxiety isn't a Xanax deficiency. They may be a gut health problem you haven't investigated yet.

Struggling with mood, cognition, or gut issues? Get my Free Balance Toolkit — comment BALANCE.

Research: Cryan JF, Dinan TG. "Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour." Nat Rev Neurosci. 2012;13(10):701-712. https://doi.org/10.1038/nrn3346

Telling someone with a chronically activated nervous system to "just relax" is like telling someone with a broken leg to...
05/30/2026

Telling someone with a chronically activated nervous system to "just relax" is like telling someone with a broken leg to "just walk it off."

The science is clear: chronic stress physically rewires the brain. The amygdala enlarges. The prefrontal cortex thins. The hippocampus — responsible for memory and context — shrinks under prolonged cortisol exposure. This is documented in structural MRI research.

What this means practically: your nervous system cannot reason its way to safety. It needs to EXPERIENCE safety repeatedly, at a physiological level, before it updates its threat calibration.

Dr. Rick Hanson's work on neuroplasticity shows that deliberately installing positive states — not bypassing the negative, but actively marinating in moments of calm, connection, and ease — builds new neural architecture over time. He recommends 15-30 seconds of consciously staying with a positive or safe experience to begin shifting synaptic weight.

Combined with resonance breathing at 5.5 breaths per minute, vagal tone work, and resolving the biological drivers keeping the alarm on — gut inflammation, hormonal disruption, nutrient deficiencies — this is how the nervous system is actually reset.

I put together a step-by-step HRV training tutorial — link in comments.

Insight alone doesn't heal. Protocol does.

Struggling with anxiety, chronic fatigue, or a body that won't calm down? Get my Free Balance Toolkit — comment BALANCE.

Research: Hanson R. Hardwiring Happiness. Harmony Books, 2013. | McEwen BS, Gianaros PJ. "Stress- and allostasis-induced brain plasticity." Annu Rev Med. 2011;62:431-445. https://doi.org/10.1146/annurev-med-052209-100430


I want to reframe how you think about exercise and metabolic health — because most people focus on cardio for blood suga...
05/30/2026

I want to reframe how you think about exercise and metabolic health — because most people focus on cardio for blood sugar and are leaving the most powerful intervention on the table.

Skeletal muscle is the primary site of glucose disposal in the body — responsible for approximately 80% of insulin-stimulated glucose uptake. When you contract a muscle, GLUT4 transporters move to the cell surface through a pathway that is partially insulin-independent. This means strength training improves glucose uptake even in cells that have become insulin resistant.

A single resistance training session has been shown to increase insulin sensitivity for 24-48 hours post-exercise. Regular resistance training consistently reduces HbA1c, fasting glucose, and fasting insulin in both diabetic and prediabetic populations.

The mechanism is structural: more muscle mass means greater total glucose storage capacity and a larger pool of GLUT4 transporters. The metabolic math is straightforward — more functional muscle tissue means the body requires less insulin to manage the same glucose load.

For women specifically, muscle mass preservation becomes critical after 40 as estrogen-related metabolic protection declines and the risk of insulin resistance rises. Resistance training is not optional in this context. It is metabolically essential.

Two to three sessions per week of compound resistance exercises — squats, deadlifts, rows, presses — produces measurable metabolic benefit within 6-8 weeks.

This is lifestyle medicine at its most evidence-based.

Want a real metabolic health strategy? Get my Free Balance Toolkit — comment BALANCE.

Research: Richter EA, Hargreaves M. "Exercise, GLUT4, and skeletal muscle glucose uptake." Physiol Rev. 2013;93(3):993-1017. https://doi.org/10.1152/physrev.00038.2012

Hashimoto's thyroiditis is the most common autoimmune condition in the United States and the leading cause of hypothyroi...
05/29/2026

Hashimoto's thyroiditis is the most common autoimmune condition in the United States and the leading cause of hypothyroidism. And the standard treatment protocol is almost universally missing the most important intervention.

Levothyroxine (synthetic T4) replaces the hormone the thyroid is no longer producing adequately. It does not — in any way — address the autoimmune process destroying the thyroid tissue.

This matters because: the antibody-mediated destruction continues. Thyroid tissue continues to be lost. Patients often require escalating doses over time as the gland is progressively damaged. And they experience no investigation of WHY their immune system lost tolerance to their own thyroid tissue.

The research on root causes is substantial:

Intestinal permeability allows partially digested proteins to enter the bloodstream, triggering cross-reactive immune responses against thyroid tissue (molecular mimicry)
Gluten sensitivity is overrepresented in Hashimoto's populations
Selenium deficiency impairs the activity of thyroid peroxidase and the deiodinase enzymes critical for T4-to-T3 conversion
Viral triggers (particularly EBV) have documented associations with autoimmune thyroid onset
Environmental toxin burden, particularly halides that displace iodine from thyroid receptors

Addressing these factors — through comprehensive gut evaluation, elimination protocols, nutrient restoration, and toxic burden assessment — has produced measurable reductions in antibody titers in clinical practice and in published research.

The thyroid is not the problem. It's the target. Treat the system.

Dealing with Hashimoto's and tired of just managing it? Get my Free Balance Toolkit — comment BALANCE.

Research: Fasano A. "Leaky gut and autoimmune diseases." Clin Rev Allergy Immunol. 2012;42(1):71-78. https://doi.org/10.1007/s12016-011-8291-x

If you’ve been chronically ill and feel stuck despite “doing everything right,” polyvagal theory may explain why.Dr. Ste...
05/29/2026

If you’ve been chronically ill and feel stuck despite “doing everything right,” polyvagal theory may explain why.

Dr. Stephen Porges developed Polyvagal Theory to show that the nervous system isn’t just fight-or-flight vs. rest-and-digest. There’s also a shutdown/freeze state controlled by the dorsal vagal branch.

When stress or threat becomes overwhelming, the body can shift into shutdown instead of activation:
• chronic fatigue
• emotional numbness
• dissociation
• feeling frozen or disconnected

This is common in people with chronic illness, autoimmune issues, and long-term gut dysfunction. After prolonged stress, shutdown can become the nervous system’s default state.

Healing, digestion, immune regulation, and repair require ventral vagal activation — the body’s safe-and-connected state. Neither chronic fight-or-flight nor shutdown supports recovery.

The vagus nerve is ~80% afferent, meaning most signals travel FROM the body TO the brain. That’s why regulation often requires bottom-up approaches rather than “thinking positively.”

One evidence-based tool is resonance breathing at ~5.5 breaths per minute. Slow exhales stimulate vagal pathways and send safety signals to the brainstem. Pairing this with feelings of gratitude, safety, or connection may further support regulation.

See link in the comments for how to do resonance breathing...

You can’t think your way out of shutdown — but you may be able to breathe and feel your way back into regulation.

Research:
Porges SW. “The polyvagal theory: phylogenetic substrates of a social nervous system.” Int J Psychophysiol. 2001.

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38777 Six Mile Road, Suite 401
Livonia, MI
48152

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