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

Small Intestinal Microbial Overgrowth: A Conversation with Dr. Vincent Pedre, MD IFMCP All microbes, not just bacteria, can contribute to problems in the small intestines. Today more than ever, we see patients with hard-to- treat gut problems. Dr. Pedre brings his own gut healing journey and Functional Medicine background to the table to talk to us about treating patients with SIBO-or as he likes to call it-SIMO, which encompasses microbes beyond bacteria and includes the oft-overlooked fungal piece of the puzzle. Dr. Pedre shares loads of treatment pearls from his gut-centric practice, but reminds us that any protocol must be individualized for the person sitting in front of us.

Dr. Carrie Jones and I went to medical school (National College of Natural Medicine) together. She was a brilliant, awesome friend then, and still is. What a privilege it’s been to watch her grow into the expert she is today. As you’ll see in her bio, Dr. Jones has been focused on women’s health and hormones her entire career which has spanned academia, clinical practice and now as the chief medical officer at Precision Analytical, home of the DUTCH dried urine hormone panel. Given Carrie’s background, she’s uniquely suited to train us on using the DUTCH panel, as she’s literally interpreted thousands of these tests over the years. Her podcast is chock full of Monday morning pearls of the best kind- actionable content I think you’ll appreciate and use immediately.

Dr. Corey Schuler is a man of many talents- an educator as well as a practitioner in integrative and functional medicine. In today’s podcast, Dr. Schuler will be wearing his nutritionist hat as we discuss individually designed elemental diets. Some of the applications we cover will be well-known to practitioners and patients alike. Others don’t have precedent in clinical practice but listen to this expert as he walks you through the critical thinking he calls on to come up with new and novel ways to use elemental diets to heal a number of conditions.

As you probably know, stem cell therapy outside of the research setting is the Wild West. It’s offered everywhere, here and outside of the US (there’s a whole “stem cell tourism trade”). Radical claims are made routinely without much evidence or oversight. Pricing for therapy, and protocols used, vary widely, although anyone (even those participating in research trials) can expect to spend thousands of dollars. Given that my patient has MS, I reached out to Dr. Terry Wahls and asked if she had any insight into a direction for us. She suggested I look into a massive, years-long multi-center clinical trial using stromal vascular fractions (AKA adipose-derived stem cells and growth factors) for a variety of conditions, including MS. The first publication from this study out February 2017, focusing on safety of SVF over 5 years, demonstrated a very low number of adverse events, and significant improvement in pain rating in a variety of musculoskeletal diseases. (N =1524)

In general, I am a fan of IgG food sensitivity testing. While we can in some cases manage just fine using a standard elimination and challenge protocol, IgG testing can benefit patients in a few ways, such as: providing motivating data, individualizing the foods needing to be removed and identify less-common antigenic foods. However, if you are using IgG food sensitivity testing in practice, you’ve no doubt encountered false negatives and positives. (Indeed, you may have abandoned IgG testing for these reasons!) Dr. Brent Dorval, through a rather remarkable epiphany during his post-doctorate work, formed the hypothesis that testing for IgG/food immune complexes, along with the specific complement protein (C3d) that induces the inflammatory response, would increase the reliability of the test considerably. After a number of years of bench and clinical research, Brent finalized the methodology for his assay (now called the FIT Test, offered through KBMO Diagnostics) and the rest is history. Tune into our podcast for an overview on IgG food sensitivity testing (great if you are new to using this laboratory test, or an individual interested in this testing), and specific details about the unique FIT test, including case studies. See the links below for all the info on the FIT Test, including his current publication. Stay tuned for more research in the pipeline!

Functional hypochlorhydria is a condition we see so often, yet Prilosec is a top ten medication: what’s the disconnect? Probiotics: which ones, how much, combo or single strain? What does the research really show probiotics are actually doing? Is there any truth to probiotics colonizing the GI tract? And what about soil-based probiotics, any reason to be jumping on that bandwagon? What is the correct lab test for identifying pancreatic exocrine insufficiency (PEI), and what is the optimal range? Is there any utility to testing fecal fats? What enzymes (vegetarian or animal-based), botanicals and other interventions are appropriate for addressing PEI?

Have you been wondering what you should really do with the 23andme genetic data that you’ve gathered? Wondering if you should even take the test at all? Or wondering what the future of genetic/epigenetic medicine is? This podcast is for you. I am especially excited to bring you this conversation with epigenetic legend, Dr. Moshe Szyf. The study of epigenetics is continually breaking new ground in understanding how our environment dramatically influences our gene expression. With myriad published research studies and his ongoing work, Dr. Szyf is at the forefront in shaping this evolution. The power of epigenetics to alter the course of our health is compelling, and I hope you will enjoy the discussion we had, which I hope will be one of many.

Thanks to Dr. Susan Blum, functional medicine has even more to offer for patients with rheumatoid arthritis (RA) and osteoarthritis (OA). She shares new insights about RA’s underlying causes, details what goes missed in treatment plans, and gives practical tips for mining data from stool tests, utilizing functional blood markers, and combining herbs and probiotics to reverse processes that other practitioners may think are permanent

Fibromyalgia can be a particularly difficult condition to address conventionally, but Functional Medicine really has a lot to offer here. In this podcast, we mine the wealth of information that Dr. David Brady brings to the table on this important topic, including: · The signs and symptoms of fibromyalgia and how it is diagnosed (previously-defined tender points are no longer used!) – see also Dr. Brady’s questionnaire at www.fibrofix.com · What other mimicking conditions need to be considered or ruled out · How fibromyalgia differs from chronic fatigue syndrome—vastly different disorders that are commonly confused · Why not all pain is driven by inflammation · How not to fall into the trap of only looking at mitochondrial dysfunction · Organic acids, catecholamines, food reactivity and other relevant labs for assessment and tracking · Childhood and adult stress patterns in (especially female-dominated) fibromyalgia, and how that factors into interventions · Additional intervention options such as sleep support, energy pathways, detox, exercise, diet, immune balancing to reset metabolic patterns and promote recovery

Dr. Cabeca is a wealth of information and inspiration when it comes to women’s health. I am delighted to share my conversation with her this month, in which you’ll learn about: - How Dr. Cabeca transitioned from performing multiple surgeries per week, to only needing to recommend a handful per year with a functional medicine approach - The best lab tests and specimens for hormone assessment - The importance of liquid chromatography mass spectrometry for serum free testosterone measures - Factors to be aware of that can confound hormone testing results - Estrogen metabolites and the importance of methylation assessment - The sweet spot of keto-alkaline status for sex hormone balance, cortisol management, mental clarity, insulin sensitivity and weight loss (target pH of 7, and some ketones 3+ days per week) - The benefits of vaginal testosterone and DHEA for tissue repair and incontinence - Watching out for behavior change with testosterone to ensure appropriate dosing and saving marriages! - Addressing vaginal dryness with safe oils and DHEA, diet and lifestyle