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

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

Marvin Singh, MD is a practicing gastroenterologist with a focus in personalized lifestyle medicine. I met Marvin in 2017 when I was asked to submit a chapter to Oxford University Press Integrative Gastroenterology, 2nd Ed. Marvin has been coediting this behemoth with my IFM colleague Gerry Mullin, MD. (Full disclosure: very large props must go to Nikky Contractor, PhD for the heavy lifting on our chapter). Marvin’s evolution from a very traditional, academic gastroenterologist to integrative gastroenterologist to a cutting-the-edge personalized lifestyle medicine doctor (folded inside his own healing) is a story I think you’ll find interesting, and relatable. As we move through his story, I ping Dr. Singh on labs, interventions, books, all sorts of content – lots included, be sure not to miss this one. Brilliant guy, and I ‘d love to hear what you think! Be sure to rate, comment and review New Frontiers, wherever you listen to the podcast – I so appreciate you listening! ~DrKF

By far one of my most wide-ranging conversations on New Frontiers, Dr. Sara Gottfried and I set out to talk about her new book Brain, Body Diet and quickly headed north. Listen to our lively, personal, smart, heart-felt conversation as we dive into her experience using a continuous glucose monitor to address fairly severe nocturnal hypoglycemia, her thoughts on addictions and genetics, taming the dopamine-deprived COMTer, and lots of women’s health. You know that Sara is, of course, extraordinarily bright, but she’s also an open book in a lovely, inspiring way. For instance: How would a concussion, obtained through a dearth of self-care plus wine, lead to the Brain Body Diet? Besides the obvious connection, Sara describes a personal reckoning and rebirth that I can certainly relate to. If you are enjoying what you hear on NFFM, PLEASE leave a review wherever you’re accessing this podcast. ~DrKF

Take a second and think about this: what clinical presentation would prompt you to prescribe cognitive behavioral coaching, breathwork or meditation? Did GERD make your list? Along with gentle, but powerful botanicals and nutraceuticals (IT’s Motility Activator, DGL Chewables, Heartburn Advantage), these are cornerstone interventions for GERD in the practice of Victoria Albina, NP, MPH. Victoria operates from a patient empowerment position, believing that it’s essential for lasting change in a ubiquitous lifestyle condition such as GERD. We also cover epidemiology (30% incidence in the US), root causes, laboratory—and really interesting to me—the variable clinical presentations GERD can take. Finally, are PPIs .. safe? Victoria discusses a recent study that made the PR rounds. Take a listen, and be sure to like, comment and rate the podcast in iTunes, Spotify, or wherever you’re hearing my voice. Thank you! ~DrKF

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