Intelligent Medicine

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.

A discussion on the concepts of weight-inclusive care and healthismSome comments on medicine's biggest failures

I've read your book on Mitral Valve Prolapse, and it helped to reduce panic attacks...but I'm still depressedThe Singulair debacle What are your thoughts on the Shingrix vaccine?Is essential tremor causing unsteadiness and balance problems when I'm walking?Can kidney stones be controlled with probiotics?What are your thoughts on bone broth?

Integrative ophthalmologist Dr. Rudrani Banik previews Eye Summit 2026, a free online event May 11–15 featuring four daily expert sessions on dry eye and ocular surface disease, cataract surgery advances (including robotic and AI-assisted planning), gut health links to eye disease, and mind-body approaches for migraine, concussion, and visual snow, with VIP options for recordings and live panels. They discuss photobiomodulation (red/infrared/yellow light) as an FDA-approved treatment for age-related macular degeneration with clinical trials showing safety and potential vision improvement, plus research on low-level red light for pediatric myopia. Banik emphasizes annual dilated eye exams after 40 to detect glaucoma and systemic disease. The episode covers dry eye nutrition (dietary omega-3s; supplements including GLA and omega-7; lutein/zeaxanthin with vitamin D), preservative concerns (BAK), GLP-1 drug associations with NAION, gene therapy delivery via viral vectors, and macular degeneration prevention with lutein/zeaxanthin-rich foods like kale, colored peppers, and egg yolks.

Dr. Hoffman continues his conversation with integrative ophthalmologist Dr. Rudrani Banik, who previews Eye Summit 2026.

Preventing Injury, Reframing Pain, and Using Physical Therapy to Avoid Unnecessary Surgery: Dr. Tom Walters is a board-certified orthopedic physical therapist, founder of Rehab Science, and author of “Rehab Science: How to Overcome Pain and Heal From Injury,” an illustrated, body-region guide to common orthopedic problems and self-managed therapeutic exercises. Walters emphasizes using PT-style mobility and resistance training preventively to increase tissue capacity, manage load, and avoid overuse injuries, while warning against “no pain, no gain” and excessive volume or weight. He discusses “movement literacy,” hip and glute stabilizers, and how weakness can drive knee and back problems. Dr. Hoffman shares his own hip injury and recovery with targeted strengthening, illustrating that imaging findings often don't dictate function. Walters explains the biopsychosocial model of pain, graded exposure, the limits of RICE and ultrasound, and roles for manual therapy, taping, TENS, shockwave, acupuncture/dry needling, and PRP. They advocate prehab/rehab around surgery and note PT training and career prospects.

Dr. Hoffman continues his conversation with Dr. Tom Walters, board-certified orthopedic physical therapist, founder of Rehab Science, and author of “Rehab Science: How to Overcome Pain and Heal From Injury.”

New-think on diet for ApoE4, a risk factor for Alzheimer's—eat meat! Is a non-invasive blood sugar monitor on the drawing board for the next Apple Watch? True or false—does drinking carbonated water help weight loss? Eating while distracted puts on the pounds; Treating duodenitis; How much whey protein should you consume? Why some people fail to lose weight on GLP-1 drugs.

Don't skip homocysteine when testing for dementia risk factors; Treating osteoporosis; New hope against pancreatic cancer; Eating right for Parkinson's Disease; Olive oil helps stave off dementia—but only the right kind; A lifestyle hack that can cut Alzheimer's risk by 38%; How to reduce high calprotectin on a stool test.

Dietitian Nutritionist Leyla Muedin discusses a Stanford-led randomized controlled trial published in Nature Medicine in which a five-day, calorie-restricted fasting-mimicking diet improved symptoms and inflammatory markers in people with mild to moderate Crohn's disease. In the three-month study of 97 patients, 65 followed monthly five-day cycles of 700–1100 calories/day with plant-based meals, while 32 continued usual diets; about two-thirds of the fasting-mimicking group reported symptom improvement, with fatigue and headaches but no serious side effects, and fecal calprotectin and other inflammatory molecules decreased. She notes bowel rest and the specific carbohydrate diet as additional approaches. The episode also explains how antibiotics can cause diarrhea by disrupting gut bacteria, lists higher-risk antibiotics, offers supportive steps (hydration, BRAT foods, avoiding irritants), recommends Saccharomyces boulardii taken away from antibiotics, and outlines warning signs requiring medical care, including possible C. difficile.

Is oatmeal healthy?I have a higher-than-normal carotid artery intima-media thickness and no appreciable plaque. Should I be concerned?Should my husband and I take the hepatitis B vaccine?

What is your protocol for 9-11 first responders for addressing toxic burden and immune support?Where do you stand on GLP-1 weight loss drugs? Help vs harm?I have a high ferritin, but cannot donate blood. Other options?

Indoor Epidemic: Prescribing Nature, Light, Air, and Movement with Dr. John La Puma, internist, chef, and regenerative farmer. His book, "Indoor Epidemic," argues that spending about 93% of life indoors undermines health through poor light timing, air quality, limited movement, and reduced nature exposure. La Puma cites data that outdoor morning light helps set circadian rhythms, while nighttime blue light can impair sleep quality and raise cardiovascular risks, referencing a large UK Biobank study. He discusses indoor pollutants and CO2 buildup affecting inflammation and cognition, recommends strategies like getting daylight early (even just a sky view), using circadian lighting, and taking brief outdoor breaks to reduce myopia risk. He describes measurable benefits of forest bathing and gardening (including immune and mood effects), notes hospital studies linking window views to shorter stays and less pain medication, and reviews his pioneering work in culinary medicine now taught widely in medical schools, emphasizing cooking and growing food as preventive and therapeutic tools.

Dr. Hoffman continues his conversation with Dr. John La Puma, internist, chef, and regenerative farmer.

New Study Links Aged Garlic Extract to Better Cognition: Holistic practitioner Jane Jansen from the Tree of Life Wellness Center in Massachusetts reveals a newly published double-blind, randomized, placebo-controlled trial at the Los Angeles Biomedical Research Institute at Harbor-UCLA involving 72 participants with pre-hypertension or hypertension. Over 12 weeks, one group took 2,400 mg/day of Kyolic Aged Garlic Extract (Reserve formula), and cognitive function was tracked using the Montreal Cognitive Assessment (MoCA). Jansen reports that 92% of the aged garlic extract group had no cognitive impairment after the trial, while the placebo group showed more cognitive decline, with benefits attributed to increased nitric oxide bioavailability, improved endothelial function, better cerebral blood flow, nerve protection/repair, and enhanced brain waste removal. She contrasts this approach with costly Alzheimer's plaque-busting drugs and discusses prevention strategies, including diet, sleep (glymphatic system), exercise, inflammation control, and circulation-supporting nutrients such as nattokinase. 

Dr. Hoffman continues his conversation with holistic practitioner Jane Jansen from the Tree of Life Wellness Center in Massachusetts.

Pump up the volume on your exercise with HIIT to optimize disease-prevention; Natural ways to lower your LDL; Choline's impact on the menopausal brain; How targeted supplementation can boost your nitric oxide for better health, an interview with Dr. Nathan Bryan, creator of N1O1.

When GLP-1 drugs supercharge eating disorders; Vitamin C's brain-protective role; Can your fast-fashion clothing give you cancer? As an experiment, scientists invented a fake disease—then AI started reporting it as real; Zeaxanthin could charge cancer treatment; How long is Kyolic aged garlic extract aged?

Nutritionist Leyla Muedin discusses joint inflammation—its symptoms (swelling, pain, redness, warmth, morning stiffness, reduced range of motion) and why it is usually a sign of an underlying condition rather than a disease itself. She reviews common causes including osteoarthritis (cartilage wear and tear), rheumatoid arthritis (autoimmune synovium attack with prolonged morning stiffness and fatigue), gout (uric acid crystals, often in the big toe), psoriatic arthritis, injuries, autoimmune diseases (e.g., lupus, ankylosing spondylitis, Sjogren's), infections such as septic arthritis requiring urgent care, and surrounding-tissue problems like tendonitis and bursitis. Lifestyle factors that worsen inflammation include excess weight, poor diet (including unaddressed food allergies; avoiding nightshades is suggested), insulin resistance contributing to gout, lack of exercise, smoking, and stress. Management strategies include rest, bracing, ice vs. heat, OTC anti-inflammatories, gentle low-impact exercise, anti-inflammatory foods, weight loss, treating root causes, and supplements such as glucosamine, chondroitin, MSM, bromelain, turmeric, Boswellia, and quercetin.

I'm confused by information presented on diets containing meat as being dangerous. Could you shed some light?Assisted living models that would be of benefit to older adults

A comment on Medicare coverage of the hs-CRP blood testAre butyrate supplements beneficial to take?Is iron overload a risk factor for heart attack?Nattokinase lowered my blood pressure!Is there a danger of clot relocation when taking systemic enzymes?

Integrative rheumatologist Dr. Aly Cohen combines conventional rheumatology medications with lifestyle and environmental health approaches to manage autoimmune disease, emphasizing nutrition, sleep, exercise, the gut microbiome, and reducing exposure to synthetic chemicals, pesticides, and contaminated water. They discuss how immunosuppressive drugs can be lifesaving but carry infection risks, and how “risk mitigation” and anti-inflammatory dietary patterns can support resilience. Cohen highlights vitamin D's importance in autoimmunity and COVID outcomes and lists four foundational supplements: a clean multivitamin (including iodine), vitamin D3 guided by blood levels, a quality probiotic, and omega-3 fish oil with adequate EPA+DHA; they also cover cautious use of curcumin, limited enthusiasm for glucosamine/chondroitin, and a measured view of collagen. Cohen promotes her hybrid Smart Human Health Summit on women's health (Saturday, April 25), featuring clinicians speaking on menopause/HRT, dementia, cardiology, endocrinology, GLP-1s, and toxins, with in-person, virtual, and recorded access.

Dr. Hoffman continues his conversation with Integrative rheumatologist Dr. Aly Cohen. 

Bioethicist and psychiatrist Dr. Aaron Kheriaty, author of “Making the Cut: How to Heal Modern Medicine,” discusses declining public trust in healthcare. Kheriaty describes his medical training and argues medicine has become an industrial, bureaucratic “turnstile” system that dehumanizes care, turns physicians into data-entry clerks, and relies on reimbursement-driven “guidelines” and narrow evidence-based medicine that favors costly pharmaceuticals. He proposes creating “parallel” grassroots medical institutions—such as direct primary care—analogous to homeschooling and Eastern European dissidents' “parallel polis,” since systemic reform from within is difficult. Kheriaty recounts opposing COVID vaccine mandates at UC Irvine, being fired after suing, and participating in Missouri v. Biden and Ho v. Newsom, which challenged government-influenced social-media censorship and California's physician “misinformation” law. He also discusses informed consent, assisted suicide opposition, and advocating opt-in organ donation.

Dr. Hoffman continues his conversation with bioethicist and psychiatrist Dr. Aaron Kheriaty, author of “Making the Cut: How to Heal Modern Medicine.”