Intelligent Medicine

Leyla Muedin, a registered dietitian nutritionist, discusses a UK Biobank analysis published in the Journal of Cachexia, “Sarcopenia and Muscle” (Nov 2025) linking continuous long-term statin use (e.g., Lipitor, Zocor, Crestor) to accelerated declines in grip strength and appendicular lean mass compared with never-users. Among 35,557 with follow-up data, grip strength declined by a mean 0.315 kg/year and appendicular lean mass by 0.057 kg/year in statin users; findings persisted after adjustment for age, sex, BMI, comorbidities, and a pharmacogenomic statin-response score. Leyla notes possible mechanisms (CoQ10/mevalonate pathway effects, mitochondrial dysfunction, apoptosis, calcium disruption, insulin resistance) and advises monitoring musculoskeletal health, supporting diet and regular physical activity, while not interpreting results as a reason to stop prescribing statins.

Highlights from Dr. Hoffman's New Zealand bike tripDo you prefer whey protein isolate or concentrate?My liver enzymes went up taking a statin drug. My doctor recommends I take milk thistle. What are your thoughts?If any supplement protocols are out of stock, should we make substitutions?

What are your thoughts on peptides?So it's not possible to get enough protein from plants only?What about the downsides to animal protein?Are there any negative reports on the usage of extra virgin olive oil?Is it true that the nutritional value of farmed seafood is the same as wild caught?

Dr. David Clarke, president of the Psychophysiologic Disorders Association, details the link between stress and chronic pain and the scope of brain-generated symptoms. Clarke says many patients have symptoms not explained by disease or injury, estimating about 20% of U.S. adults (about 50 million) live with chronic pain, with costs estimated at $650 billion, and notes clinicians are often not trained to evaluate psychosocial stressors. He describes clues that pain is brain-generated (e.g., multiple long-lasting or shifting symptoms, lack of objective nerve damage) and a broad symptom spectrum from migraines and IBS to pelvic pain and rashes. Clarke discusses adverse childhood experiences, triggers, personality traits, and repressed emotions, cites randomized trials showing “pain relief psychology” can reduce pain and change MRI findings, and shares resources including a clinician directory, self-assessment quiz, and the Curable app. 

Dr. Hoffman continues his conversation with Dr. David Clarke, president of the Psychophysiologic Disorders Association.

How Continuous Glucose Monitors Can Optimize Metabolic Health—and Where GLP-1 Drugs Fit: Emergency physician-turned-preventive/metabolic medicine specialist Dr. Paul Kolodzik of Metabolic MD reveals how continuous glucose monitors (CGMs) are a tool not only for diabetics but also for non-diabetics and pre-diabetics to personalize diet, sleep, and exercise by seeing real-time glucose patterns instead of relying on fingersticks or A1c averages. Kolodzik describes CGM use in his clinic (two-week diagnostic wear, then therapeutic guidance), highlights insulin resistance, fasting insulin testing, glucose variability, and the role of low-carb eating, intermittent fasting, and strength training to improve metabolic syndrome, triglycerides, and fatty liver. They discuss CGM sourcing/cost, device mechanics and accuracy, possible future noninvasive wearables, and GLP-1/GIP weight-loss drugs, emphasizing supervised, limited-dose use with protein and lifestyle changes to avoid muscle loss and weight regain. A free PDF of

Dr. Hoffman continues his conversation with Dr. Paul Kolodzik of Metabolic MD.

Are eggs good or bad for the brain? Low levels of a key nutrient can foster anxiety; Dealing with muscle cramps that develop hours after exercise; Garlic mouthwash outperforms chemical antibacterials; 76% of the world’s population aren’t getting enough omega-3s; Surgery may hasten progression to Alzheimer’s, but a vitamin may help; After marijuana legalization, some states want a do-over.

The pros and cons of natural vs synthetic vitamins; Telehealth site for ADD meds lands founder in prison; Why eradicating H. pylori may set the stage for Alzheimer’s; Why integrative physicians often don’t accept insurance; Far-infrared phototherapy may offer “electroceutical” treatment for dementia; Hobbies may forestall all-cause mortality—by 29%! 

Nutritionist Leyla Muedin discusses nutrition and menopause, defining menopause as 12 months without a period and noting it can occur naturally or due to surgery/medical procedures. She links declining estrogen to increased cardiometabolic risk, endothelial dysfunction, vascular aging, musculoskeletal pain, and higher risks with early menopause (including cardiovascular disease, chronic kidney disease, and dementia), and notes many estrogen-modulated conditions are associated with gut dysbiosis. She emphasizes lifestyle—especially nutrition—as key, highlighting anti-inflammatory, minimally processed eating and warning against ultra-processed foods, refined carbs, and excess omega-6. She cites research that high adherence to a Mediterranean diet improves markers like heart rate, lipids, triglycerides, CRP, and overall cardiometabolic risk, and mentions omega-3s lowering triglycerides while modestly raising HDL and LDL. She reviews diet approaches for hot flashes, suggests reducing caffeine, alcohol, sugar, and

Half of US adults are interested in GLP-1 agonists for weight lossIs spelt matzoh better than traditional wheat matzoh for Passover?Is a dry red wine preferable to sweet wine or grape juice?Is Einkorn flour a better alternative to modern wheat?Which liver support supplements are best for alcoholic issues?

I was diagnosed with Exocrine Pancreatic Insufficiency. Which digestive enzymes are best to take?I still have pain and tingling after a shingles outbreak. What can I take for it?So many protein shakes contain carrageenan, but isn't it a carcinogen?My 5-year-old grandson has pancolitis.  Do you have any recommendations?What do you think of an organic acids test for chronic fatigue?How can I find the cause of my atopic dermatitis?  

Oral Health, Inflammation, and Periodontal Disease: Dr. William Levine, a board-certified periodontist and chief scientist at Peri Active Oral Rinse, offers a deep-dive on periodontal disease as an infectious inflammatory condition with autoimmune-like tissue destruction. It affects over 50% of U.S. adults over 35 and rises with age. He details bidirectional links between gum disease and systemic conditions, including cardiovascular disease, stroke, diabetes, and some dementias, and notes signs such as bleeding, pain, swelling, loose or shifting teeth, and gum recession. Levine explains plaque, dysbiosis, and biofilms, emphasizing mechanical plaque removal to preserve a healthy oral microbiome. Standard care includes scaling and root planing, possible surgery, and lasers; antiseptic rinses like chlorhexidine can be harsh and limited against biofilms. Levine describes a plant-bioactive rinse (gotu kola, echinacea, elderberry) designed to reduce harmful bacteria, penetrate gums, lower inflammation, and promote

Dr. Hoffman continues his conversation with Dr. William Levine, a board-certified periodontist and chief scientist at Peri Active Oral Rinse.

Herbal Medicine, Quality Control, and Adulteration Prevention: Mark Blumenthal, founder and executive director of the American Botanical Council (ABC), recounts his entry into herbalism via vegetarianism in 1968, off-grid living, and starting a wholesale herb business in 1974 before shifting to nonprofit education, research, advocacy, and quality control. The discussion covers the evolution from teas and tinctures to standardized extracts, the complexity and synergy of multiple constituents, and how standardization supports quality control and therapeutic consistency. Blumenthal explains ABC’s Botanical Adulterants Prevention Program and its free, peer-reviewed resources addressing global fraud, plus GMP requirements and laboratory methods for identity, contamination, and potency testing. He discusses herbs including ashwagandha, turmeric/curcumin and adulteration risks, maca, nigella, and milk thistle, and outlines ABC resources, HerbClip, and membership options at herbalgram.org.

Dr. Hoffman continues his conversation with Mark Blumenthal, founder and executive director of the American Botanical Council (ABC).

New weight loss drugs may portend end of “Fat Acceptance” movement; Celebs and Southerners embrace GLP-1s; Trump clears path for more access to diet drugs; Mid- and late-life exercise slash dementia risk; “Ethicists” urge more tick-borne meat allergy to save planet—as alpha-gal syndrome claims first fatality; What’s wrong with the melatonin study that claims it leads to heart failure? How to detox 9-11 first-responders? Can weekend warriors obtain same benefits as regular exercisers? 

Can natural herbs aid recovery from anorexia? What an analysis of Hitler’s DNA tells us about how genes shaped his personality; Can surgical anesthesia accelerate memory loss?  Bananas could be interfering with your smoothie’s health benefits; Not just sun, but pesticides and herbicides increase risk for melanoma; Chemical residues on produce impair male fertility; Proliferation of fast-paced social media videos are dumbing us down; Doctors aren’t less resilient, the demands of medicine are just fostering unprecedented levels of physician burnout.

Registered dietitian nutritionist Leyla Muedin discusses a New England Journal of Medicine paper (July 2024, cited via Holistic Primary Care) warning about drug-induced magnesium depletion, especially from diuretics, proton pump inhibitors (e.g., Nexium, Prilosec), and certain antibiotics. She notes magnesium is often not routinely measured despite links between deficiency and cardiovascular, metabolic, and neurological problems, including arrhythmias (AFib, long QT, torsades), endothelial dysfunction, and longer ICU stays. Prevalence estimates range from 7–11% (up to 20%) in hospitalized patients and 2–4% among outpatients, with higher rates among long-term PPI and diuretic users. She reviews symptoms and causes, explains limits of serum magnesium testing, highlights associations with diabetes, alcohol use, low potassium and calcium, and outlines evaluation options and oral repletion approaches, favoring better-absorbed forms like magnesium glycinate over oxide due to diarrhea risk.

A discussion of the book "Rethinking Diabetes" by Gary TaubesCORRECTION: Transcatheter Mitral Valve Replacement (TMVR)The impact of hops on the microbiomeA listener's suggestion on avoiding microplastics