New Frontiers in Functional Medicine

Some of the most extraordinary work happening in medicine right now comes from the GrowBaby team of Leslie Stone, MD and her daughter, Emily Rydbom, CNS. In their mostly Medicaid model, they’ve adopted a systems approach to pregnancy, and thereby doing so, have remarkably improved outcomes. Their rates of autism, eczema, ADHD, premature labor, gestational diabetes and pregnancy-induced hypertension fall well, well below national averages. Learn about their unique program and outcome studies in this episode of New Frontiers. Of all the podcasts I’ve conducted over the years, this one hit home and is the most life-changing. Take a listen, be sure to review and rate us on iTunes or wherever you listen to New Frontiers, and as always, I so appreciate your time and energy! ~DrKF

If you’re practicing functional medicine, you’re aware of (and likely prescribing) the autoimmune paleo diet, pulling folks off of many foods, lowering carbs, reducing or eliminating lectins (and nightshades). In this terrific podcast with Dr. Datis Kharrazian, we talk about his research in stratifying who’s who with regard to autoimmunity. For example, Dr. K suspects that very roughly about 30% of his autoimmune patients are truly lectin sensitive; they tend to be those with arthritic musculoskeletal autoimmunity, most classically, RA. For many of these folks, lectins must be eliminated. However, lectin/nightshade elimination may not be required for, say, Hashimoto’s; although there IS a collection of potential cross reactive foods that could play a role in promoting antibody production (and removing will reduce ab production)…. Check out the podcast. And there are loads of citations (DK publishes only in open access journal.)Listen and learn, then PLEASE rate and comment on iTunes, or wherever you listen to New Frontiers! ~DrKF

Are you thinking about age management with your patients these days? I am. And I’m thinking about it regarding myself, quite frankly. To that end, I just had a tour-de-force conversation with clinician researcher Joe Raffaele, MD. Can we halt, or even reverse, the biological aging process? There are an extraordinary number of variables to consider here, but the take-home appears to be YES. Of course, FxMed is our foundation, but layer onto that telomere biology, and telomerase activation using innovative approaches such as the astragalus-derived molecule like the one found in TA-65, and some pretty impressive outcomes are possible, as we discuss. With over 5000 “N of 1’s” in his database, and principle investigator of a number of published clinical trials, Dr. Raffaele has plenty of experience on how we want to be addressing (and measuring) the aging journey. Generally, lifestyle interventions – such as those we’re doing in FxMed – will slow biological aging. But what about HALTING or even REVERSING biological aging? Listen to our convo on New Frontiers, and PLEASE be sure to comment and share wherever you listen to the podcast, and let us know what you think! ~DrKF

In this podcast of New Frontiers, I’m talking with Dr. Elisa Song, a functional medicine pediatrician and superb teacher. If you are practicing FxMed, you’re probably seeing more and more kids if your scope allows (even if you didn’t before). Kids need FxMed, yet there are arguably LESS pediatricians transitioning into FxMed than other disciplines. Thus, working with kids can come with questions – labs, dosing interventions. Listen as Dr. Song and I gallop through loads of foundational information (and we’ll provide more down the road – a blog, another podcast – we’ll see) as this is a huge, important area for us. Here, the bulk of our time on New Frontiers is on PANS/PANDAS: how to identify, and what to do. Both are forms of infection-triggered autoimmune encephalitis. Take a listen, and be sure to comment on iTunes or wherever you’re listening. I’d love to learn your thoughts! ~DrKF

As a clinician interested in participating in research, it’s very exciting to see others jumping into the research conversation, too. Today I talk to Dr. Erik Lundquist, who heads a large, integrative clinic out in Southern California. Erik recently completed a clinical pilot study looking at the use of SPMs (just 2 gelcaps per day) in patients diagnosed with fibromyalgia (Dr. Lundquist reports that the bulk of these patients have underlying mold exposure or Lyme as the primary etiology for FMS). While labs and pain scores didn’t improve markedly in the population, there was a clear, statistically significant jump in quality of life for these folks. In fact, Dr. L suspects that the increased movement and engagement in life probably influenced the lack of drop in pain. And further, Dr. L pointed out that standard labs such as CRP were NOT elevated at baseline in the chronic mold/Lyme population. Listen to the details, and Erik’s story. If you are wanting to participate in clinical research yourself, I’d love to hear about it, and, as always, I appreciate you listening and ask that you please rate, comment and share New Frontiers with your colleagues! ~DrKF

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.