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New Frontiers in Functional Medicine

Welcome to New Frontiers in Functional Medicine™. Each month, I interview the best minds in Functional Medicine. Expect thought provoking ideas, new research, lots of clinical pearls for practitioners and step-change information for consumers and patients. I hope you join us. Don’t hesitate to email me with ideas for future podcasts.

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The best episodes ranked using user listens.

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Episode 27: SPONSORED | Using DUTCH hormone Test with Dr. Carrie Jones

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.

47mins

28 May 2017

Rank #1

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Episode 14: Taking a Deeper Dive into Eat Fat, Get Thin with Dr. Mark Hyman

Science has demonstrated for over a century that fat simply isn’t the macronutrient villain it’s been made out to be. Join me and Dr. Mark Hyman as we spend some time discussing his new NYT best-selling book Eat Fat, Get Thin. We drill down into the research that has been published over the years demonstrating the largely beneficial aspects of most fatty acids.

39mins

31 May 2016

Rank #2

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Episode 37: The Gut/Thyroid Connection with Dr. Michael Ruscio

Join me for an interesting, clinician-friendly conversation on the gut/thyroid axis with Dr. Mike Ruscio. Dr. Ruscio challenges both conventional understanding (where the gut/thyroid relationship isn’t recognized outside the research setting) and in the functional medicine world, where he argues we are often over-treating and over-testing thyroid function. What is the thyroid adrenal relationship? What should we expect with regard to thyroid antibodies and successful treatment? What should we be thinking about with regard to gut health when diagnosing and treating thyroid disease? Listen to this great New Frontiers episode where we dive deep into all this and more!

1hr 5mins

16 Mar 2018

Rank #3

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Episode 41: Food: What the Heck Should We Eat with Expert Dr. Mark Hyman

In my conversation with Mark Hyman on his new NYT best seller, Food: What the Heck Should I Eat?, we discuss the myriad challenges consumers face in figuring out the correct diet, but also, what WE as clinicians caring for patients – what do we prescribe? What do the data show? Are grains really verboten? Is dairy completely off-the-plate? What about meat? And fats/cholesterol and the APOE4 patient? Mark enlightens me to the new “regenerative agriculture” movement; going far beyond organic, regenerative agriculture regenerates the environment while providing good, clean food. Amazing, right? He also addresses the common price complaint. What is the cost of eating clean vs eating conventional? We also go behind the scenes to address the insidious agribusiness at the heart of US policy, and chat about Steven Savage’s recent take-down of Environmental Working Group’s Dirty Dozen Clean Fifteen lists. This was such a fun convo for me, and as always, Mark is doing great detective work getting to the heart of concerns around diet and the ecology of eating. Take a listen, I bet you’ll be as intrigued as I was.

44mins

6 May 2018

Rank #4

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Episode 4: Natural Cures for Dummies - with Dr. Kara Fitzgerald and Dr. Banks

Just released April, 2015, Natural Cures for Dummies is a superb survey of all things Natural Medicine. In this podcast, Dr. Banks and I cover a ton of content: The book, appropriate diets, including the elimination diet and the perils of gluten, we cover his approach to detox, appropriate supplements, genomics and systems medicine, Functional Medicine and so much more.

58mins

12 Aug 2015

Rank #5

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Episode 76: SP: The Business of Functional Medicine: Secrets for Success for your FxMed Practice

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!

58mins

12 Dec 2019

Rank #6

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Episode 6: Enacting an Elimination Diet: Tips for Patients, Clinicians with Jennifer Fugo

One of the cornerstone tools of functional medicine is the elimination diet, be it a straightforward gluten/dairy free plan, or an involved, customized removal of many different foods. On top of this, we want our patients to choose clean, organic sources of foods. This dietary prescription is a tall order for many of our patients. Many years ago, Jen Fugo (author of The Savvy Gluten-Free Shopper: How to Eat Healthy Without Breaking the Bank) was prescribed just such a diet. With very limited funds, she figured out how to navigate the myriad pitfalls and change her life. Today, she’s dedicated her career to assisting individuals on therapeutic diets make the transition healthfully, affordably and successfully.

55mins

13 Oct 2015

Rank #7

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Episode 23: Functional Strategies for the Management of Gastrointestinal Disorders

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?

1hr 7mins

21 Mar 2017

Rank #8

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Episode 7: From Cell to Soul with Dr. Sara Gottfried

From Cell to Soul: A Functional Approach to Women’s Hormone Management with Sara Gottfried, MD.Dr. Sara Gottfried has elegantly distilled her years of clinical experience and thousands of patient contacts into a user-friendly body of knowledge for physician and layperson alike. She’s truly a functional/systems medicine pioneer, combining the best of scientific data with the art (and heart) of medicine. An expert in the area of women's hormones, Dr. Gottfried candidly shares her own personal experience with hormone imbalances. Sara was pivotal on my own journey toward better self-care, as you’ll hear in this podcast.

1hr

14 Nov 2015

Rank #9

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Episode 12: Always Hungry? A Conversation with David Ludwig, MD PhD

David S. Ludwig, MD, PhD, is a practicing endocrinologist and researcher at Boston Children’s Hospital, Professor of Pediatrics at Harvard Medical School and Professor of Nutrition at Harvard School of Public Health. He is Founding Director of the Optimal Weight for Life (OWL) program at Boston Children’s Hospital, one of the oldest and largest family based weight management programs. He also directs the New Balance Foundation Obesity Prevention Center. Described as an “obesity warrior” by Time Magazine, he has been featured in the New York Times, Boston Globe and USA Today and on NPR, ABC, NBC, CBS, CNN and other networks. His new book ALWAYS HUNGRY? published on January 5 is a New York Times bestsellerdrdavidludwig.com/ www.facebook.com/davidludwigmd/

46mins

7 Mar 2016

Rank #10

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Episode 20: A Deeper Understanding of Fibromyalgia and Clinical Approaches

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

1hr 7mins

28 Dec 2016

Rank #11

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Episode 46: SPONSORED Endotoxemia: The Underlying Reason Most of Your Patients Need Immunoglobulins

Endotoxemia. A fundamental driver of chronic disease. What is it? And more importantly, what do we do to address it? In my podcast with Dr. Jill Carnahan this month, she unleashes a torrent of compelling science and clinical savvy on all things endotoxemia. From heart disease and diabetes to autoimmunity (genetic or acquired) and mast cell activation, Dr. Carnahan is clear that pathological intestinal permeability (she discusses testing, but at this point in her career believes most everyone who sees her with chronic disease has IP) drives inflammation by allowing excess microbial endotoxins- primarily as lipopolysaccharide (LPS)- to enter circulation. Focused on root cause functional medicine (toxins, diet, infection, genetics), she concurrently heals the gut to drop the inflammatory burden. A key intervention for Jill is sugar-free, GMO-free, serum-derived bovine immunoglobulin (SBI), and we spend quite a bit of time on why SBI is crucial. With 43 human trials behind it, if you are not using SBI yet, you’ll be compelled to start, I suspect. We also have a fun dialogue on the role of fatty acids and toll-like receptor activation, connected directly to LPS. Jill shares a handful of very compelling case vignettes AND talks candidly about how she set up an extremely successful functional medicine practice and positioned herself as an expert in the field. And let me know: will you be changing how you prescribe high fat diets based on the research we discuss?

37mins

25 Jul 2018

Rank #12

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Episode 63: Strategies Preventing Cognitive Decline with Neurologist Dr. David Perlmutter

In this episode of New Frontiers, Dr. Fitzgerald talks with Dr. Perlmutter about the best strategies for preventing and slowing cognitive decline, and how his thinking about preventive lifestyle strategies has evolved since he published his first book Grain Brain.

1hr 9mins

16 May 2019

Rank #13

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Episode 3: The Oral Microbiome - with Dr. Kara Fitzgerald and Cass Nelson-Dooley, MS

The oral microbiome is an important part of the gut microbiome and tending to its balance should a routine part of any good “gut protocol.” Indeed, dysbiosis of the oral microbiome (and a leaky oral mucosa) might be key underlying imbalances in pathogenesis of systemic diseases, including autoimmune (IBD, rheumatoid arthritis, Sjogren) as well as cardiovascular disease. As clinicians, addressing our patient’s oral health may be the missing link in treating many systemic diseases. This podcast is great for clinicians as well as anyone interested in gut health, the oral microbiome, autoimmunity, leaky gut and cardiovascular disease.

57mins

6 Jul 2015

Rank #14

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Episode 72: Nocturnal Hypoglycemia & Continuous Glucose Monitoring: the amazing Dr. Sara Gottfried

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

1hr 2mins

8 Oct 2019

Rank #15

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Episode 67: Functional Medicine Pediatrician Dr. Elisa Song on PANS/PANDAS DX and Treatment

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

1hr 20mins

13 Jul 2019

Rank #16

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Episode 19: Functional Gynecology Practice Pearls with Dr. Anna Cabeca

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

58mins

14 Nov 2016

Rank #17

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Episode 51: All things Mast Cell with World-Renowned Clinical Researcher Dr. Theoharides

In my Tour de Force conversation with the brilliant Dr. Theoharis Theoharides, we covered all things mast cells, from “bench to bedside.” In case you have not yet encountered his work yet, he is one of the most highly decorated, well-published clinician researchers in the world. The focus of his life’s work has been on all things mast cells, and mast cell associated conditions. Given the meteoric rise in said conditions (and our improved understanding of the role of mast cells in most chronic diseases), as clinicians, we need to understand how to diagnose and treat. Buckle up for this podcast, and get your pen and pad ready – the depth and breadth of Dr. T’s knowledge requires careful listening. Give a listen, then give a thumbs up for this brilliant, generous clinician!

1hr 41mins

20 Nov 2018

Rank #18

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Episode 38: SPONSORED HPA, Organic Acids and the DUTCH Test with Dr. Carrie Jones

Why would Precision Analytical, the laboratory famous for the ground-breaking DUTCH test (Dried Urine Test for Comprehensive Hormones) and Cortisol Awakening Response test, decide to offer a handful of key organic acids on their panel (incidentally, at no extra charge)? The answers will wow you in this terrific podcast with Dr. Carrie Jones, Medical Director at PA. Turns out, looking at compounds such as homovanillic acid, vanillmadilic acid, 5HIAA, pyroglutamate, 8OH2DG and xanthurenate have LOADS to do with our sex hormones and our HPA axis at many different levels. As usual, Dr. Jones provides fun analogies (how does a trampoline explain perimenopause?), clinically useful information on test interpretation and on intervention considerations. Don’t miss it.

45mins

21 Mar 2018

Rank #19

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Episode 43: Fasting Mimicking Diet: Beyond caloric restrictions with Dr. Valter Longo

Wow! What a great conversation with Dr. Valter Longo, director of USC’s Longevity Institute. It’s always exciting to talk to someone in the trenches of bench and clinical research, especially a rock-star like Valter Longo! You can hear my nerves as we begin ☺, yet there’s much to learn about Dr. Longo’s journey from a Blue Zone upbringing in Italy to music major to biochemisty major to leading expert in articulating the biochemical and genetic underpinnings of the aging process. Dr. Longo was a post-doc under Dr. Roy Walford – famous for his research on caloric restriction and longevity. While Walford’s work – famously the 2-year Biosphere study conducted on humans – yielded remarkable improvements in chronic diseases, there were many side effects. The limitations of the human Biosphere study prompted Dr. Longo to turn his attention to longevity in single-celled organisms (S. Cervascie, specifically), then animal studies, and most recently humans. Longo designed his short term fasting mimicking diet (FMD), which does away with the fallouts he observed in long term caloric restriction. We cover a lot of great material in this conversation – and Dr. Longo makes compelling points against the unfettered use of MCT and exogenous ketones. Take a listen and let me know what you think!

1hr 2mins

8 Jun 2018

Rank #20