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

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 evidence for transdermal estradiol, oral progesterone. We discuss compounding, dosing, testing, addressing metabolites … and SO MUCH MORE. Keep a pen or your phone handy for note-taking, there’s tons of info in this podcast. Thanks as always, to Precision Analytical, creators of the DUTCH test, for bringing Dr. Saltiel to our listeners. She’s incredible! Please share New Frontiers with your network, and if you would be so kind, leave us a comment and review wherever you listen. As always, thank you listening! ~DrKF

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 comment -- if you would be so kind! Thank you! ~DrKF

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 analyte that can readily be assessed that is a surrogate marker of brain cholesterol: consider this if needed. Enjoy this in-depth conversation, and be sure to leave New Frontiers a rating on iTunes or Stitcher or wherever you listen. It’s the best thing you can do to help share this valuable content and help put FxMed in front of more and more listeners! Thank you! ~DrKF

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 us through a lovely breathing exercise at the end of our conversation. It was one of the most grounding – and informative- podcasts I’ve done 😊, and I can’t wait to hear what you think. Leave us a review and 5-star rating on iTunes or wherever you listen to New Frontiers. Thank you! ~DrKF

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. Thanks for listening, and please leave us a review wherever you listen to New Frontiers! ~DrKF