New Frontiers In Functional Medicine

It’s not often that I get to spend an hour chatting with a busy clinician on pearls learned over years of practice. In today’s podcast, I’m talking with long time integrative medical clinician and anti-aging expert Lynne Mielke, MD about her approach to bioidentical hormones and why the Precision Analytical DUTCH is her preferred test for assessing HRT response. It’s her experience that the “gold standard” blood tests often lead to over-prescribing, and she commonly finds herself initiating tapers for those patients who come to her already on biHRT. Lynne also shares with us her journey to integrative medicine- as a psychiatrist, she faced the limitations of her training when her son was diagnosed with autism. As she puts it, she entered another world as she dove into integrative, biomedical treatments for autism decades ago: “Given the complexity of spectrum disorders, If you know how to treat them, you know integrative medicine.” From there, she leaped into anti-aging medicine, as parents of autistic child

Dr. Mona Morstein has focused the bulk of her career on treating all types of diabetes (DM). In late 2017, she published the a superb 500+ page very well-referenced book on the topic, titled Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes. Despite written in layman language, clinicians will find it meaty enough to be useful in practice – I especially like the sections on DM complications. In our conversation, we look at the four main types of diabetes, discuss etiology and epidemiology of types 1 and 2. We discuss standard labs, including the limitations of A1C, and the utility of the GlycoMark test. Learn how she does a glucose/insulin tolerance test and specialty lab testing considerations in patient management, managing the microbiome, intestinal permeability, food sensitivities. Diets: Dr. M recommends a very low carbohydrate diet (VLCD), but we had a great sidebar convo on the paradox of VLCD and vegan macrobiotic diets demonstrating equally good outcome

If you’ve listened to my podcasts, you surely know that I love what I do. And my podcast with Dr. Stephen Sinatra is no exception. One of my most inspiring conversations to date, Dr. Sinatra is, as you know, a pioneer in the field of integrative cardiology. Hear about his remarkable, very early transition to integrative cardiology, including pivotal encounters with patients and scientists that shaped his thinking; his gutsy, hospital grand rounds presentations on the use of CoQ10 for heart failure patients, and the story of my mom working as a cardiac nurse with him during his fellowship. While Sinatra doesn’t maintain an active medical practice anymore, he still goes into his office often “to see how my former heart failure patients are doing. I don’t charge them. I just want to check in” He talked about a 9 year old boy he saw with florid heart failure. That boy is 32 years old now, and doing great. He was involved in designing the treatment plan for the now oldest-living person with tetralogy of Fallot.

Endotoxemia. A fundamental driver of chronic disease. What is it? And more importantly, what do we do to address it? In my podcast with Dr. Jill Carnahan this month, she unleashes a torrent of compelling science and clinical savvy on all things endotoxemia. From heart disease and diabetes to autoimmunity (genetic or acquired) and mast cell activation, Dr. Carnahan is clear that pathological intestinal permeability (she discusses testing, but at this point in her career believes most everyone who sees her with chronic disease has IP) drives inflammation by allowing excess microbial endotoxins- primarily as lipopolysaccharide (LPS)- to enter circulation. Focused on root cause functional medicine (toxins, diet, infection, genetics), she concurrently heals the gut to drop the inflammatory burden. A key intervention for Jill is sugar-free, GMO-free, serum-derived bovine immunoglobulin (SBI), and we spend quite a bit of time on why SBI is crucial. With 43 human trials behind it, if you are not using SBI yet, you’ll

Anxiety can get in the way of patients achieving their health goals—especially when a practitioner recommends significant lifestyle and nutrition changes. Patients may feel suffocated by the new regimen and then make changes for a while but revert back—or they may not make them at all. The Emotional Freedom Technique, also known as tapping, can help patients ease anxiety and better achieve their health goals. It can also help with the subjective experience of pain or be used in service of a specific health goal, like overcoming weight loss resistance. In this podcast, Dr. Fitzgerald talks to Jessica Ortner, author of The Tapping Solution for Weight Loss & Body Confidence, about how tapping could help patients in a functional-medicine clinic setting. And, together, they walk step-by-step through a round of tapping so listeners can hear how it’s done (and follow along).

After suffering through a lengthy Lyme infection himself (with classic presentation), which initially responded to antibiotics but didn’t resolve the infection, Dr. Darin Ingels went on a years-long quest to recover, returning to naturopathic principles and discovering essential less-used protocols. The results are in his book: The Lyme Solution: A 5-Part Plan to Fish the Inflammatory Autoimmune Response and Beat Lyme Disease (Penguin Random House), and he has been treating patients with Lyme and co-infections successfully since then. In this clinical pearl dense podcast, Dr. Ingels pulls from his experience as a clinical microbiologist by training, to share what he is doing today in practice – from labs that work and those that don’t, using immunotherapy, the association with mold allergy and mycotoxicity, to botanical protocols and when to use antibiotics. While he doesn’t use the word “functional,” it’s clear that his approach to Lyme embraces a full functional approach, and that addressing the whole perso

Wow! What a great conversation with Dr. Valter Longo, director of USC’s Longevity Institute. It’s always exciting to talk to someone in the trenches of bench and clinical research, especially a rock-star like Valter Longo! You can hear my nerves as we begin ☺, yet there’s much to learn about Dr. Longo’s journey from a Blue Zone upbringing in Italy to music major to biochemisty major to leading expert in articulating the biochemical and genetic underpinnings of the aging process. Dr. Longo was a post-doc under Dr. Roy Walford – famous for his research on caloric restriction and longevity. While Walford’s work – famously the 2-year Biosphere study conducted on humans – yielded remarkable improvements in chronic diseases, there were many side effects. The limitations of the human Biosphere study prompted Dr. Longo to turn his attention to longevity in single-celled organisms (S. Cervascie, specifically), then animal studies, and most recently humans. Longo designed his short term fasting mimicking diet (FMD), wh

Yes, hemp & marijuana are major providers of cannabinoids, and in the FxMed space, we are extremely excited about this potent family of bioactive molecules. In particular, we are looking at CBD for indications ranging from pain to mood, inflammation, memory and more. Turns out the endocannabinoid system (ECS) extends body-wide, and similarly, phytocannabinoid sources extend far beyond hemp and marijuana. Listen to my conversation with Dr. Jacqueline Jacques, Senior VP with THORNE – and tour the ECS and the use of phytocannabinoids from hemp, rosemary, clove, black pepper and even hops, whose constituents have an “entourage” effect on the ECS, along with other commonly prescribed compounds including diindolylmethane, ginseng, echinacea. It strikes me as extremely logical we’d be thinking about using phytocannabanoids with most of our patients and ourselves – probably PCs are foundational interventions not dissimilar to the regularly prescribed essential fatty acids. We get the inside scoop on all this and mor

In my conversation with Mark Hyman on his new NYT best seller, Food: What the Heck Should I Eat?, we discuss the myriad challenges consumers face in figuring out the correct diet, but also, what WE as clinicians caring for patients – what do we prescribe? What do the data show? Are grains really verboten? Is dairy completely off-the-plate? What about meat? And fats/cholesterol and the APOE4 patient? Mark enlightens me to the new “regenerative agriculture” movement; going far beyond organic, regenerative agriculture regenerates the environment while providing good, clean food. Amazing, right? He also addresses the common price complaint. What is the cost of eating clean vs eating conventional? We also go behind the scenes to address the insidious agribusiness at the heart of US policy, and chat about Steven Savage’s recent take-down of Environmental Working Group’s Dirty Dozen Clean Fifteen lists. This was such a fun convo for me, and as always, Mark is doing great detective work getting to the heart of concer

I am thrilled and honored to podcast with Dr. Randy Jirtle. The field of epigenetics has exploded in the last decade, initiated almost exclusively by the groundbreaking research of Randy and his colleague Robert Waterland. Their 2003 study on the effects of nutrition on epigenetic gene regulation in agouti mice is the most cited paper in the history of science, and his trailblazing discoveries have expanded our understanding of human health and the etiology of disease. Listen to my fascinating conversation with Dr. Randy Jirtle.

A lot of scientific discoveries are borne out of serendipitous moments where a brilliant idea and unmet need collide. Such is the case with one of my all-time favorite “workhorse” botanical combination products, Biocidin. Listen to Dr. Rachel Fresco, founder and president of Bio-Botanical Research, talk about the story of Biocidin, the decades of interesting and on-going in-vivo and in-vitro research, and loads of clinical reports demonstrating efficacy. Also hear about Bio-Botanical’s suite of other no less creative products, including Oliverex, Proflora4R and GI Detox. In my practice, Biocidin is a work horse botanical combination I use ALL the time. It’s well-tolerated, and being a liquid formulation, I can dose low and slow or high and aggressively as I need to. Listen to my conversation with Dr. Rachel Fresco here!

Why would Precision Analytical, the laboratory famous for the ground-breaking DUTCH test (Dried Urine Test for Comprehensive Hormones) and Cortisol Awakening Response test, decide to offer a handful of key organic acids on their panel (incidentally, at no extra charge)? The answers will wow you in this terrific podcast with Dr. Carrie Jones, Medical Director at PA. Turns out, looking at compounds such as homovanillic acid, vanillmadilic acid, 5HIAA, pyroglutamate, 8OH2DG and xanthurenate have LOADS to do with our sex hormones and our HPA axis at many different levels. As usual, Dr. Jones provides fun analogies (how does a trampoline explain perimenopause?), clinically useful information on test interpretation and on intervention considerations. Don’t miss it.

Join me for an interesting, clinician-friendly conversation on the gut/thyroid axis with Dr. Mike Ruscio. Dr. Ruscio challenges both conventional understanding (where the gut/thyroid relationship isn’t recognized outside the research setting) and in the functional medicine world, where he argues we are often over-treating and over-testing thyroid function. What is the thyroid adrenal relationship? What should we expect with regard to thyroid antibodies and successful treatment? What should we be thinking about with regard to gut health when diagnosing and treating thyroid disease? Listen to this great New Frontiers episode where we dive deep into all this and more!

When Chris Kresser, M.S., L.Ac, was in his early twenties, he traveled the world surfing and learning to meditate. Along the way, he fell ill — and when he returned to the States he discovered that the conventional medical paradigm had little to offer when it came to treating complex, chronic illness. So he embarked on his own healing journey, studying acupuncture and Chinese medicine and learning about ancestral health. Today he is a globally recognized leader in the fields of functional and integrative medicine. In this podcast, he talks with Dr. Fitzgerald about being one of the first holistic practitioners to establish a solid online presence; why blogging and writing about functional, ancestral, and integrative approaches to health matter today more than ever; and how the current medical paradigm needs to be reinvented both to prevent and reverse chronic disease and to prevent the collapse of the entire healthcare system. His new book Unconventional Medicine is available now.

Small-intestinal bacterial overgrowth, or SIBO, is notoriously hard to treat. Patients often experience persistent bloating—and even when they find relief, symptoms can return months later, seemingly out of the blue. After struggling to help patients feel better using the tools of conventional gastroenterology, Dr. Ken Brown began to research compounds that could effectively treat SIBO-related bloating. The result of his work is Atrantil, the only all-natural formulation for treating SIBO-related bloating. In this podcast, Dr. Fitzgerald talks to Dr. Brown about dosing and treating patients with Atrantil, when to run further tests, and what other treatments can be used in conjunction with Atrantil to get the best results.

JJ Virgin was a well-known fitness and nutrition expert and author of several books when her son was hit by a car and severely injured. The doctors told her to prepare for the worst; they didn’t expect him to make it through the night. But, Grant lived. And JJ’s insistence on making sure he had access to both conventional and functional medical care is the reason why. She became an expert on the essential interventions for severe traumatic brain injury and insisted on their use during his recovery. In this podcast, the four-time New York Times bestselling author tells the story of her son’s accident and recovery, talks about her newest book, Miracle Mindset, and shares amazing clinical pearls on treating traumatic brain injury with functional interventions. In this podcast, you’ll hear JJ’s list of essential interventions for severe traumatic brain injury, including CBD oil with omega 3’s Essential oils, lavender combination (find details at www.grantvirgin.com) Autologous stem cell therapy (stem cell re

Elemental Diets have a long therapeutic use history for myriad GI issues. EDs allow the gut to take a break from the hard work of digestion, offering the GI tract a chance for renewal and repair. They have been shown to help with a variety of conditions, including SIBO, IBS, non-specific intestinal inflammation, and autoimmunity, including IBD (among others). In this podcast, the director of clinical affairs for Integrative Therapeutics, Dr. Corey Schuler, answers some of the most frequently asked questions about using the Elemental Diet with patients, from how to use it while simultaneously treating other conditions (like fungal overgrowth or severe vitamin D deficiency) to creative ways to help patients stick to a challenging eating protocol.

Mark Newman is the founder Precision Analytical and the developer of the DUTCH test, one of the most accurate and patient-friendly measures of sex hormones on the market. The test eliminates the need for multiple types of testing by using dried urine to measure sex hormones, hormone metabolites, and free cortisol. Free cortisol is a key indicator of the health of the HPA axis — and having that measure, alongside a measure of sex hormones and their metabolites, gives providers more information so they can achieve better clinical outcomes. The test can be especially valuable in complex cases. Now, Mark has developed DUTCH Plus with Cortisol Awakening Response and he talks with Dr. Fitzgerald about the new test, testing best practices, and the most cost effective tests for patients.

Tumor cells have more insulin receptors than healthy cells, so they preferentially metabolize glucose. When you cut off the glucose supply to tumor cells, they struggle to make the fuel they need to proliferate. The ketogenic diet sharply limits the glucose that reaches tumor cells (while providing other anticancer benefits), and animal studies (and one small but seminal human study) have shown promise in using the ketogenic diet as an adjunctive treatment for cancer. Author of the new book, Keto for Cancer, Miriam Kalamian, EdM, MS, CNS, talks with Dr. Fitzgerald about the how ketogenic eating for cancer differs from other keto and low-carb protocols and outlines specific steps for pacing a keto protocol for the specific needs of cancer patients.

Dr. Terry Wahls was a practicing primary care physician when she was diagnosed with relapsing-remitting MS. Despite treatment at some of the finest medical institutions in the United States, her health progressively declined until she could no longer walk. When she discovered functional medicine, she made a rapid turnaround. Soon she wasn’t just walking again, she was doing 20-mile bike rides. Today, Dr. Wahls conducts research using variations of her protocol, including intensive directed nutrition, progressive exercise programs, electrical stimulation, and the use of dietary supplements for patients with MS. She conducts her research at the Iowa VA, through the University of Iowa and is supported through grassroots fundraising. In this episode of New Frontiers in Functional Medicine, Dr. Wahls talks with Dr. Fitzgerald about her physical and spiritual transformation — and how other patients with chronic conditions can realize similar results.