The Root Cause Medicine Podcast

This conversation reframes joy as a physiological state with measurable clinical impact, not just an emotion. Dr. Libert blends neuroscience, functional medicine, and spiritual reflection to show how cultivating joy and gratitude can help to restore parasympathetic balance, support healthy immune function, and enhance cognitive flexibility. The episode offers an accessible, hopeful model for physicians—one that unites emotional health, brain resilience, and integrative lifestyle care.Clinical Takeaways from This EpisodeJoy as a Measurable Biological State: Joy, positive affect and gratitude practices appear to increase activity in the ventral striatum and prefrontal cortex (Rueschkamp, 2019), and have some evidence for improving neuroplasticity, vagal tone, and immune resilience while reducing inflammatory cytokines like IL-6 (Dutcher, 2021).Gratitude Practices and Neurochemistry: Regular gratitude journaling boosts dopamine and serotonin, rewiring the reward pathways that reinforce positive affect and motivation. It may even help people to exercise more often over time (Emmons, 2003).Positive Affect and Cognitive Performance: Studies show that positive affect can enhance cognitive flexibility and attention-switching—even brief exposure to positive emotion improves executive function (Wang, 2017).Micro “Joy Prescriptions” for Busy Clinicians: Dr. Libert recommends short “Vitamin G” (gratitude) walks, deep-breathing practices, or quick notes of appreciation to activate joy and resilience in under 10 minutes per day.Integrative Cognitive Health Framework: Joy supports foundational systems—sleep, movement, nutrition, and connection—that underlie cognitive longevity, aligning with the Bredesen Protocol and functional medicine principles.Guest IntroductionCynthia Libert, M.D. is a board-certified family physician, educator, and founder of the Caring for the Body Functional Medicine Center in Asheville, NC. With over 20 years of experience, she specializes in cognitive health, longevity, and burnout prevention. She is the creator of ReThink Aging and The Joy Prescription, a podcast and clinical framework helping patients and practitioners reconnect with purpose and vitality. caringforthebody.org | thejoyprescription.comLabs, Nutrition, and Lifestyle SupportFunctional Labs for Brain and Mood HealthHigh-sensitivity CRP, IL-6, and HbA1c for inflammatory and metabolic insightB12, vitamin D, magnesium, and thyroid panels for cognitive optimizationSex hormones, insulin resistance, and micronutrient status for personalized longevity mappingNutrition and Supplement ConsiderationsAnti-inflammatory protocols rich in omega-3s, polyphenols, and curcuminSupportive nutrients for neurotransmitter balance: B-complex, magnesium glycinate, phosphatidylcholineGut–brain support through probiotics, fiber diversity, and fermented foodsLifestyle and Behavioral StrategiesDaily gratitude or journaling rituals shown to reduce anxiety and depression by ~7 % (Diniz, 2023)Movement and strength training for muscle preservation and insulin sensitivityStructured rest—weekly breaks, retreats, or community connection for burnout preventionGroup programs like Dr. Libert’s SoulCare circles to rebuild belonging and resilienceTimestamps00:00 - Introduction and episode overview02:50 - Why joy is crucial in clinical care & science behind it05:28 - Dr. Libert’s personal story with burnout and rediscovery of joy07:29 - Practical ways to prevent burnout and cultivate joy11:33 - The science of joy, neuroplasticity, and brain connectivity12:35 - Joy’s effects on the stress response and inflammation18:37 - Observed patient changes with joy and lifestyle interventions24:41 - Neuroanatomy: prefrontal cortex & limbic system role in emotional regulation26:12 - Impact of brain connectivity in ADHD & emotional control31:38 - Practical strategies for reconnecting patients with joy and purpose36:20 - Research on gratitude and mental health improvements38:24 - Dr. Libert’s movement and exercise routine41:10 - Adjusting fitness goals according to life seasons46:05 - Final thoughts on addressing neurodegeneration and root causes48:00 - Closing remarks CitationsEmmons RA, Sefick, WJ, Froh, JJ. Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being. J Pers Soc Psychol. 2003.Van der Stigchel S et al. Positive emotion and cognitive flexibility. Front Psychol. 2017.Ochsner KN et al. Cognitive regulation of emotion: functional networks and mechanisms. Soc Cogn Affect Neurosci. 2012.Cole SW et al. Eudaimonic well-being and gene expression: CTRA down-regulation. Proc Natl Acad Sci USA. 2013.UC Braid Clinical Trials Registry: Ventral striatum activity correlated with decreases in IL-6 and CRP.Diniz, et al. The effects of gratitude interventions: a systematic review and meta-analysis. PMC 2023.Rueschkamp, Johanna M Grosse. “Neural Correlates of Up-Regulating Positive Emotions in FMRI and Their Link to Affect in Daily Life.” Social Cognitive and Affective Neuroscience, vol. 14, 2019

In this episode, Dr. Chris Magryta and Dr. Erik Lundquist to discuss their new course, Advanced Blood Labs 201—a masterclass in interpreting metabolic and immune biomarkers for proactive, data-informed clinical care. They explore how early identification of metabolic dysfunction and immune dysregulation can improve long-term health outcomes through advanced yet accessible diagnostics. The discussion covers biomarkers such as C-peptide, adiponectin, leptin, fructosamine, LDH, GGT, and glutathione, along with emerging immune markers like SII and SIRI. Listeners will learn how to integrate these insights into practice for earlier, more precise intervention in both children and adults.You’ll LearnWhy early biomarker detection matters for identifying metabolic and immune imbalances before symptoms developHow to interpret C-peptide, adiponectin, leptin, fructosamine, LDH, and GGT for a clearer picture of metabolic and oxidative stressWhat advanced immune markers—cytokines, NK cells, T-cells, SII, and SIRI—reveal about inflammation and immune activationHow to use affordable tests like a CBC to gain immunometabolic insightsWhy trend tracking and pattern recognition offer more clinical value than single lab snapshotsHow oxidative stress and mitochondrial biomarkers can guide chronic disease prevention and managementAbout the GuestsDr. Chris Magryta is a pediatrician at Salisbury Pediatrics and host of Women and Children First. His work centers on identifying the root causes of pediatric chronic illness through biomarker analysis, nutrition, and early intervention.Dr. Erik Lundquist is the founder of Temecula Center for Integrative Medicine and host of The Root Cause Business of Medicine Podcast. He specializes in integrative and functional medicine, teaching clinicians to bridge evidence-based practice with systems biology.Together, they lead the Blood Labs 101 and Advanced Blood Labs 201 courses—comprehensive programs helping practitioners translate complex biomarker data into actionable insights.Labs MentionedC-peptideFructosamineAdiponectinLeptinLDH (Lactate Dehydrogenase)GGT (Gamma-Glutamyl Transpeptidase)8-Hydroxy-D-GuanineMPO (Myeloperoxidase)CBC (Complete Blood Count)Supplements MentionedGlutathione (discussed for educational purposes only; not intended as a treatment recommendation)Courses MentionedAdvanced Blood Labs 201 November 2025Timestamps00:00 – Introduction and course overview02:03 – Early biomarker detection and childhood metabolic health04:07 – Evolution from Blood Labs 101 to 20108:27 – Understanding C-peptide and insulin activity11:08 – Fructosamine and short-term glucose trends13:24 – Adiponectin and leptin in inflammation and metabolism15:20 – Oxidative stress, LDH, glutathione, and DNA damage17:20 – GGT and antioxidant balance20:54 – Cytokines, NK cells, and the SIRI index26:07 – Monocytes and immune pattern recognition32:41 – Why each clinician chose medicine50:52 – Personal growth and lessons beyond the clinic54:00 – Final reflectionsLearn MoreDr. Chris Magryta’s Podcast: Women and Children FirstDr. Erik Lundquist’s Podcast: The Root Cause Business of MedicineCourse Information: Advanced Blood Labs 201 at rupahealth.comSponsor: Fullscript – Free platform for whole person care, lab ordering, and supplement managementFrequently Asked Questions About Pediatric and Adult BiomarkersWhat is C-peptide and why might it be important to measure in both children and adults?C-peptide is released with insulin from pancreatic β-cells and reflects endogenous insulin production and β-cell function. Elevated C-peptide may indicate insulin resistance, while low levels can signify β-cell exhaustion. It can be a key tool for identifying early metabolic dysfunction in both pediatric and adult patients early in disease progression (American Diabetes Association, Diabetes Care, 2025).How does adiponectin relate to inflammation and metabolism across ages?Adiponectin regulates glucose and lipid metabolism and has anti-inflammatory properties. Low adiponectin levels are linked to insulin resistance and chronic inflammation in children and adults (Nature Reviews Immunology, 2024) and respond positively to healthy lifestyle interventions (The Journal of Clinical Endocrinology & Metabolism, 2008).What does leptin resistance imply in pediatric and adult patients?Leptin helps to regulate appetite and energy balance. When cells become resistant to leptin, metabolism and inflammatory control are impaired. Elevated leptin with low adiponectin can correlate with metabolic syndrome and obesity risk across age groups (Nature Reviews Immunology, 2024).How do SII and SIRI biomarkers relate to immune dysregulation?The Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) use platelet, neutrophil, lymphocyte, and monocyte counts from a CBC to reflect immune activation and inflammation balance. Elevated SII or SIRI can indicate systemic inflammation or immune imbalance. Recent pediatric studies found these indices correlate with insulin resistance and metabolic status in adolescents (Frontiers in Endocrinology, 2024).Can oxidative stress markers like LDH and GGT help to assess long-term health?These markers can reflect the body’s oxidative stress burden and antioxidant capacity. Elevated LDH or GGT may suggest increased oxidative load and reduced resilience, potentially influencing mitochondrial and metabolic health (Artery Research, 2024).What is the role of fructosamine in blood sugar evaluation for children and adults?Fructosamine can provide a two- to three-week snapshot of blood glucose control, offering faster feedback than HbA1c. It’s useful in both adults and children for monitoring short-term glycemic changes (BMJ Open, 2015) and for pediatric patients with variable glucose control (Diabetes Care, 1991).Are these biomarkers clinically useful in pediatrics, or only in adults?The guests describe that these biomarkers can be relevant across ages. Early metabolic and immune imbalances often begin in childhood, and monitoring markers like C-peptide, adiponectin, leptin, and SII/SIRI can help identify at-risk children (Frontiers in Endocrinology, 2024).ReferencesConnecting the Spots: Serial Home C-Peptide Measurements for Assessing β-Cell Function. Diabetes Care, American Diabetes Association, 2025. https://diabetesjournals.org/care/article/48/9/1472/163233/Connecting-the-Spots-Serial-Home-C-peptideAdiponectin as a Key Regulator of Inflammation and Metabolism. Nature Reviews Immunology, 2024.  https://www.nature.com/articles/s41577-024-01103-8Changes in Adiponectin and the Leptin/Adiponectin Ratio During Lifestyle Intervention and Association With Metabolic Improvement in Obese Children. The Journal of Clinical Endocrinology & Metabolism, Vol. 93, Issue 8, 2008. https://pubmed.ncbi.nlm.nih.gov/18492759/Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) as Markers of Metabolic Risk in Adolescents. Frontiers in Endocrinology, 2024. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1426404/fullOxidative Stress Biomarkers and Mitochondrial Dysfunction in Cardiometabolic Health. Artery Research, 2024. https://arteryresearch.biomedcentral.com/articles/10.1007/s44200-024-00062-8Evaluation of Fructosamine as a Short-Term Glycemic Marker in Diabetes. BMJ Open, 2015. https://bmjopen.bmj.com/content/5/5/e007689Use of Fructosamine Test in Diabetic Children. Diabetes Care, Vol. 14, Issue 7, 1991. https://diabetesjournals.org/care/article/14/7/578/17573/Use-of-Fructosamine-Test-in-Diabetic-ChildrenDisclaimer: The information discussed in this episode is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. The views expressed are those of the speakers and do not necessarily reflect those of Fullscript, Rupa Health, or affiliated organizations. Always consult your licensed healthcare provider before making changes to your health regimen.

Is lithium the missing link in brain health and dementia prevention?In this episode of The Root Cause Medicine Podcast, Dr. Kate Kresge sits down with Dr. James Greenblatt, a renowned integrative psychiatrist and expert in nutritional psychiatry, to explore the latest research on lithium’s role in brain health. From the groundbreaking 2025 Harvard study to practical clinical applications, they discuss how low-dose lithium - particularly in the form of lithium orotate - may offer a safe, natural approach to preventing and reversing cognitive decline, including Alzheimer’s disease. The conversation covers the science, safety considerations, and how clinicians can thoughtfully integrate lithium into their practice to support neurological resilience and mental well-being.If you’re ready to expand your understanding of mineral neuroscience and explore innovative strategies to support cognitive health, this episode provides the science, clinical insights, and practical tools you won’t want to miss.Clinical Takeaways from This EpisodeThe Latest Harvard Research & Its Implications: The recent study showing that lithium naturally exists in the brain and diminishes early in Alzheimer’s, with animal models demonstrating that lithium orotate can reverse memory deficits.Mechanisms of Lithium in Brain Health: Its anti-inflammatory, neuroprotective, and neuroregenerative actions, including inhibition of GSK3, enhancement of neurotrophic factors, and support of myelin integrity.Differences Between Lithium Forms: Lithium carbonate (medication) vs. nutritional lithium orotate; why the latter is safer at microdose levels and less sequestered by amyloid plaques.Safety and Monitoring: Practical considerations for dosing, laboratory testing (such as hair mineral analysis), and monitoring thyroid and kidney function over time.Environmental and Dietary Lithium: The influence of water sources, diet, and geographic variations on lithium status, and implications for mental health and neuroprotection.Impulsivity, Mood, and Behavioral Regulation: How low-dose lithium may support impulse control, reduce irritability, and improve emotional stability across various psychiatric and neurological conditions.Future Therapeutic Directions: The potential for broader use of low-dose lithium as a public health intervention to reduce rates of suicide, neurodegenerative diseases, and mental health disorders.Guest Bio: Dr. James Greenblatt, MD — An integrative psychiatrist and pioneer in nutritional psychiatry, Dr. Greenblatt has over 40 years’ experience in the field. He is the author of The Cinderella Story of Nutritional Lithium and offers extensive training programs for clinicians on natural interventions for mental health and cognitive decline.Labs Mentioned (Monitoring & Context)Hair mineral analysis (lithium marker)Thyroid function testsKidney function testsIngredients & Therapeutic Nutrition MentionedLithium orotate Magnesium supplementsDietary sources of lithium (e.g., drinking water, herbs like thyme)Resources MentionNutritional Lithium: A Cinderella Story Lithium deficiency and the onset of Alzheimer’s disease 2025 paperTimestamps00:00 Introduction & episode overview02:04 Harvard’s groundbreaking research on lithium and cognition05:36 Historical context: lithium in psychiatry and nutrition07:43 Lithium’s neuroprotective mechanisms: inflammation, neurogenesis, GSK3 inhibition11:54 Differences between lithium carbonate and lithium orotate—clinical implications13:35 Lithium sequestration by amyloid plaques and the unique properties of orotate15:28 How lithium supports neurotransmitter balance and mood stability19:21 Safety strategies: dosing, lab monitoring, and real-world practice23:35 Assessing lithium levels: hair analysis and environmental factors26:54 Geographic influences on natural lithium exposure and implications for mental health29:03 Lithium’s role in impulsivity regulation and behavioral health35:16 Clinical case examples: children to adults, mood stabilization, addiction, and cognitive decline37:15 Treatment timelines and patient outcomes with low-dose lithium42:50 Long-term management considerations and lab monitoring protocols46:12 The preventive potential of low-dose lithium for Alzheimer’s disease and dementia49:18 Industry influence, patent issues, and future directions in natural lithium therapies55:05 Resources for clinicians and closing remarksDisclaimer: The views expressed in this episode are those of the host and the guest. They do not necessarily reflect the views of Fullscript or any affiliated organizations. This podcast is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider before making changes to your healthcare routine.

In this episode of The Root Cause Medicine Podcast, Dr. Kate Kresge sits down with Margie Bissinger, PT, MS, CHC—a leading voice in integrative bone health and founder of the Certified Integrative Bone Health Practitioner Program. Together, they explore the new science of osteoporosis care in 2025, where bone strength is viewed as a reflection of whole-person metabolic and structural health—not just calcium and vitamin D intake. Clinicians will learn about the synergy between next-gen nutrients like collagen peptides, magnesium, vitamin K2 (MK-4 and MK-7), and gain a nuanced understanding of updated protein recommendations, power training, posture work, and low-intensity vibration in the treatment of bone density issues. Margie shares evidence-informed protocols, bone turnover marker monitoring, and strategies for gut–bone axis optimization—empowering practitioners to guide patients through safe, measurable, and sustainable bone rebuilding.Clinical Takeaways from This EpisodeOsteoporosis as a Systems Issue: Bone loss is often a downstream signal of broader imbalances—inflammation, gut health, nutrient absorption, and stress physiology—not just low calcium intake.Vitamin K2 Synergy (MK-4 and MK-7): Margie highlights evidence for both forms: MK-4’s fracture reduction benefits and MK-7’s cardiovascular and bone maintenance support. She recommends using both for comprehensive osteocalcin activation and calcium metabolism balance.Magnesium and the Mineral Matrix: Magnesium glycinate, citrate, and threonate are preferred for absorption and metabolic synergy. Boron and zinc round out the trace mineral support network.Protein and Collagen Peptides for Bone Formation: Research in 2025 updates protein goals to ≥1.1 g/kg/day in older adults. Collagen peptides paired with vitamin C and resistance training can enhance BMD and reduce fracture risk.Gut–Bone Axis and Microbiome Influence: Dysbiosis and gluten sensitivity may impair bone remodeling. Stool testing can guide probiotic selection and dietary strategies; Lactobacillus reuteri and strain-diverse probiotics show early promise.Hormone and Parathyroid Considerations: Margie stresses evaluating estrogen, DHEA, cortisol, and parathyroid status. Subtle hyperparathyroidism can drive hidden bone resorption—often missed in standard workups.Bone Turnover Markers CTX and P1NP: Functional use of P1NP (bone formation) and CTX (bone resorption) provides faster feedback than DXA alone. Optimal CTX and P1NP suggest balanced remodeling.Power Training, Posture & the Onero Program: Evidence from the LIFTMOR and Onero trials supports high-intensity, low-rep resistance training (5 × 5 sets, twice weekly) under supervision. Margie emphasizes core stabilization, and avoiding forward flexion to reduce fracture risk.Jumping, Impact & WBV Platforms: Even heel-drop jumps improved BMD in trials. For non-impact populations, low-intensity vibration plates may safely stimulate mesenchymal stem cells toward osteogenesis. Margie advises avoid high intensity vibration plates. Inflammation, Homocysteine, and CRP Monitoring: Elevated hs-CRP and homocysteine (>15 µmol/L) correlate with increased fracture risk. Functional ranges (<1.0 mg/L CRP; <8 µmol/L homocysteine) guide anti-inflammatory and methylation support with omega-3s and activated B vitamins.Guest Introduction: Margie Bissinger, PT, MS, CHC is a physical therapist, integrative health coach, and founder of The Bone Health Academy and Happy Bones, Happy Life Podcast. With 30+ years of clinical and teaching experience, she integrates posture-focused PT, nutrient synergy, and mindset coaching to empower patients and practitioners alike. Margie co-founded the Certified Integrative Bone Health Practitioner Program with Dr. Kim Millman and serves on the New Jersey Interagency Council on Osteoporosis. 🔗 margiebissinger.comCore Labs for Monitoring & PersonalizationBone turnover: P1NP, β-CTX (baseline → 3–4 mo follow-up)CalciumVitamin D (25-OH)Magnesium (RBC)Zinc (RBC)Homocysteinehs-CRPParathyroid hormone (PTH)Thyroid panel24-hour urine calciumBody composition metricsDEXA + trabecular bone score (TBS)Nutrients & Supplements DiscussedCollagen peptidesVitamin CMagnesium glycinate, citrate, threonate Vitamin K2 (MK-4 & MK-7)BoronZincTocotrienols to support osteoblast activityActivated B-vitamins (B6, B12, folate) to support homocysteine regulationOmega-3 fatty acids (EPA/DHA) for inflammation modulationLifestyle & Exercise StrategiesOnero/power trainingPostural strengthening to reduce vertebral compressionBalance work (Tai Chi, Qigong, proprioceptive drills)Low-intensity WBVJump trainingStress & sleep regulationTimestamps00:00 Episode intro; topic overview (osteoporosis & bone health in 2025)03:00 Exercise advances and empowerment through strength training05:50 Nutrition overview: calcium, vitamin D, absorption & gut health08:08 Vitamin K2: MK‑4 vs MK‑7 research and dosing discussion11:50 Importance of magnesium and preferred forms18:33 Protein needs updated: ≥1.1 g/kg for some populations and essential amino acids24:22 Bone turnover blood markers: CTX and P1NP — interpretation & clinical use31:05 Common drivers of elevated CTX: inflammation, hormones, parathyroid36:43 Exercise prescription specifics, posture, stabilization, and BoneFit / PT resources43:16  Weighted vests: when they help and when they hurt45:35 Vibration plates: low‑intensity vs high‑intensity, safety considerations49:01 Hormone replacement therapy: role in bone protection and CTX improvement55:22 How Margie began focusing on bone health and integrative care59:25 Strontium: effects on DEXA accuracy and recommendations01:02:56 Jumping protocols and impact dosing for bone01:07:05 Homocysteine and bone: thresholds and correction01:13:33 Resources and recommended reading (Dr. Keith McCormick; Bone Health & Osteoporosis Foundation; BoneFit)01:17:20 Closing: reframing diagnosis as opportunity; where to find MargieCitationsHigh-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial - PubMedHigh-intensity exercise to prevent fractures — risk or gain? | Nature Reviews Endocrinology Heavy resistance training provides short-term benefits on bone formation in well-functioning older adults - ScienceDirect McCormick K. Great Bones: Taking Control of Your Osteoporosis. 2023.Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.

If metabolic flexibility is the key to longevity, are we missing critical opportunities to help our patients achieve it? In this episode of The Root Cause Medicine Podcast, we sit down with Dr. Rob Downey and Monique Class, two respected functional medicine clinicians presenting at Fullscript Forward 2025, to explore how precision approaches to metabolic health are reshaping longevity care. Dr. Downey reveals how metabolic phenotyping, stress and HRV mapping, and gut function insights can inform individualized care strategies, while Monique shares her thoughtful approach to microdosed GLP-1 protocols, titration by response, and slow tapering models designed to complement lifestyle-first interventions. Together, they unpack the art and science of whole-person metabolic medicine—covering body composition tracking, lab-based decision-making, and muscle-preserving movement routines that clinicians can integrate into real-world workflows.If you’re ready to help your clients achieve true metabolic transformation, this episode offers the frameworks, data points, and clinical pearls you won’t want to miss.Clinical Takeaways from This Episode Metabolic Phenotyping & Personalized Patterns in Longevity Care: Dr. Downey discusses using patterns such as body shape, lifestyle context, and lab trends to categorize presentations and organize evaluation, rather than applying one standardized protocol to everyone.“Body-Knows-the-Way” Framing & Foundational Inputs: Both Dr. Downey and Monique Class describe a model focused on reducing burdens (e.g., chronic stress, inflammation, dysbiosis) and adding supports (sleep, whole foods, movement) so adaptive pathways may function more effectively.Stress Physiology, HRV, Sleep & Behavior Change: Conversation covers the role of chronic sympathetic arousal and low HRV in metabolic challenges, and how breath work, meditation, or similar practices were used by some patients in their experience to shift autonomic balance.GLP-1 Microdosing, Titration & Slow Tapering: Monique explains her rationale for starting below common starter doses when appropriate, titrating to the lowest perceived effective dose to reduce “food noise,” and planning tapering from the outset—positioning medications as a potential bridge during lifestyle change.Side-Effect Themes & Constipation Workflow on GLP-1s: Both practitioners review proactive steps they consider before initiation of GLP-1s, such as addressing reflux/constipation and dysbiosis, and discussed tools often used in practice (hydration strategies; magnesium citrate/Cal-Mag; buffered vitamin C; ginger/bitters; gradual fiber; stool positioning) to manage common GI complaints.Nutrition Patterns, Endogenous GLP-1 Signaling & Glycemic Awareness: The dialogue highlights food-quality patterns (protein with meals; colorful produce; fermented foods/fiber) discussed in relation to satiety, SCFA production, and L-cell signaling, as well as interest in meal timing and CGM-based learning.Muscle Preservation & Body Composition Tracking: Monique and Dr. Downey discuss prioritizing resistance training, NEAT/micromovement, and tracking lean mass vs. visceral fat (e.g., Seca metrics, phase angle) as more informative than scale weight alone.Medication Reviews During Weight Loss: The guests emphasized reviewing other medications (e.g., blood pressure, lipid, glycemic, or psychiatric medications) as weight, intake, and vital signs change, with attention to orthostasis or hypoglycemia risk.Gut–Brain–Metabolic Axis Considerations: Guests describe empiric GI support and, in some cases, stool testing, as well as nutrients like glutamine and zinc (including zinc carnosine)in the context of comfort and barrier support.Metabolic Rebound & Relapse Prevention: The conversation covers reports of rebound with rapid dose escalation/high doses and abrupt discontinuation, and discussed slower titration, gradual tapering, and habit “scaffolding” (meal timing, movement, sleep, alcohol awareness) as strategies they consider to help maintain gains.Guest BiosDr. Rob Downey, MD, IFMCP — Functional medicine physician at Seaworthy Medicine (AK); discussed phenotyping, HRV/stress context, and gut-metabolic foundations in complex cases.Monique Class, FNP, IFMCP — Family nurse practitioner with 35+ years in functional medicine; discussed GLP-1 microdosing, tapering/off-ramps, and whole-person frameworks for weight management, inflammation, and longevity.Labs Mentioned (Monitoring & Context)Glycemic/insulin markers: Fasting insulin, fasting glucose, HbA1c, optional CGM patternsLipid & metabolic context: Standard lipid panel; triglycerides; uric acid; waist circumferenceEndocrine/sex hormones: Thyroid panel; sex hormones as indicatedGI & micronutrients: Stool testing where applicable; micronutrient analysesBody composition: Visceral fat and phase angle (e.g., Seca), lean mass vs. fat massIngredients & Therapeutic Nutrition Mentioned Gut/immune: Boswellia, bromelain, quercetin; probiotics (product/strain selection varies)Stress/adaptogens: Ashwagandha, cordyceps, phosphatidylserine; ginseng/licorice when appropriateMetabolic support: Chromium, bitter melon; glutamine, zinc / zinc carnosine, lecithinConstipation toolkit: Magnesium citrate or Cal-Mag, buffered vitamin C, ginger/bitters, aloe options, gradual fiber, hydration, stool positioningDiet patterns referenced: Protein at meals, fermented foods, colorful produce, structured meal timing, mindful alcohol intakeFullscript Forward DetailsFullscript Forward Summit – Oct 17 → https://www.fullscriptforward.com/Timestamps00:00 Intro & Fullscript Forward overview01:54 Guest intros03:15 Downey’s journey: autoimmunity → metabolic health focus10:20 Phenotype & hormonal pattern assessment13:18 Sequencing foundational interventions before advanced steps15:39 Labs for assessing metabolism19:22 GLP-1 tapering and off-ramp planning22:26 Small-dose GLP-1 protocols & titration discussion30:31 Metabolic rebound: drivers & mitigation approaches43:03 Whole-person care & healthspan goalsFrequently Asked QuestionsQ: What makes this episode different from other GLP-1 discussions? Most conversations stop at dosing. This one goes further—into phenotyping, nutrient status, and tapering protocols that integrate lifestyle medicine. It’s about how to use GLP-1s thoughtfully within a personalized, long-term metabolic framework.Q: What is “metabolic phenotyping,” and why does it matter? Dr. Downey explains how identifying phenotype patterns—such as stress physiology, body composition, and gut-driven inflammation—can help clinicians prioritize interventions and understand why certain patients plateau despite doing “everything right.”Q: What key labs and metrics do the guests discuss? They review labs that provide insight into insulin sensitivity, thyroid health, inflammation, and micronutrient status, as well as body composition measures (like visceral fat and phase angle) that reveal metabolic trends beyond weight alone.Q: What can providers take away from this conversation? A clearer view of how to connect physiology, psychology, and behavior change in metabolic medicine—plus practical insight into tapering, monitoring, and optimizing care over time.Q: Who should listen to this episode? Healthcare professionals interested in functional and lifestyle medicine, longevity, or integrative metabolic care—particularly those seeking to bridge the gap between pharmacology and personalized nutrition.Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.

In this episode, we unpack the updated 2025 GLP-1 consensus advisory with Lara Zakaria, IFMCP. Lara reframes GLP-1 medications as a window of opportunity for lifestyle transformation and emphasizes that prescribing should be paired with proactive nutrition, movement, and lab monitoring. She outlines a three-tiered approach to lab work, highlights the importance of muscle preservation for long-term metabolic health, and shares practical tips for addressing common gastrointestinal side effects.Clinical Takeaways from This EpisodeGLP-1 Therapy as a Catalyst for Metabolic Health: How to use GLP-1 medications as a tool to initiate lifestyle change, reset eating patterns, and improve overall body composition rather than relying on medication alone.GLP-1 Nutrition Screening & Eating Disorder Risk Assessment: Why clinicians should screen for disordered eating and evaluate baseline diet quality—including fiber, protein, and phytonutrient intake—before initiating GLP-1 therapy.Protein Intake & Muscle Preservation During GLP-1 Treatment: Evidence-informed guidance on maintaining protein intake (0.4–0.5 g/kg/day) and combining GLP-1s with resistance training to reduce muscle loss and support long-term metabolic health.Micronutrient Monitoring for GLP-1 Patients: Recommended lab tests to monitor iron, vitamin D, RBC magnesium, zinc, and fat-soluble vitamins (A, D, E, K) to help prevent nutrient insufficiency and support patient energy and recovery.Managing GLP-1-Related GI Side Effects Naturally: Stepwise strategies for reducing nausea, constipation, and bloating with smaller meals, fiber, hydration, magnesium, ginger, and digestive bitters.Tracking Body Composition in GLP-1 Weight Loss: Why measuring visceral fat, lean mass, and muscle density provides a more complete picture of progress than weight alone—and how to use body composition scales effectively.Multidisciplinary GLP-1 Care Team Approach: How dietitians, physical therapists, trainers, mental health providers, and pharmacists can collaborate to create comprehensive, patient-centered care plans.Optimizing Clinical Workflows for GLP-1 Prescribing: How to build visit templates, lab panels, and follow-up systems to integrate guideline-based nutrition, exercise, and lab monitoring into everyday practice.Guest IntroductionLara Zakaria, PharmD, MS, CNS, CDN, IFMCP, is a licensed pharmacist and functional medicine practitioner specializing in metabolic health, neuroinflammation, and chronic disease. As a faculty member for the Institute for Functional Medicine, she teaches clinicians how to integrate pharmacology with nutrition and lifestyle medicine. Lara is passionate about helping practitioners use GLP-1s as a bridge to sustainable habit change—rather than as a stand-alone solution. Learn more at larazakaria.com or follow her at @foodiepharmacist on Instagram and LinkedIn.GLP-1 Lab Monitoring for Nutrient StatusCMP, CBC with iron studiesRBC magnesiumVitamin DFull thyroid panel (TSH, free T4/T3, reverse T3, antibodies)Functional testing options: NutrEval, organic acids, stool testGLP-1 Nutrition & Supplement Support for Metabolic HealthTargeted protein intake (0.4–0.5 g/kg/day)Multi-mineral or multi-nutrient powder, divided dosesVitamin D + K2, B-complex, and iron as clinically indicatedElectrolyte support during titrationGLP-1 Constipation Toolkit from Lara ZakariaMagnesium citrate or Cal-Mag combination for low magnesium constipationBuffered vitamin C (titrated to bowel tolerance) and hydration for osmotic constipationTriphala, ginger, digestive bitters as appropriate to support peristalsisSquatty potty and morning routines to activate parasympathetic tone and support optimal pelvic floor functionGLP-1 Lifestyle & Movement RecommendationsStrength training 2–3x per week to protect muscle massWalking, yoga, gardening, or functional movement on non-training daysSleep and stress hygiene support to balance circadian rhythmCitations:Mozaffarian D, Agarwal M, Aggarwal M, et al. Nutritional Priorities to Support GLP-1 Therapy for Obesity: A Joint Advisory From the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society. 2025.Timestamps:00:00 – Episode introduction and overview of prescribing considerations for GLP-1s03:28 – Historical context: GLP-1 development and off-label use for weight loss05:54 – The recent consensus statement and its implications for practice06:43 – Decision tree considerations: muscle loss, fat distribution, and diet quality09:05 – The importance of nutrition counseling and the gut-brain axis12:05 – Holistic assessment framework: screening, laboratory biomarkers, and functional testing14:10 – The role of fiber and gut health in optimizing GLP-1 outcomes17:50 – The significance of screening for nutrient deficiencies: iron, vitamin D, magnesium, B vitamins, zinc22:07 – Prevention of sarcopenic obesity during weight loss interventions25:51 – Importance of assessing micronutrient status before and after GLP-1 therapy27:54 – Lab assessments for liver, thyroid, and metabolic health indicators40:51 – Advanced testing considerations and personalized evaluation strategies47:02 – Managing GI side effects proactively: counseling, lifestyle, herbal supports50:56 – Gut motility, herbal supports, and the importance of lifestyle factors54:43 – Titrating and off-boarding GLP-1 medications for long-term health55:30 – Resources 

In this episode, we explore the science of postpartum recovery with Serena Saeed-Winn, CNM, WHNP, IBCLC. Serena explains why the standard six-week visit may miss key opportunities to support tissue healing, hormonal recalibration, lymphatic flow, and maternal mental health. Drawing from more than a decade of clinical experience, she discusses how multi-touchpoint care can enhance recovery and help families feel supported.Clinical Takeaways from This EpisodeRedefining Postpartum Care: Why the six-week visit may miss key needs—and how earlier touchpoints can support maternal well-being and mental health.Therapeutic Breast & Lymphatic Techniques: Step-by-step discussion of breast massage, lymphatic drainage, and partner involvement that may help relieve engorgement and support healthy milk flow.Supporting Wound & Scar Healing: Practical ways to guide sitz baths, gentle scar mobilization, and pelvic floor comfort strategies.Postpartum Neuroendocrine & Mental Health Screening: Considerations for thyroid labs, preeclampsia monitoring, and timely mental health referrals.Family Systems & Partner Engagement: How partner education and involvement can help reduce isolation and support the family unit.Postpartum Nutrition & Labs: Labs to consider (thyroid, iron studies, vitamin D) and food-first nutrition, hydration, and select supplement strategies for whole-body recovery.Building Your Care Team: Best practices for collaborating with lactation consultants, pelvic floor PTs, mental health professionals, and other postpartum resources.Guest Introduction: Serena Saeed-Winn is a certified nurse midwife and women’s health nurse practitioner with more than a decade of experience in birth and postpartum care. She is the founder of the KAZ Project, a home-based postpartum service focused on personalized, holistic family support. Serena is passionate about creating a physiologically, psychologically, and socially integrative model for postpartum care. Learn more at KAZ Project.Serena Saeed-Winn's Postpartum Resources Postpartum Health Books & AuthorsHormone Intelligence by Dr. Aviva RommThe Natural Pregnancy Book & Botanical Medicine for Women’s Health by Dr. Aviva RommWomen’s Power to Heal Through Inner Medicine by Maya TiwariPostpartum Websites & ToolsBreast Gymnastics – Maya Bolman, IBCLCPostpartum Support InternationalPostpartum Labs & ConsiderationsThyroid labs: consider screening first trimester and postpartum as clinically indicated.Iron studies: evaluate prenatally or postpartum if symptomatic or at risk.Vitamin D testing: consider assessing levels to guide individualized support.Postpartum Nutrition & SupplementsHerbal infusions (e.g., calendula sitz baths)Omega-3 fatty acids (EPA/DHA)B-vitamins (B12, Folate)Vitamin D and iron as neededElectrolytes and hydration supportBreastfeeding Comfort Tools & SuppliesSilverette Nursing CupsHaakaa Ladybug Milk Collector

In this episode of The Root Cause Medicine Podcast, Dr. Kate Kresge welcomes Dr. Asare Christian, MD, a pain medicine and rehabilitation specialist, to explore the complex physiology of migraines and how a root-cause or functional medicine approach can transform treatment. They discuss the various triggers, including hormonal fluctuations, gut health, inflammation, and environmental toxins, as well as innovative natural therapies, supplements, and device options that empower patients to take control of their headache management. This conversation offers a comprehensive view of migraine care beyond conventional medications, emphasizing education, prevention, and personalized strategies for lasting relief.You'll hear them discuss: The evolving understanding of migraine pathophysiology, including neuronal triggers and the trigeminal systemConventional vs. natural approaches to migraine treatmentThe role of hormones, gut health, micronutrients, and environmental toxins in migraine triggersThe importance of education and personalized pain management plansCutting-edge devices and non-pharmacological therapies for acute and preventative careThe significance of sleep, stress management, and resilience in migraine reductionThe impact of gut microbiome and inflammation on chronic pain conditionsGuest Introduction:Dr. Asare Christian is a physical medicine and rehabilitation specialist, founder of Ether Medicine, and a leader in integrating functional medicine approaches into pain management. His focus is on identifying root causes of chronic pain and migraines—such as hormonal imbalances, gut dysbiosis, and inflammation—and offering personalized, natural, and innovative treatments to optimize health and reduce symptom burden.Labs Mentioned: Hormone panels (estrogen, testosterone, thyroid)Microbiome testingCMP (Comprehensive Metabolic Panel)Nutrient levels (magnesium, B vitamins, vitamin D, cellular nutrient testing)Infections (H. pylori, candida)CoQ10 and other mitochondrial markersSupplements Mentioned: MagnesiumB vitaminsVitamin DCoQ10Fish oil / Omega-3s / Specialized pro-resolving mediators (SPMs)Ketone estersButterburFeverfewChaste Tree (Agnus Castus)Wild YamLDN (Low Dose Naltrexone)Guest and Sponsor Details: Practice: Aether MedicinePhone: 484-806-1101Town: Wayne, PATimestamps:  00:00 – Introduction and episode overview01:42 – Dr. Christian’s pathway into functional pain medicine03:04 – Understanding why pain isn’t just a symptom, but a driver of patient health04:53 – Defining migraine and its impact globally06:55 – Conventional medication history and recent advances such as CGRP antagonists11:04 – Systemic and neural pathways involved in migraine physiology13:25 – Triggers including hormonal fluctuations, diet, gut health, stress, and toxins15:20 – Modulating pain through neuroaffective strategies and vagus nerve stimulation17:11 – Educating patients on triggers, and developing personalized pain and migraine plans24:40 – The microbiome’s influence on pain and inflammation28:20 – The role of micronutrients and cellular energy in migraine management34:00 – Shared physiology in other pain conditions, energy regulation, and mitochondria36:54 – Inflammation management and safe supplement use, including LDN and peptides49:00 – Natural herbs like butterbur, feverfew, and stabilizing mast cells54:25 – Neuromodulation devices for in-office and on-the-go migraine management58:27 – Patient success rates and hope for those suffering from migraines01:00:16 – Key takeaways: triggers, nutrition, and personalized care for migraine resolution

In this episode, Dr. Kate Kresge welcomes Dr. Christy Evans, an OB/GYN with a passion for functional women’s health. They discuss how pregnancy transforms every body system, the importance of a comprehensive lifespan approach to women's health, and the innovative methods Dr. Christy uses at Almond OB/GYN. She shares her journey from accountant to physician, the significance of addressing root causes behind common symptoms, and how holistic care can optimize vitality and long-term health. Plus, insights into postpartum recovery, PCOS, and practical strategies to support women at every stage of life.You'll hear them discuss:  The systemic changes during pregnancy and postpartumDr. Christy's journey from accountant to women’s health specialistThe Four Outputs and Five Pillars approach for vitality assessmentDeep dive into vaginal microbiome testing and supportThe importance of lifespan care and preconception health optimizationAddressing common issues like PCOS with a root cause approachThe need for healthcare reform that truly centers women’s unique physiologyPractical lifestyle tips for hormonal and metabolic healthHow community and social connection impact women’s well-beingGuest Introduction:Dr. Christy Evans is an OB/GYN specializing in functional women’s health at Almond OB/GYN. She combines conventional OB/GYN care with a root cause, systems-based approach to promote vitality across a woman’s lifespan. Her background includes work in Nairobi, Kenya, where she learned firsthand about the impact of healthcare access on women’s lives, fueling her mission to make holistic women’s health care more accessible. She also co-founded New Dawn Africa, supporting maternal health initiatives in Nairobi.Labs Mentioned:  A1CFasting insulinFasting glucoseLipoprotein(a)Comprehensive thyroid panelIron panel (ferritin, iron)Vitamin DMicronutrient testingSupplements Mentioned:  Vaginal probiotics (specific strains like Lactobacillus crispatus)Guest and Sponsor Details:  Website: almondobgyn.comInstagram: @almondobgynFoundation website for Kenya support: newdawnafrica.orgTimestamps:  [00:00] Introduction and podcast overview[01:00] Dr. Christy's journey from accounting to medicine[03:00] Why women’s health is foundational to communities[05:00] The Almond OB GYN approach: integrating functional medicine[07:00] The four outputs of vitality assessment[08:30] Deep dive into vaginal microbiome testing and support strategies[12:00] Recognizing symptoms related to vaginal dysbiosis[15:00] The connection between gut health and women's health[18:00] Looking at metabolic health indicators and testing[24:00] Making functional medicine accessible through insurance-based care[27:00] Postpartum care: what women truly need[30:00] The physiological changes in postpartum body and recovery timeline[35:00] Understanding PCOS beyond symptom management[39:00] The role of social connection in women’s health[42:00] How to access Almond’s nationwide services and clinic in LA[45:00] Personal health practices of Dr. Christy[50:00] Advocating for women-centered healthcare reform[53:00] Final thoughts and resources

300 "Anxiety: What to Do When Labs are Normal" with Dr. Ellen VoraIn this episode, Dr. Kate Kresge is joined by Dr. Ellen Vora to explore holistic approaches to anxiety beyond physiological root causes. They discuss how mindful movement, play, connection, and emotional regulation—such as cry therapy—can serve as powerful tools in managing true anxiety. Emphasizing the importance of integrating mind, body, and spirit, this conversation offers practical strategies for clinicians and individuals looking to deepen their understanding and treatment of anxiety.You'll hear them discuss: The role of exercise, especially dance, in improving mood and mental healthHow movement combined with music influences the nervous systemDifferentiating between false (physiological) and true (purposeful) anxietyPractical tools for body-based emotional regulation, like shaking and breathworkThe importance of play and joy in healing and well-beingCultivating social connection as a form of emotional detoxTechniques for letting go of unresolved grief and practicing emotional detoxThe neuroscience behind crying and its healing effectsThe significance of embracing vulnerability and levity in mental healthGuest Introduction:Dr. Ellen Vora is a Yale and Columbia-trained psychiatrist, author of The Anatomy of Anxiety, and a pioneer in holistic mental health approaches. She incorporates functional medicine, neurobiology, and spiritual insights to address anxiety and emotional well-being, emphasizing that mental health is deeply interconnected with physical health and lifestyle.Labs Mentioned: Hemoglobin A1CFolate and B12 levelsVitamin D levelsRed blood cell magnesium levelsGI mappingInflammatory markersSupplements Mentioned: MagnesiumFolateGuest and Sponsor Details: Dr. Ellen Vora's WebsiteThe Anatomy of Anxiety BookFullscript (sponsor): fullscript.comTimestamps: 00:00 Introduction & Exercise as a Mood Booster01:31 Overview of Practicing Whole Person Care with Fullscript03:32 Recap of physio-psychological approach to anxiety05:30 Lifestyle interventions for anxiety (sleep, blood sugar)07:05 Addressing persistent anxiety after physiological stabilization09:18 Understanding true vs. false anxiety11:20 Honoring purposeful anxiety and making space for it13:10 The role of social connection and community15:34 Disarming control and embracing impermanence19:42 Movement, shaking, and emotional release techniques23:58 The neuroscience of joy, singing, and play36:17 Reclaiming joy and levity in adult life43:04 Connection as a remedy for loneliness and social support47:46 Cultivating a grounding community influence49:48 Letting go: grief, tears, and emotional detox54:26 Crying as a healing tool and emotional release55:49 Final thoughts and where to find Ellen