Dr. Kara Fitzgerald | New Frontiers in Functional Medicine, Longevity, Epigenetics

Once upon a time, in a pre-antibiotic world, bacteriophages were a hot research topic in this country and elsewhere. In the 1940’s, Eli Lilly had seven OTC bacteriophage products available – good for everything from abscesses to URIs and mastoiditis. However, with the advent of antibiotics, the research into and use of phages ceased in the US. But in the age of antibiotic resistance, we’re back at phage research, and its wildly interesting and extremely important to explore. Phages are bacterial viruses that invade and kill bacterial cells: an obvious answer to antibiotic resistance. Listen to my conversation on New Frontiers with phage scientists Paul Turner and Benjamin Chan of The Paul Turner Laboratory at Yale University, get the background on all things phage research, and hear a handful of inspiring case reports from “pond to bench to bedside” as Drs. Turner and Chan like to say. Sit back and listen to this terrific podcast, and be sure to comment on iTunes, share with your colleagues, and let me know your thoughts! ~DrKF

Compounding pharmacies: SO essential to the FxMed clinician’s toolkit. Compounding individualized prescriptions are at the heart of what we do, and on this podcast of New Frontiers, I am delighted to talk to Michelle Violi, Pharm. D, of Women’s International Pharmacy. Located in Wisconsin and Arizona, but serving clinicians and patients everywhere, WIP has been compounding bioidentical hormones for decades. Join our conversation, where we cover the background of WIP, their commitment to education (patients and clinicians; how to access), regulation of compounding pharmacies (its rather extraordinary), how to pick a good compounding pharmacy (check for PCAB status), and of course, we talk about hormones, too. Listen and give us a review on iTunes, or wherever you listen to New Frontiers! ~DrKF

In this episode of New Frontiers, Dr. Fitzgerald talks with Dr. Perlmutter about the best strategies for preventing and slowing cognitive decline, and how his thinking about preventive lifestyle strategies has evolved since he published his first book Grain Brain.

I enjoy discussing all things nutritional biochemistry, and few minds are more engaging to chat with than David Quig, PhD, VP of Scientific Support at Doctor’s Data. In this NFFM podcast, we’re drilling down into the laboratory assessment of methylation and sulfuration. As Dr. Quig makes clear (yet again)--- while we might make some *basic* inferences around methylation activity by looking at a person’s SNPs, SNPs are not our destiny (thank God!). Ultimately, SNP assessment doesn’t hold a candle to direct assessment of key methylation intermediates. And indeed, we often find our biochemistry- i.e. what is actually happening in the body at any given time—is very, very different from what our SNP patterns suggest we might find. You’re going to want to hear what he has to say, so settle in because you’re going to learn a lot. And you’re not going to want miss the valuable downloads in the shownotes! ~DrKF

A huge, constant question we get from clinicians and patients is: what to do about refractory SIBO? Patients want hope, clinicians want to successfully resolve… Listen to my podcast to discover what one of the greatest minds thinks about all this and more. Dr. Steven Sandberg-Lewis, co-founder with Dr. Allison Siebecker of the National University of Natural Medicine SIBO Center – one of only four centers in the US dedicated to diagnosis, treatment, education and research, is a longtime naturopathic physician and perennially popular professor of gastroenterology at NUNM. In this NFFM episode, DrSSL covers less commonly explored reasons for SIBO, including hiatal hernia syndrome, ileocecal valve syndrome, adhesions & scar tissue and hypochlorydria. Learn signs/symptoms (often unexpected), diagnosis and treatment for these all-too-often missed underlying issues. FYI – great downloads in the shownotes too – the “common causes of SIBO” PDF is essential, IMO. Be sure to rate, like, comment, and share our podcasts! Thanks always! ~DrKF

What’s the best way to test hormones? That is the key question that drove Mark Newman to create the DUTCH test. DUTCH stands for Dried Urine Test for Comprehensive Hormones and it gives clinicians a robust picture of a patient’s hormone levels and functioning. DUTCH tests are used by many leading functional medicine practitioners, including hormone expert Sara Gottfried, MD. Here, Dr. Kara Fitzgerald talks with Mark Newman about the advantages of using the DUTCH test, the strengths and limitations of lab testing in general, and how to interpret results. If you’re a clinician who relies on lab testing in your practice, you won’t want to miss it.

One of the bright lights in the naturopathic/FxMed world, Dr. Lyn Patrick has devoted much of her career to training physicians in environmental medicine. She’s got loads of exquisitely valuable information, and I spent every inch of our hour together mining as much as I can for you. Take a listen and let me know what you think.

Lyme disease (and co-infections) can be tough to treat. The Lyme spirochete, Borrelia burgdorferi, has adopted loads of devilishly clever cloaking devices – from thriving in biofilm to existing in pleomorphic forms – to ensure survival despite aggressive treatment. Enter botanical therapy. With or without concurrent antibiotics, botanical combinations are an essential component of the FxMed clinician’s toolkit.

DSL’s GI-MAP stool test is, as CEO Tony Hoffman states, “a clinician diagnostic tool;” it’s not a microbiome test. Yes, of course the GI-MAP looks at the microbiome, but it's not a broad sweep of the myriad of bugs taking up residence. Rather, it’s a carefully curated investigation of organisms with demonstrated imbalance potential, be it pathogenic or dysbiotic in nature. The test is designed to be user-friendly, interpreted rapidly, logically, providing clearly actionable data that, when addressed, gets results. I’ve known Tony for years; we were both involved in the development of the first stool test using PCR analysis offered to clinicians. He’s brilliant, fun to listen to, and offers loads of pearls in this conversation. Take a listen, share, comment, and let us know what you think!

A wide body of research—not to mention centuries of use in Chinese medicine—has shown the power of medicinal mushrooms in promoting health, and no one knows more about the cultivation, manufacture, and distribution of supplemental mushrooms in modern integrative health care than Jeff Chilton. The president of Nammex, one of the biggest medicinal mushroom extract companies in the nutritional supplement industry, Jeff talks with Dr. Fitzgerald in this episode of New Frontiers about how mushrooms are grown and cultivated (and why that matters for supplement quality) and how clinicians and consumers can tell if mushroom supplements contain any actual medicinal value or not.

Dr. Deanna Minich preaches: Eat a rainbow. Why? There are over 700 carotenoids found in plants – all bioactive, and generally pleotropic (ie: they do more than one thing in the body). We don’t need tons of any single carotenoid, and indeed – if anyone recalls the beta carotene smoker study from the early 2000’s, too much of a single compound could arguably be toxic. But variety is essential. And amazingly, certain groups of carotenoid colors favor certain organs. Think “orange for ovaries”; blue for brain and green for heart. Listen to my riveting conversation with Dr. Deanna Minich as she shares her own healing journey from endometriosis and how color, plant medicine and spirit converged…. carotenoid science to artist. Variety. ‘Bridging the gap between science, soul and art’ in medicine. And hear about the Scio and how you can test your food nutrient density in this cool, cutting edge, handheld device – and loads MORE! There are 25,000 plant phytonutrients that we are aware of, and probably many, many more that we are not. Listen to this revealing podcast with the incredible Dr. Deanna Minich, and be sure to comment, give a thumbs up, and share with a friend!

Non-alcoholic fatty liver disease is an urgent, often unrecognized concern. It’s the hepatic pandemic of the 21stcentury, and there is NO approved pharmaceutical therapy (the race is on, however…). Fortunately for us, there is MUCH we can do in functional medicine – indeed, our toolkit is powerfully effective in turning around NAFLD and even NASH – the next step progression. Listen to my conversation with my good friend and longtime colleague Dr. Robert Rountree (finally on NFFM!). Bob outlines the scope of the problem (did you know 80% of obese kids are at risk?) how to evaluate for it, and most importantly: what to do. This was such a content-dense discussion, I am most grateful Bob has made his full powerpoint deck available to you for download. Take a listen to the podcast, then circle back to the deck for all the specific details on what to do.

Dr. Joel Evans – you probably know him as long-time IFM faculty teaching in the Advanced Practice Hormone Module. He’s also donned a newish hat as KBMO’s Medical Director. Dr. Evans loves the FIT test for delayed hypersensitivities to foods, and states that the addition of complement fragment C3d to their test significantly reduced the incidence of false positive results found on standard IgG testing. Listen to our convo on the FIT test, how he’s using it in practice, who he uses the test on, and why its essential in preconception planning. Also: this just in! We’re the first to hear about his study using KBMO vs healthy diet on 100 individuals with IBS – get the outcome data here.

The centrality of gut health in overall health cannot be overstated, and for many years researchers and practitioners have encouraged probiotic use to promote gut health. But their recommendations have been based on early and inchoate research. Today, several decades after the emergence of gut health as the ground zero of overall health, science has been able to correlate specific bacterial strains with specific health outcomes—and one man has spent years anthologizing all that research and making it available to practitioners and patients. Dr. Jason Hawrelak is a scientist, educator, and naturopathic physician. He’s one of the leading experts in microbiota manipulation and the use of specific strains for specific conditions. He is also the creator of probioticsadvisor.com, where practitioners and patients can access information about specific bacterial strains. Check out my conversation with Dr Hawrelak on NFFM. I am thrilled to be introduced to his work (have referred folks to him already), and so appreciate his dedication to crunching the data for us clinicians on Probioticadvisor.com.

In my Tour de Force conversation with the brilliant Dr. Theoharis Theoharides, we covered all things mast cells, from “bench to bedside.” In case you have not yet encountered his work yet, he is one of the most highly decorated, well-published clinician researchers in the world. The focus of his life’s work has been on all things mast cells, and mast cell associated conditions. Given the meteoric rise in said conditions (and our improved understanding of the role of mast cells in most chronic diseases), as clinicians, we need to understand how to diagnose and treat. Buckle up for this podcast, and get your pen and pad ready – the depth and breadth of Dr. T’s knowledge requires careful listening. Give a listen, then give a thumbs up for this brilliant, generous clinician!

Some of our most popular podcasts have been with Dr. Corey Schuler: he’s down-to-earth, practical in his approach to patient care, and very evidence-informed. And today is no exception! Join me and Corey as he talks through his “4 Pillar” approach to treating anxiety and depression. He discusses the multifactorial biochemical underpinnings of both conditions, his assessment tools (including labs), treatment (for acute presentations, chronic and co-managing those on pharma) and expectations of outcome. You won’t find the usual arsenal of natural therapeutics in Corey’s approach – he rarely uses 5HTP or St. Johns Wort – rather, he starts with full functional medicine and drills down into his 4 Pillars to determine next steps. We chat on new research – I think you’ll be impressed – and citation links are in show notes – including a recent study on Theracumin for memory and mood. Give us a thumbs up, leave a comment, and let us know what you think! ~ DrKF

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 children sought her care. Dr. Mielke discusses her transition into practicing integrative medicine, and what her clinic looks like today. ~DrKF

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 – learn why Dr. Morstein suspects that is. Toxins, particularly POPs, but also metals, play a huge role in ushering in diabetes – learn how she’s evaluating and treating. We discuss nutraceutical interventions, medications – what she’s using and why. Of course, no conversation on DM is complete without discussing the influence on lifestyle. An interesting point Mona makes is that the program of treatment must be doable and relatively stress-free. Please give this terrific podcast a thumbs up and share if you like it as much as I think you will, and as always, let me know your thoughts!

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. What did he prescribe? The “fearsome foursome”: CoQ10, magnesium, ribose and carnitine. At 73 years old, the first heart failure patient he prescribed CoQ10 to (10mg TID!) is alive and well. We move through loads of research on nutrients (yes, we discussed K2) diets, fats and what we need to be doing for ourselves, our families and our patients. Update: Dr. Sinatra and I spent a chuck of time on the famous PREDIMED study, published in the New England Journal of Medicine in 2013. PREDIMED garnered much attention by validating the use of a Mediterranean diet supplemented with olive oil or mixed nuts for reducing incidence of cardiovascular disease in persons at high risk. Interestingly, the day we recorded, news broke that the PREDIMED was retracted. However, the study authors re-published the PREDIMED in NEJM June, 2018 with compromising data omitted. The findings remained similar to the original PREDIMED. Listen to Dr. Jeff Bland discuss the details.

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 be compelled to start, I suspect. We also have a fun dialogue on the role of fatty acids and toll-like receptor activation, connected directly to LPS. Jill shares a handful of very compelling case vignettes AND talks candidly about how she set up an extremely successful functional medicine practice and positioned herself as an expert in the field. And let me know: will you be changing how you prescribe high fat diets based on the research we discuss?

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 person, and their environment, is essential to recovery.

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), which does away with the fallouts he observed in long term caloric restriction. We cover a lot of great material in this conversation – and Dr. Longo makes compelling points against the unfettered use of MCT and exogenous ketones. Take a listen and let me know what you think!

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 more in New Frontiers! Take a listen and let me know what you think:

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 concerns around diet and the ecology of eating. Take a listen, I bet you’ll be as intrigued as I was.

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 revolution) Progesterone/hormone balancing Prayer Diet Very high dose omega-3 fatty acids (up to 20 grams) Amino acids (higher dose branched-chain amino acids to prevent catabolism) Hyperbaric oxygen therapy The power of mindset Avoiding hospital food

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.

I went to school with Dr. Hilary Andrews. She graduated before me, but I recall her then—she had a reputation for brilliance (and was voted class valedictorian, incidentally). Hilary applied that brilliance to childhood health and nutrition, which inevitably included investigation around vaccine safety. Flash forward to current time, Hilary continues to research and lecture extensively on the topic of immunization. She’s developed a number of CE courses available for clinicians. Make no mistake: Dr. Andrews recognizes the profound benefits of immunization-from the virtual elimination of polio, to the exciting work in cancer. However, Dr. Andrews also recognizes among other things, that one immunization schedule does not fit all. And that optimizing baby’s health, including supporting immune system maturation, ensuring nutrient sufficiency, and adequate detoxification capacity, is essential to ensure the safest, most effective response.

Small Intestinal Microbial Overgrowth: A Conversation with Dr. Vincent Pedre, MD IFMCP All microbes, not just bacteria, can contribute to problems in the small intestines. Today more than ever, we see patients with hard-to- treat gut problems. Dr. Pedre brings his own gut healing journey and Functional Medicine background to the table to talk to us about treating patients with SIBO-or as he likes to call it-SIMO, which encompasses microbes beyond bacteria and includes the oft-overlooked fungal piece of the puzzle. Dr. Pedre shares loads of treatment pearls from his gut-centric practice, but reminds us that any protocol must be individualized for the person sitting in front of us.

Dr. Carrie Jones and I went to medical school (National College of Natural Medicine) together. She was a brilliant, awesome friend then, and still is. What a privilege it’s been to watch her grow into the expert she is today. As you’ll see in her bio, Dr. Jones has been focused on women’s health and hormones her entire career which has spanned academia, clinical practice and now as the chief medical officer at Precision Analytical, home of the DUTCH dried urine hormone panel. Given Carrie’s background, she’s uniquely suited to train us on using the DUTCH panel, as she’s literally interpreted thousands of these tests over the years. Her podcast is chock full of Monday morning pearls of the best kind- actionable content I think you’ll appreciate and use immediately.

Dr. Corey Schuler is a man of many talents- an educator as well as a practitioner in integrative and functional medicine. In today’s podcast, Dr. Schuler will be wearing his nutritionist hat as we discuss individually designed elemental diets. Some of the applications we cover will be well-known to practitioners and patients alike. Others don’t have precedent in clinical practice but listen to this expert as he walks you through the critical thinking he calls on to come up with new and novel ways to use elemental diets to heal a number of conditions.

As you probably know, stem cell therapy outside of the research setting is the Wild West. It’s offered everywhere, here and outside of the US (there’s a whole “stem cell tourism trade”). Radical claims are made routinely without much evidence or oversight. Pricing for therapy, and protocols used, vary widely, although anyone (even those participating in research trials) can expect to spend thousands of dollars. Given that my patient has MS, I reached out to Dr. Terry Wahls and asked if she had any insight into a direction for us. She suggested I look into a massive, years-long multi-center clinical trial using stromal vascular fractions (AKA adipose-derived stem cells and growth factors) for a variety of conditions, including MS. The first publication from this study out February 2017, focusing on safety of SVF over 5 years, demonstrated a very low number of adverse events, and significant improvement in pain rating in a variety of musculoskeletal diseases. (N =1524)

In general, I am a fan of IgG food sensitivity testing. While we can in some cases manage just fine using a standard elimination and challenge protocol, IgG testing can benefit patients in a few ways, such as: providing motivating data, individualizing the foods needing to be removed and identify less-common antigenic foods. However, if you are using IgG food sensitivity testing in practice, you’ve no doubt encountered false negatives and positives. (Indeed, you may have abandoned IgG testing for these reasons!) Dr. Brent Dorval, through a rather remarkable epiphany during his post-doctorate work, formed the hypothesis that testing for IgG/food immune complexes, along with the specific complement protein (C3d) that induces the inflammatory response, would increase the reliability of the test considerably. After a number of years of bench and clinical research, Brent finalized the methodology for his assay (now called the FIT Test, offered through KBMO Diagnostics) and the rest is history. Tune into our podcast for an overview on IgG food sensitivity testing (great if you are new to using this laboratory test, or an individual interested in this testing), and specific details about the unique FIT test, including case studies. See the links below for all the info on the FIT Test, including his current publication. Stay tuned for more research in the pipeline!

Functional hypochlorhydria is a condition we see so often, yet Prilosec is a top ten medication: what’s the disconnect? Probiotics: which ones, how much, combo or single strain? What does the research really show probiotics are actually doing? Is there any truth to probiotics colonizing the GI tract? And what about soil-based probiotics, any reason to be jumping on that bandwagon? What is the correct lab test for identifying pancreatic exocrine insufficiency (PEI), and what is the optimal range? Is there any utility to testing fecal fats? What enzymes (vegetarian or animal-based), botanicals and other interventions are appropriate for addressing PEI?

Have you been wondering what you should really do with the 23andme genetic data that you’ve gathered? Wondering if you should even take the test at all? Or wondering what the future of genetic/epigenetic medicine is? This podcast is for you. I am especially excited to bring you this conversation with epigenetic legend, Dr. Moshe Szyf. The study of epigenetics is continually breaking new ground in understanding how our environment dramatically influences our gene expression. With myriad published research studies and his ongoing work, Dr. Szyf is at the forefront in shaping this evolution. The power of epigenetics to alter the course of our health is compelling, and I hope you will enjoy the discussion we had, which I hope will be one of many.

Thanks to Dr. Susan Blum, functional medicine has even more to offer for patients with rheumatoid arthritis (RA) and osteoarthritis (OA). She shares new insights about RA’s underlying causes, details what goes missed in treatment plans, and gives practical tips for mining data from stool tests, utilizing functional blood markers, and combining herbs and probiotics to reverse processes that other practitioners may think are permanent

Fibromyalgia can be a particularly difficult condition to address conventionally, but Functional Medicine really has a lot to offer here. In this podcast, we mine the wealth of information that Dr. David Brady brings to the table on this important topic, including: · The signs and symptoms of fibromyalgia and how it is diagnosed (previously-defined tender points are no longer used!) – see also Dr. Brady’s questionnaire at www.fibrofix.com · What other mimicking conditions need to be considered or ruled out · How fibromyalgia differs from chronic fatigue syndrome—vastly different disorders that are commonly confused · Why not all pain is driven by inflammation · How not to fall into the trap of only looking at mitochondrial dysfunction · Organic acids, catecholamines, food reactivity and other relevant labs for assessment and tracking · Childhood and adult stress patterns in (especially female-dominated) fibromyalgia, and how that factors into interventions · Additional intervention options such as sleep support, energy pathways, detox, exercise, diet, immune balancing to reset metabolic patterns and promote recovery

Dr. Cabeca is a wealth of information and inspiration when it comes to women’s health. I am delighted to share my conversation with her this month, in which you’ll learn about: - How Dr. Cabeca transitioned from performing multiple surgeries per week, to only needing to recommend a handful per year with a functional medicine approach - The best lab tests and specimens for hormone assessment - The importance of liquid chromatography mass spectrometry for serum free testosterone measures - Factors to be aware of that can confound hormone testing results - Estrogen metabolites and the importance of methylation assessment - The sweet spot of keto-alkaline status for sex hormone balance, cortisol management, mental clarity, insulin sensitivity and weight loss (target pH of 7, and some ketones 3+ days per week) - The benefits of vaginal testosterone and DHEA for tissue repair and incontinence - Watching out for behavior change with testosterone to ensure appropriate dosing and saving marriages! - Addressing vaginal dryness with safe oils and DHEA, diet and lifestyle

Everyone is abuzz with Functional Medicine these days- the IFM Certification process is humming along, and record numbers of clinicians are making the transition to this amazing and satisfying practice. But what about the business of FxMed? Ahhhh! Daunting! Arguably, the establishment of a financially successful FxMed practice is a top concern on many of our minds. How do we make our practices grow and thrive without blowing out our HPA axis? This month’s podcast is with Dr. Dan Kalish, CEO and founder of the Kalish Institute. Dan is a world-renown clinician and highly successful businessman who assists many doctors in the transition to a lucrative practice. A podcast full of pearls and ideas, Dan message is: Jump in, the water’s fine. You’ve got this!

Dr. Alschuler is a world-renowned expert in integrative oncology. Lise is well-versed in the current literature and has done a remarkable job in translating findings into actionable steps (listen for her approach to the five key bodily pathways in oncogenesis and how to address them). A teacher to her core, Lise a mentor to many of us, myself included. This is a jam-packed discussion on cancer prevention and management, from the soul-searching demands of a cancer diagnosis to highly practical treatment approaches.

Dr. Seyfried has dedicated his career to changing the way we think about- and therefore treat- cancer. Going back to Otto Warburg and others, couple with newer research Tom and his colleagues are actively conducting, it’s clear that the origin of cancer is in a fundamental disruption of mitochondrial oxidative phosphorylation. Cancer is not, as is commonly thought, a genetic disease. While somatic genetic mutations abound, their origin is from a proliferation of reactive oxygen species generated by damaged mitochondrial cellular respiration. The triggering agents for cancer are anything that disrupts mitochondrial energy metabolism, from chemicals and xrays, to viruses, diet (including GMOs) and lifestyle habits. Switching primary fuel sources from glucose to ketones by using the calorie-restricted ketogenic diet (RKD), we start to shut down the energy supply to cancer cells and reverse the trajectory of the disease.