Intelligent Medicine

Deprescribing thyroid and other meds in older adultsCan I safely take serrapeptase for longer than four weeks?I want to take nattokinase but isn't there a 'clot dislodging' risk?Could you discuss C. difficile and how to treat it?

I do stair climbing indoors in bad weather instead of walking outdoors. Is this worthwhile?The FDA no longer recommends use of radiation shields during X-ray procedures.  What say you?I have a queasy stomach feeling, and my blood sugar is higher than usual.  What are your thoughts?I've been using magnesium taurate to control palpitations and find I need more than usual.A comment about performance-enhancing drugs in professional sports

Dr. Garth Nicolson, Founder, President, Chief Scientific Officer, and Emeritus Research Professor of Molecular Pathology at the Institute for Molecular Medicine in Huntington Beach, California, and Research Advisor for Nutritional Therapeutics, explains how membrane damage from free radicals and loss of mitochondrial transmembrane potential contribute to declining energy with age, noting studies in older adults showing improved energy output, fatigue, cognition, mood, and activity after NTFactor lipids, a protected phospholipid supplement balanced toward mitochondrial lipid composition. He describes evidence of lipid delivery using fluorescent-tagged lipids in sperm, with improved motility, and discusses applications including wound healing in veterans, removal of hydrophobic toxins via a concentration-driven “conveyor belt” process, and improved transport of nutrients like CoQ10. He details articles on normal aging, menopause-related changes supported by membranes, dementia risk linked to hearing loss, and rat studies showing delayed hearing loss with NTFactor, and mentions research on EMF sensitivity and planned schizophrenia trials.

Dr. Hoffman continues his conversation with Dr. Garth Nicolson, Founder, President, Chief Scientific Officer, and Emeritus Research Professor of Molecular Pathology at the Institute for Molecular Medicine in Huntington Beach, California, and Research Advisor for Nutritional Therapeutics.

The “Enhanced Games”, with no-holds-barred performance-enhancing drugs, yields scant advantages over “clean” contests; Does saturated fat increase insulin resistance? Can a heart attack victim avoid statin use with CoQ10? Omega-3 fish oil shows promise vs. type 2 diabetes; Motorized e-scooter use needs to be regulated NOW!

AI founders call for Congress to set guardrails against AI-accelerated bioweapon development; Deprescribing thyroid medication in seniors; Low-arginine/high lysine diets vs. herpes; Researchers test the “5 second rule” for dropped food; Long-term antidepressant use comes under new scrutiny.

Nutritionist Leyla Muedin discusses research showing simple strength tests—grip strength and a five-rep sit-to-stand chair test—predict longevity in older women. In a University at Buffalo study of over 5,000 women ages 63–99 followed for eight years, stronger grip and faster chair-stand times were linked to lower mortality; every additional 7 kg of grip strength corresponded to a 12% reduction in death risk, and faster chair-stands were also associated with improved survival, even after adjusting for activity, cardiovascular fitness, and inflammation. She emphasizes prioritizing muscle-strengthening alongside aerobic exercise and suggests accessible resistance options (weights, bodyweight moves, or household items) with professional guidance as needed. She then cites UK Biobank data linking long-term statin use to declines in grip strength and appendicular lean mass, urging discussion with physicians and added vigilance, especially for those also using GLP-1 drugs that may reduce protein intake and muscle mass.

Can topical B12 help relieve itching?The types of doctors to avoidGetting back to basicsA case study of lavender oil helping to relieve itchingYou say you're dairy sensitive but you use whey protein. Please explain.What are your thoughts on a lactose relief patch that is on offer?

Is high blood pressure genetic? Are we stuck having to take blood pressure meds?Could you please critique the study asserting fish oil supplements elevate the risk of atrial fibrillation?I've had strep throat three times in two months! What gives?I've had queasy reactions to protein added foods

A Brand New Tool for Gut, Inflammation, and Brain Support: Holistic practitioner Jane Jansen details Essential Formulas' Dr. Ohhira's Postbiotic Fermented Food Concentrate, a non-GMO, gluten-free, dairy-free, capsule-free fermented paste in travel-friendly, non-refrigerated sachets. She explains the difference between probiotics and postbiotics, emphasizing that this concentrate delivers postbiotic metabolites (including short-chain fatty acids like butyrate, plus enzymes, amino acids, vitamins, peptides, and growth/repair factors) created via a five-year fermentation of 14 fruits, vegetables, mushrooms, and seaweeds; the paste contains no live probiotics because they are heat-killed. The discussion highlights use cases for people who don't tolerate fiber or probiotics (IBS, SIBO, Crohn's, ulcerative colitis), potential benefits for leaky gut, systemic inflammation, gut-brain/mitochondrial health, insulin resistance, children, and pets, and suggests it can complement Dr. Ohhira's capsules and may be taken less than daily.

Dr. Hoffman continues his conversation with holistic practitioner Jane Jansen.

Naturally Healthy Pets: Whole-Food Diets, Microbiome Repair, and Integrative Therapies with integrative veterinarian Dr. Judy Morgan, DVM, CVA, CVCP, CVFT. She argues that pet ownership benefits human wellbeing and that pets concentrate household toxins, warning against routine pesticide-based flea/tick and other veterinary drugs due to environmental contamination and adverse events. She recommends species-appropriate whole-food diets (cats as obligate carnivores; dogs mostly meat) and criticizes ultra-processed pet foods, synthetic nutrient premixes, grains/legumes in kibble, and high-carb diets that fuel yeast and inflammation; she discusses safe calcium, zinc, and vitamin D sources. In part two, she describes veterinary acupuncture, chiropractic, and laser/red-light therapies with case examples, links skin/ear “allergies” to gut dysbiosis, uses microbiome testing, FMT capsules, and detox support, highlights omega-3s, PEA for pain, and CBD for seizures/anxiety, and outlines multi-layered natural flea/tick prevention. Intelligent Medicine listeners can get 50% off Dr. Judy authored books found on NaturallyHealthyPets.com. Just use the coupon code INTELLIGENT50.

Dr. Hoffman continues his conversation with integrative veterinarian Dr. Judy Morgan, DVM, CVA, CVCP, CVFT. 

A tale of 2 pneumonias—NASCAR racer Kyle Busch dead at 41 while Rudy Giuliani, age 81, survives critical care; Newly discovered evidence that Neanderthals were practicing dentistry—59,000 years ago! “Fatty 15”—does it measure up to the hype? Stem Wave—A shocking way to obtain pain relief; When to give antibiotics for a tick bite; Proposed ban on tobacco products for future generations of Brits aims to eradicate smoking.

Soon-to-arrive drugs promise to address elevated Lp(a); Best natural alternatives to repel mosquitoes and ticks; When cancer treatments cause osteoporosis; Organoids and computer simulations promise to reduce the toll of live animal experimentation; Land snails and pythons yield clues for new drug development; Shortfall in doctors accelerated by early retirement as physicians cite “hassle factor.”

Registered dietitian nutritionist Leyla Muedin discusses the growing interest in biological age versus chronological age and explains that biological aging is modifiable through consistent lifestyle choices. She outlines common measurement tools and biomarkers, including epigenetic clocks (DNA methylation), telomere length, VO2 max, inflammatory markers, grip strength, and muscle mass, noting that genetics account for only about 25–40% of biological aging variation. Key interventions include regular aerobic and resistance exercise, protein-adequate nutrition to preserve muscle and prevent sarcopenia (with whey protein and leucine-rich foods noted), improved sleep, stress management, reducing processed foods and visceral fat, and lowering chronic inflammation (CRP, IL-6). She also reviews hormetic stressors such as sauna use and mentions red/near-infrared light and sun exposure without sunglasses. Leyla shares client examples showing biological age can worsen or improve, and encourages repeat testing after lifestyle changes.

An overview of itchingWould tofu be a good addition to my diet?Is TMAO a risk factor for heart disease when eating meat?How about interviewing an expert on vegetarianism?

Would you discuss vertebroplasty vs. kyphoplasty?I recently had a fundoplication surgery and now have gastroparesisCould you recommend a healthy aging supplement?How to treat Meibomian Gland Dysfunction/dry eye disease?Should we get wool carpeting or hardwood flooring?

Dr. Corey Schuler, PhD(c), FNP, DC, CNS, and director of medical affairs at Allergy Research Group, details his paper “Energy Allocation Resilience and Endocrine Integration” in the International Journal of Molecular Sciences. He introduces the Energy Allocation System (EAS), which emphasizes how the body allocates energy—not just produces it—and links many symptoms to impaired bioenergetics and resilience. They discuss mitochondria as energy generators and cellular signaling hubs, the integrated stress response and endocrine coordination (HPA axis, thyroid, gonads), and mitohormesis/eustress (exercise, fasting, heat/cold, circadian “zeitgebers”). Schuler explains nuanced testing for fatigue (diurnal cortisol, CGM patterns, thyroid markers including T3/reverse T3) and a case of a perimenopausal woman where oral contraceptives and cortisol dysregulation affected glucose patterns. They cover mitochondrial support (removing obstacles like pollutants/antibiotics, triglycerides, carnitine, dietary fats, micronutrients) and pacing/sequencing lifestyle interventions.

Dr. Hoffman continues his conversation with Dr. Corey Schuler, PhD(c), FNP, DC, CNS, and director of medical affairs at Allergy Research Group.

Dr. Marty Makary out as FDA Commissioner—was he the victim of a BigPharma purge? Are “liquid biopsies” useful for predicting recurrences, as well as guiding therapy, for cancer? Nighttime smartphone by adolescents surges, eroding kids' sleep needs; Persistent itch may require an “all of the above” approach to break its vicious cycle—could topical vitamin B12 provide an answer? Study critiques research methods that fast-tracked new Alzheimer's drugs.

You won't believe this new medical use for Classic Coca-Cola; The solution for menopausal sleep problems goes beyond mere hormone replacement; Paxlovid strikes out vs. Covid in new trials; Pesticide exposure may explain rising colorectal cancer rates in young people; Big Food touts faulty study that claims healthier food regulations will cost consumers; Higher aerobic fitness boosts size of the brain's memory centers—as does memorizing London taxi routes. 

Eccentric Exercise: Better Results with Less Effort. Leyla Muedin, a registered dietitian nutritionist, discusses eccentric exercise and research suggesting it may deliver better results than strenuous workouts that cause muscle damage and delayed onset muscle soreness (DOMS). She explains contraction types—isometric, concentric, and eccentric—highlighting that eccentric contractions involve muscle lengthening during the lowering phase (e.g., lowering a dumbbell, walking downstairs) and can provide greater mechanical loading with lower perceived effort, less fatigue, and broad accessibility across ages and health conditions, though requiring more focus and control. She cites studies including stair-descending in elderly obese women improving cardiovascular function, insulin sensitivity, cholesterol, and strength, and a five-minute home routine (chair squats, wall pushups, chair reclines, heel drops) improving strength, flexibility, mental health, and encouraging continued exercise. She notes athletic benefits and the need for further research.

Highlights from Dr. Hoffman's Scandinavian tripShould I eliminate the nightshade family of foods from my diet?My friend has been experiencing acid reflux since using a reverse osmosis water filtration system

Where can I access peptide therapy for my wife in California?What are other methods of lowering LDL doing exactly that niacin is not?Should we all be using unbleached toilet paper?Would I benefit from taking minoxidil and finasteride for hair growth?What can I do about my festoons?

Dr. Jacob Teitelbaum, an Integrative Medicine physician, researcher, and best-selling author specializing in chronic fatigue syndrome, details “adrenal fatigue,” contrasting Endocrine Society guidelines focused on overt adrenal failure with his view that the adrenals can be functionally exhausted and may be missed by standard testing and “normal ranges.” They discuss adrenal roles in stress response, blood sugar regulation, blood pressure, immunity, and symptoms suggesting low adrenal function (irritability when hungry, sugar cravings, fatigue, recurrent infections, lightheadedness/brain fog, mood shifts). Contributors include high sugar intake, chronic stress, dehydration, and salt restriction, with modern media fear/divisiveness cited as a major stressor; hypothalamic dysfunction and circadian rhythm disruption may cause “tired but wired” insomnia. They cover options such as licorice (not DGL), dietary and lifestyle changes, Adrenaplex, adaptogens (ashwagandha standards, HRG80 red ginseng study), phosphatidylserine for high nighttime cortisol, cautious low-dose hydrocortisone thresholds, and DHEA/pregnenolone considerations, plus resources at endfatigue.com.

Dr. Hoffman continues his conversation with Dr. Jacob Teitelbaum, an Integrative Medicine physician, researcher, and best-selling author specializing in chronic fatigue syndrome.

Hyperbaric Oxygen Therapy (HBOT): Beyond the Bends—Wounds, Stroke Recovery, Radiation Injury, and Performance. Nicole Garrett, founder and COO of Under Pressure Hyperbarics, details hyperbaric oxygen therapy (HBOT). She explains how HBOT treats divers' decompression sickness by recompressing nitrogen bubbles and reducing inflammation, and how therapeutic benefits depend on reaching adequate pressure (commonly around 2.0 atmospheres or more; diver treatment may begin at 2.8). Garrett describes HBOT's history, FDA-approved uses such as diabetic wound healing, radiation injury, and sudden sensorineural hearing loss (often combined with steroids), and off-label use for stroke/TBI recovery, cognitive issues, autoimmune flares, Crohn's disease, athletic recovery, anti-aging research (including telomere findings), and adjunctive cancer care. She contrasts “soft” chambers with higher-pressure medical chambers, discusses treatment courses (often 10–60 sessions), safety and contraindications (ears, pneumothorax, retinal bubble procedures), and practical barriers like cost, insurance coverage, and facility/oxygen regulations.

Dr. Hoffman continues his conversation with Nicole Garrett, founder and COO of Under Pressure Hyperbarics.

Now do we have to start worrying about Hantavirus? Digestive enzymes for pancreatic insufficiency; Space exploration yields new treatments for resistant bacterial infections; Alternatives to prednisone for autoimmune hearing loss; Casey Means bows out of Surgeon General nomination—next up, Nicole Saphier; Multivitamins found to slow biological aging.

Hydrogen water—breakthrough or scam? Osteoporosis fixes; Nattokinase for cardiovascular prevention; Why vitamin D helps a subset of diabetics; When oral vitamin D doesn't work, sublingual D may normalize blood levels; Vitamin D found beneficial for colitis; Why fructose stokes food cravings; Flawed fluoridation study claims no IQ harms to kids.

Nutritionist Leyla Muedin discusses a listener question about whether agave nectar can contribute to obesity like high-fructose corn syrup, arguing that regular use of sweeteners—including agave, honey, monk fruit, stevia, aspartame, sucralose, allulose, and sugar alcohols—can maintain sweet cravings, spike insulin, and contribute to weight-loss plateaus, with added concerns such as microbiome effects, GI upset, and aspartame's neurotoxicity. She notes insulin's role in fat storage and blood pressure via sodium retention, and suggests that needing a sweetener in coffee or tea may indicate dependence on sweetness. She then covers a newly developed, validated Food Noise Questionnaire (FNQ) published in Obesity to measure intrusive food-related rumination, highlighting its five Likert-scale items, study sample characteristics, and the need for further research, including effects of GLP-1 drugs.

More on “eat the rainbow” . . . or notMedical breakthroughs that we don't really needCan you discuss the order of eating macronutrients and its impact on blood glucose?What about the impact of apple cider vinegar on blood sugar?

If I start taking urolithin A, will it make my insomnia worse?I'm a 54-year-old postmenopausal woman with no libido—can supplements help?Can you talk more about the vegan twin study, saying plant-based diet improved fertility?What do you think of IV NAD vitamin drips?

Sugarless: Dr. Nicole Avena on Hidden Sugars, Brain Addiction, and Practical Steps to Cut Back: Neuroscientist and author Dr. Nicole Avena reveals sugar's pervasiveness and health impacts, drawing on her book “Sugarless: The Seven-Step Plan to Uncover Hidden Sugars, Curb Your Cravings, and Conquer Your Addiction.” Avena explains how modern industrialized, highly processed foods—many containing added sugars—have transformed innate preferences for sweetness into harmful overconsumption linked to obesity, diabetes, cardiovascular disease, non-alcoholic fatty liver disease, and possible dementia via insulin signaling changes. She discusses research showing sugar can stimulate dopamine reward pathways similarly to drugs and that prenatal exposure may alter offspring metabolism, preferences, and sensitivity to drugs/alcohol. For solutions, she discourages strict “cold turkey” approaches due to hidden sugars and relapse psychology, emphasizes inventorying sources and triggers, starting with eliminating sugar-sweetened beverages and sugary coffee drinks, improving breakfast, choosing protein/fat-based snacks, and viewing alternative sweeteners as a temporary crutch; she also notes diet changes can improve mood stability and reduce anxiety.

Dr. Hoffman continues his conversation with neuroscientist and author Dr. Nicole Avena.

Functional Diagnostic Nutrition: Using Saliva Testing, Food Sensitivity Labs, and Lifestyle to Find Root Causes: Reed Davis, Board Certified Holistic Health Practitioner (HHP) and Certified Nutritional Therapist (CNT), is founder of Functional Diagnostic Nutrition (FDN). He discusses using functional testing alongside conventional care to uncover “dysfunction” when standard labs appear normal. Davis describes assessing adrenal and metabolic stress via saliva testing for circadian cortisol patterns, cortisol-DHEA balance, sex hormones, secretory IgA, and melatonin, emphasizing clinical correlation and individualized “studies of one.” He outlines an approach targeting multiple “healing opportunities” (H-I-D-D-E-N: hormones, immune, digestion, detoxification, energy, nervous system) and applying D-R-E-S-S (diet, rest, exercise, stress reduction, supplementation) rather than relying on supplements alone. A case example links chronic hives, medication-related weight gain, and food triggers identified through additional testing, including the Mediator Release Test. The discussion also covers stress-driven gut dysbiosis, digestion decline, and EFT tapping for stress-related symptoms, and notes FDN practitioners can be found via FDNtraining.com/medicine.

Dr. Hoffman continues his conversation with Reed Davis, Board Certified Holistic Health Practitioner (HHP), Certified Nutritional Therapist (CNT), and founder of Functional Diagnostic Nutrition (FDN). 

Registered dietitian nutritionist Leyla Muedin discusses a Nature Communications study of 108,723 French adults in the NutriNet-Santé cohort (2009–2023) examining long-term exposure to food preservatives and type 2 diabetes. Using detailed dietary records cross-referenced with product/additive databases, researchers identified 58 preservative-related additives and analyzed 17 consumed by at least 10% of participants; 1,131 diabetes cases occurred. Higher overall preservative intake was associated with a 47% increased diabetes risk (49% for non-antioxidant preservatives; 40% for antioxidant additives), with several specific additives linked to higher risk. Leyla questions whether the findings reflect preservatives themselves or the ultra-processed, refined-carbohydrate foods that contain them, emphasizing recommendations to favor fresh, minimally processed foods and limit refined carbs and processed foods.

A case study where a second opinion is necessaryWhat are your thoughts on the recent news implicating niacin in cardiovascular disease? 

What could it mean to get spasms in your sleep?  Is this a prediction of Parkinson's?What is the best general magnesium to use?What can my brother with diabetes take for recurrent urinary tract infections?Could my prescribed medications be causing tinnitus?Is the herpes virus a risk factor for dementia?        

Gary Taubes on Rethinking Diabetes: Diet, Insulin, and the History Behind Low-Carb Treatment: Journalist Gary Taubes is author of “Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments.” The book traces diabetes treatment history and argues that carbohydrate restriction was standard care from 1797 through the early 20th century until insulin therapy shifted practice toward drug-centered management and higher-carbohydrate diets. Taubes explains how insulin's discovery changed dietary priorities, how later technology (radioimmunoassay) revealed that most diabetes is type 2 with insulin resistance and high insulin rather than deficiency, and why giving more insulin can worsen weight gain. They discuss major trials (including ACCORD, ADVANCE, and Look AHEAD) that failed to show benefits from intensive drug-based glucose control, the influence of low-fat guidelines, Richard Bernstein's role in blood-glucose self-monitoring and low-carb control, controversies about obesity models, ketosis vs ketoacidosis, GLP-1 drugs, and LDL increases on ketogenic diets.

Dr. Hoffman continues his conversation with journalist Gary Taubes, author of “Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments.”

Urolithin A (MitoPure)--Mitophagy, Muscle Recovery, Immunity, and Skin Health: Dr. Brad Currier, clinical trial manager at Timeline, a Swiss biotech company, details urolithin A (MitoPure), a postbiotic derived from pomegranate precursors that most people cannot produce due to microbiome differences. Currier explains MitoPure's mechanism—stimulating mitophagy to recycle dysfunctional mitochondria—and reviews evidence from multiple clinical trials. He reveals a Sports Medicine study in elite male distance runners showing reduced creatine kinase and lower perceived exertion, suggesting improved recovery, plus trials in middle-aged and older adults showing improvements in strength, six-minute walk test, and VO2 max at 500 mg–1 g doses. They also cover a Nature Aging immune study reporting rejuvenation of stem-like CD8 T cells with improved mitochondrial fatty acid oxidation, ongoing research directions, supplement quality/testing for athletes, and topical urolithin A skincare trials and partnerships, including L'Oréal Lancôme.

Dr. Hoffman continues his conversation with Dr. Brad Currier, clinical trial manager at Timeline, a Swiss biotech company.

Registered dietitian nutritionist Leyla Muedin discusses how exposure to natural daylight may improve metabolic health beyond diet and exercise, highlighting a controlled crossover study of 13 adults aged 65+ with type 2 diabetes published in Cell Metabolism. Participants spent 4.5 days in living spaces lit by either natural light through large windows or artificial light, with identical meals, sleep, activity, and screen time; after a 4-week washout they switched conditions. Natural light was associated with more hours of blood glucose in the normal range, less glucose variability, higher evening melatonin, and improved fat oxidative metabolism, suggesting effects on circadian “body clocks” and coordination between central and peripheral clocks. Muedin recommends getting morning light on the face, reducing sunglasses and high SPF use, dimming lights at night, keeping consistent sleep, and spending more time outdoors; she also notes that architecture can limit sunlight exposure.