New Frontiers In Functional Medicine

Is it fair that I say – yet again – that this was one of my best conversations of the year? A deeply personal, honest, scientific, evidence-informed (and pearl-ladened) conversation on cancer and recovery, and completely from the heart. Dr. Patrick Hanaway, MD is a mentor, a colleague, a friend, and an amazing guy. His journey as a leader in functional medicine through stage IV laryngeal cancer and his embrace of a metabolic approach is profound, and something you’re going to want to hear. His transformation took him to the Sierra Madres in Mexico to learn indigenous healing approaches from the Mara’akame, and back to his functional and integrative medicine roots exploring the research on using ketogenic and fasting dietary approaches alongside chemotherapy and radiation therapy. He does a fantastic job explaining the mechanisms of a ketogenic diet for cancer and how to support immune resilience through nutritional and herbal interventions. Dr. Hanaway is an inspiration always, and especially during the

There’s no better person to have on New Frontiers to talk about the underlying mechanisms that activate an immune response than Dr. Tom O’Bryan, a foremost expert in understanding wheat sensitivity and the development of autoimmune conditions and cognitive dysfunction. What a pleasure to talk to! Settle in: this is a great, fun, and informative podcast covering all the way back to Tom’s first exposure to EMF in 1978 to the hundreds of pounds of toxins we are all exposed to daily. We cover brain health (of course!) and Tom shares which labs he uses and why, how to interpret them, and the interventions he’s using to help fix his patients’ brains. Clinicians: you’re sure to grasp great insight to share with your patients, and we (practitioners or not!) can all learn A TON about food sensitivity and autoimmunity with this master teacher and clinician.

Dr. Mark Pimentel. We all know him as the clinician/scientist who understands the varied pathogenic underpinnings of IBS/SIBO/IMO. In my recent conversation with him, we cover the definition of terms, causes, when to use a stool test. We discuss the Pimentel low fermentation diet, intervention (including botanicals), and diagnosing hydrogen sulfide (a test is coming soon, but wasn’t available at time of recording). Probiotics: any utility? Elemental diet, and so much more. Grateful to have Dr. Pimentel on the podcast, and know you will benefit from this insightful convo. Thanks for listening, please leave a review if you can! ~DrKF

As a functional medicine clinician and scientist, I absolutely appreciate the deep literature dives my colleagues take. When they come up for air, there is a synthesized body of knowledge that is riveting, satisfying to listen to, trust-worthy and, most importantly, practice-changing. Such was my conversation on all things menopausal hormone therapy with Dr. Doreen Saltiel, currently consulting for Precision Analytical (they’re lucky to have her). She spent the bulk of her impressive career as an interventional cardiologist (although confesses she wanted to go into OBGYN) and jumped into integrative and functional medicine after her own “ah-ha” healing journey, involving hormone replacement therapy, relatively early on in her life. The first solid debunking Doreen provides are the findings from WHI. IT’S TIME these ideas are PUT TO BED. I asked Dr. S about the political backstory for the WHI debacle – it’s a good listen, and like me, you’ll probably want to read more. We then dive into the solid body of evide

I very much enjoyed my conversation with Dr. Dale Bredesen- from his story of finding functional medicine (it’ll resonate with many of you, as it did me, I’m sure) to where the ReCODE program is now (pay attention to the large clinical trial now underway and the refinements of Dr. Bredesen’s thinking over the last decade) and the launch of The End of Alzheimer’s Program (a goldmine of a resource for clinicians and regular folks alike). Links on the podcast shownotes page -- don't miss these! In this episode of New Frontiers, he talks with me about the pandemic of Alzheimer’s disease, which is now the third leading cause of death in the United States, and what he’s learned over decades as an expert in neurodegenerative diseases. Enjoy this podcast, and please share and leave us a review wherever you listen to New Frontiers! ~DrKF

Harvard scientist and NYT best-selling author David Sinclair, PhD and I take a tour around the science of aging. If aging is THE root cause of all of the chronic diseases of aging, then arguably, if we focus on the aging journey itself, we might be able to stop playing “whack-a-mole medicine.” A lot of complex environmental, genetic, epigenetic and biochemical processes go into the aging journey, however, as Dr. Sinclair discusses, it looks like a very heavy lifter in aging is epigenetic changes – specifically, DNA methylation and demethylation (plus histone acetylation). In this episode of New Frontiers, learn about the amazing research going on at Dr. Sinclair’s lab, hear what’s getting translated to humans, and what you can do NOW to stop the epigenetic clock from ticking…. Listen and learn, leave us a 5 star review if you’d be so kind, and be sure to share with your colleagues! ~DrKF

COVID19 is upon us. Months earlier, we scheduled James Maskell to discuss his recent book: The Community Cure. Amazingly, his message today is all the more urgent. James argues for the group visit model, was an early adopter and proponent of group visits (in fact, we discuss the pre-publication Cleveland Clinic group visit research findings, which are astonishingly good; even better than the first JAMA publication comparing functional medicine one-on-one with family medicine.) Now, with COVID19 and self-isolation, the virtual visit and the virtual group visit (where James saw FxMed eventually going) is upon us. And specifically, his vision is that this model works in insurance – and even Medicare. James’ message – the promise of functional medicine – is timely, inspiring, and essential. ~DrKF

The GI360 is a smart, evidenced-based stool test that is easily actionable by the clinician. Listen to my conversation today with VP of Scientific Support from Doctor’s Data, Dr. David Quig. One of the most useful tools I am aware of in stool testing is the Dysbiosis Test, which identifies and characterizes more than 45 targeted analytes across six Phyla using PCR and compares the patient results to a characterized normobiotic reference population. DDI is also using the Luminex PCR panel for pathogens, parasites and viruses – an FDA cleared panel for accurate detection of microbes that are almost always a problem. But what if they are not? Hear my discussion with Dr. Q on that. Finally, beta glucuronidase – it’s SO MUCH more complex than we’ve understood. Yes, we’re aware of the estrogen connection, but the BG story has evolved. We also walk through the chemistries – DDI includes a wide range of chems (appreciated by me and my colleagues here in our practice). Give us a listen, then leave a 5 star review and

What a superb conversation with leading expert lipidologist and – importantly – clinician of 30+ years, Tom Dayspring, MD. In this tour-de-force conversation, we break down the essential cardiovascular risk laboratory analysis you need to be undertaking on all your patients. We spend a little extra time on Lp(a) and the coronary calcium score. Our conversation is practical; I was fervently taking notes through the entire recording, as I suspect you’ll be doing. I will likely bring Tom back for additional conversation, perhaps focusing on women’s cardiovascular health, so stay tuned! As with many of my podcasts, I chat with my guests before and after the recording. Tom and I discuss on the podcast whether we’re concerned about brain cholesterol deficits with an excessively lowered LDL. He unequivocally stated not; we synthesize all the cholesterol we need locally, including in the CNS. However, after the recording, he added that statins can cross the BBB and lower brain cholesterol. Serum desmosterol is an a

Globally, stress and anxiety levels have never been higher. According to one recent survey, a full 70% of Americans are stressed out, with a disproportionate impact on people of color. From worry about getting sick, to sick family members, to financial pressures, to homeschooling, the list of possible contributing factors is long. How do we care for our patients or clients in this climate? Victoria Albina, NP MPH is a family nurse practitioner in NYC – the COVID epicenter. She’s also a cognitive behavioral life coach and breathwork meditation facilitator. In short, she’s remarkably suited to walk us through tools to consider using with patients immediately. Victoria was an early adopter of using CBD for anxiety and has a wealth of knowledge around how to work with it for acute anxiety (regardless of how it presents: from insomnia to addictive “buffering” behavior). She also covers lifestyle interventions and key botanicals she’ll use concurrently when the need exists. And to top it off, Dr. Albina walks

Many of us in functional/integrative medicine have used organic acid testing for decades to identify nutrient, toxin, and genetic imbalances. I am proud that the lab I once worked in developed one of the original panels – still quite popular and in wide use today. Inspiration for organic acid testing came from inborn errors of metabolism research, where a handful of compounds are (still) measured in newborns to rule out severe genetic diseases. Flash forward to the “Omics” revolution: you know, the genome, the epigenome, exposome, microbiome, etc. We’re beyond the 42 organic acids of old, and moving closer to clinical metabolomics. For me, it's about time, to be honest. Metabolomics in the research setting has been happening for years, and today I talk with Betsy Redmond, PhD, on the ultimate metabolomic panel for clinicians and what that might look like: actionable, straightforward, and evidence-based. Perfect for the busy clinician, and satisfying for those who want a drill-down into the biochemistry. Than

A nurse wakes in the night in profound anxiety, she can’t breathe, her first panic attack. Her husband is quarantined with COVID19; while she works the frontlines at a large hospital, witnessing what looks like the apocalypse. She begins a series of gentle, EFT Tapping exercises. After three brief rounds, she’s through the panic, able to once again relax. Nick Ortner is the CEO of The Tapping Solution, LLC, and my guest today on NFFM. Tapping is such a simple, elegant, immediate solution to the profound anxiety that comes with the out-of-control stress, fear and economic panic intrinsic in the COVID pandemic. With the Tapping Solution app (full access is available to healthcare providers for free), we can ground ourselves as needed. And for the data hounds among us (yes, that would be me); the app is tracking outcome. Over 1.5 million sessions have been conducted using the app. Regarding COVID19 specific exercises, Nick reports a couple of things: 1. Stress is at an all-time high 2. There is a daily averag

Dr. Alex Vasquez has been teaching clinicians, publishing articles, books, and also edits his own journal – for decades. If you know Alex, you know he’s a bright light – highly regarded in our field. You may also know he’s struggled with a “tough gut” for years; in fact, this is what brought him to integrative medicine. From our years teaching together, I know Dr. V is diligent – profoundly committed, actually – to trying/vetting/evolving integrative protocols for gut health (botanicals, diets, pharma, fiber combinations, gentle, aggressive), often receiving small measure of benefit. He’s used various protocols with his patients, case studies he often generously shares when teaching. But here’s the thing: when Dr. Vasquez says he experimented for a long time on himself, creating and tweaking, over and over, a fiber-centric product that resolved his gut issues, we shut up and listen, do we not? So that’s what this podcast is about: talking about a wonder product, designed primarily by Dr. Alex Vasquez, that

Traditional Chinese Medicine (TCM) is used in all settings in China for COVID19, with preliminary outcome data very, very strong. Indeed, outcome data using TCM for prevention and treatment of SARS Cov1 was equally strong. Listen to one of the most important and timely conversations I’ve had to date on New Frontiers with Dr. John Chen, one of the world’s leading experts in TCM (with western pharma training). Framing TCM in language clear for the Western-trained clinician, and translating the early descriptive language, Dr. Chen (author of the seminal textbooks used in all the TCM training programs in the US) is actively following TCM in China, and shares his experience, insight, and observations with all of us. An incredible, and timely, conversation, worthy of your utmost attention. ~DrKF Dr. Chen, author of the seminal textbooks used in all the TCM training programs in the US is actively following TCM in China

We are all familiar with the Wahls Protocol. But how about the story behind the protocol? Did you know, for instance, that her director at U of Iowa (Terry is a clinician researcher) told her to write up herself as a case report? That was the first step. Her “N of 1”; then she wrote up a case series. Then she received a small grant and product for a slightly larger study. Then a million dollars. And now she’s heading into her largest study to date (yes, you will be able to refer patients). Listen to our New Frontiers conversation on how YOU as an FxMed clinician can contribute to the body of research demonstrating that: What. We. Do. Works. Terry and I also talk about behavioral change as THE MOST Important piece of the change journey. Hear how she supports it. This was by FAR one of my most treasured convos this year, and I appreciate you listening, commenting, giving us a 5-star review pretty please, and sharing with your colleagues! ~DrKF

Dr. Jocelyn Strand is the Director of Clinical Education at Bio-Botanical AND a great clinician herself. Prepare yourself: this is a very actionable podcast for clinicians using bioB. And for me, a huge pearl on refractory SIBO was unaddressed oral microbiome! In this episode of New Frontiers, learn how Dr. S addresses sibo using BB products. To test or not to test? And the underlying pathophysiology: tune in and listen to current thinking from a great clinician – she’s got to say and you’re going to learn a lot. Then, if you would be so kind, please leave us a rating and review wherever you listen to New Frontiers! I so appreciate your time and ears – thanks for listening! ~DrKF

This interview was, without doubt, one of the most moving for me. What Dr. Perlmutter and his son, Austin Perlmutter MD, have created is really nothing short of a revolution in returning us to our consciousness. It directly addresses one of the biggest elephants in the room – despite what we know to be good for us, good for others, good for the planet, why do we more often than not fall short of putting that knowledge into action? We. Are. Disconnected. As a people. As a world. Our prefrontal cortex allows us to engage in reflection, empathy and good decision making. However, when we lose the ability to engage our prefrontal cortex, we regress to a more primitive part of our brain – the amygdala – which fosters impulsivity, narcissism, and anger. It is virtually impossible to make the choices that we want to when our amygdala is in charge. And as we make those poorer choices – poor diet, less sleep, less exercise, more screen time – we reinforce our amygdala’s superior position. It’s a vicious cycle. In

Dr. Jeff Gladd is a brilliant Fx/integrative physician who is PASSIONATE about all things Fx business. If there is ONE area I get more requests on, it’s business: setting up a practice, platform building, building a reputation, finding one’s focus and passion. Extra-clinic revenue streams. And mentorship: finding your tribe, building your collegial connection, moving off the island of medicine and into your tribe. With that in mind, Jeff – who is the CMO at Fullscript – and I have a tour-de-force convo on all of these topics. Learn about FS’s integrated EMR, our Clinic Immersion and Fx Residency programs, with top tips for building your brand. And so much more. Check out the shownotes for loads of links, references, downloads and more, and be sure to leave a review wherever you listen to New Frontiers! As always, thank you for listening!

As FxMed docs, we’re committed to working with the body’s own capacity for health. Dr. Josh Mitteldorf offers a contrarian strategy, one which he says is grounded in a new breed of evolutionary medicine. He tells us that diseases of old age are qualitatively different from the diseases we get when we’re younger, different because in old age, our bodies are part of the problem, not part of the solution. Aging, says Josh, is the body deliberately destroying itself (for the sake of the population), via inflammation and apoptosis and autoimmune diseases. In this interview, Josh and I find common ground talking about hormesis. In Josh’s theory, the fact that the body lives longer when stressed (e.g. caloric restriction) is proof that the body isn’t trying its hardest to stay young when it’s not stressed. It may sound like philosophy, but there are real consequences for the future of medicine. These are challenging ideas, so I’m eager to hear what you think, and be sure to leave a review wherever you listen to

A work horse laboratory in any functional medicine practice is stool testing. But really gleaning the best insight into our patient’s clinical picture can be tough. What do all of these commensal organisms really suggest? How do they correlate with the inflammatory findings? Of the bell weather bugs (like akkermansia) how can we increase levels? Is there ANY place for microscopy (O&P) and culture in today’s high throughput Omics world? You see where I’m headed. Even for the most seasoned FxMed clinician, a review of how to use these tests with an eye towards what to expect in new technology is essential. Disagreement with methods? Yes. Why? Zonulin Family Peptide – any utility? A great conversation with Dr. Michael Chapman of Genova Diagnostics. Thrilled with their commitment to in-house “data mining” and peer reviewed publication (IMO all of the Fx labs should be doing this). ~DrKF