Intelligent Medicine

Leyla Muedin, a registered dietitian nutritionist in New York City, discusses the growing shift from symptom-only “sick care” to a clinically grounded holistic approach to health and recovery. She argues that self-guided wellness routines can leave gaps when underlying medical issues, mental health conditions, substance use disorders, or trauma remain unaddressed, and emphasizes integrating evidence-based clinical evaluation (including labs and deficiency testing) with lifestyle practices. She explains how treating symptoms in isolation misses connections (e.g., stress, sleep, grief) and defines true holistic care as addressing physical, mental, emotional, relational, environmental, and purpose-related factors without rejecting medical treatment. Key components include consistent movement, individualized nutrition built on basics, nervous system regulation (sleep, nature, breathing, meditation/prayer), meaningful social connection, and a sense of purpose as clinically relevant to resilience.

Is there evidence for statins in the treatment of aortic valve stenosis?How the bacteria behind gum disease can affect heart healthWouldn't it be better to resume taking probiotics after finishing a round of antibiotics?Would it be safe to take olive leaf extract with amoxicillin?I'm considering surgery for varicose veins. Is this just a temporary fix? Can they return?

My 25-year-old son has bipolar disorder and can't tolerate his medications. Any natural recommendations?Is chondroitin effective?  It's in my collagen capsules, which I take to hopefully reduce wrinklesI believe I am still suffering from the negative effects of COVID. What would you suggest I take?

Naturopathic gastroenterologist Mark Davis, ND (FABNG), discusses his work in fecal microbiota transplantation (FMT), research, and integrative approaches to GI disease. Davis explains FMT history, screening criteria, delivery methods, how it differs from probiotics, and why it is highly effective for recurrent C. difficile (about a 90% durable cure), while noting FDA-approved products (Rebyota, Vowst) and off-label applications. He describes IRB-approved studies on naturopathic care for IBS and ulcerative colitis and a blinded project comparing consistency across 15–20 stool microbiome labs. The conversation covers evidence for diet in IBS/IBD (including SCD and a semi-vegetarian diet), low-FODMAP as a temporary tool, breath testing and relapse in SIBO, helminthic therapy options and legality, targeted probiotics (Saccharomyces boulardii, Akkermansia, soil-based species), enema therapies, indigo naturalis benefits and risks, saffron evidence for mood, telemedicine practice, and a crowdfunding platform for clinical trials.

Dr. Hoffman continues is conversation with naturopathic gastroenterologist Mark Davis, ND (FABNG).

Psychedelic Therapy for Mental Health: Research, Safety, and the Path to FDA Approval: Dr. Will Van Derveer and Keith Kurlander, co-authors of “Psychedelic Therapy: A Revolutionary Approach to Restoring Your Mental Health and Reclaiming Your Life,” reveal the shift from recreational psychedelics to structured, research-based psychedelic-assisted therapy for conditions like PTSD, depression, and anxiety. Van Derveer describes limitations of conventional psychiatry (citing STAR*D remission rates) and his entry into MDMA-assisted PTSD research after promising results. They contrast controlled clinical protocols—screening, preparation, safe setting, trained facilitation, medical monitoring, and post-session integration—with uncontained recreational use. The discussion covers current policy momentum under Trump and RFK Jr., VA interest for veterans, and key agents: ketamine (including abuse risks and clinic-only Spravato), MDMA (phase 3 but not approved in 2024), psilocybin (phase 3, potential FDA approval), LSD (GAD trials), ibogaine (arrhythmia risk, Mexico clinics), ayahuasca, peyote, and microdosing. They also note commercialization, including Eli Lilly's acquisition of a 5-MeO-DMT nasal spray developer, and emphasize an integrative “all-of-the-above” mental health approach.

Dr. Hoffman continues his conversation with Dr. Will Van Derveer and Keith Kurlander, co-authors of “Psychedelic Therapy: A Revolutionary Approach to Restoring Your Mental Health and Reclaiming Your Life.” 

Science is conquering diseases—now breakthroughs in gene editing promise to vanquish aging itself; The healing potential of hydrogen; Attending concerts, museums and movies may help keep your body younger; Dr. Jeffrey Bland dishes on the benefits of a new full-spectrum fish oil, Omega-3 Rejuvenate.

This week's supplement spotlight—spermidine; American Heart Association does a 180° on coffee; How accurate are health tracker wearables for sleep, blood pressure, heart rate? A skin disorder practically no one has heard of is often confused for skin cancer; Vitamin D—what forms and what dosages are optimal? Popular sugar substitutes may be worse for the brain than natural sugar.

What Triggers Age-Related Belly Fat? New Stem Cell Findings and a Nutrition Perspective: Nutritionist Leyla Muedin discusses research from City of Hope (published in Science) on why belly fat increases with age even without major weight gain, emphasizing the health risks of visceral fat as an endocrine organ linked to inflammation, diabetes, heart disease, and accelerated aging. The study suggests aging activates adipocyte progenitor cells (APCs) and produces an age-specific stem cell population called committed preadipocytes (CP-As) that generate new fat cells, with experiments showing older APCs create more fat cells even when transplanted into young mice. Single-cell RNA sequencing identified greater CP-A activity in middle-aged mice and similar cells in higher numbers in middle-aged human tissue. Researchers implicate the LIFR signaling pathway and propose future therapies to block these cells, while Leyla questions root causes and argues metabolic dysfunction—insulin resistance, hyperinsulinemia, high carbohydrate intake, and sedentary behavior—should be addressed nutritionally rather than via a pill.

Nature or nurture—which is more important when it comes to health conditions?Would I benefit from taking nattokinase along with my statin?Mechanism of action of nattokinase vs. statin medications on coronary artery health

My LDL is 421, and I have mild to moderate aortic stenosis. Must I take a statin?Lean Mass Hyper-responders on low carb diets explainedWould you consider writing a book about health in advancing age?A revisit of Dr. Hoffman's published booksWhat is the best dose of lithium orotate for therapeutic benefit?Must I exercise fasted? Why?  

The Brain–Body Connection, Gut Health, Stress, and Medical Gaslighting: board-certified psychiatrist Dr. Susan Trachman, author of “It's Not Just In Your Head,” about psychosomatic medicine and the two-way brain–body connection. Trachman explains how patients with complex symptoms are often dismissed as having “medically unexplained symptoms” and discusses medical gaslighting, especially affecting women and people of color, with examples of missed diagnoses. She describes how inflammation, the gut microbiome, leaky gut, diet, probiotics, fermented foods, and even fecal transplants can influence mood and health, and reviews vagus nerve stimulation research. The conversation covers stress effects, including Takotsubo “broken heart” cardiomyopathy, CBT for anxiety, IBS, and pain, the role of sleep and the brain's glymphatic system, pandemic-related mental health and long COVID symptoms, concerns about GLP-1 drugs causing emotional flatness, and careful SSRI tapering to avoid withdrawal. 

Dr. Hoffman continues his conversation with board-certified psychiatrist Dr. Susan Trachman, author of “It's Not Just In Your Head.”

Can Infections Drive Alzheimer's? Nikki Schultek, founder of Intracel Research Group and co-founder of the Alzheimer's Pathobiome Initiative, details evidence that pathogens may contribute to Alzheimer's and other neurodegenerative and neuroimmune disorders beyond the amyloid hypothesis. Schultek recounts her own misdiagnosed systemic illness with neurodegenerative symptoms, later found to involve Lyme disease, Babesia, and chronic infection with the intracellular respiratory bacterium Chlamydia pneumoniae, treated with combination antibiotics. The discussion covers PANS/PANDAS as an infection-associated pediatric neuropsychiatric condition, parallels with neuroinflammation and blood–brain barrier changes, and a 2023 Alzheimer's & Dementia “research roadmap” documenting 86 infection-associated dementia cases and calling for actionable testing and collaboration. They review links involving herpes viruses, COVID-related cognitive decline, gum pathogen P. gingivalis therapies, and controversies around chronic infection diagnosis and long-term antibiotics, and share resources including alzpi.org, ILADS, MAPS, and Schultek's Pathobiome Research Center at PCOM.

Dr. Hoffman continues his conversation with Nikki Schultek, founder of Intracel Research Group and co-founder of the Alzheimer's Pathobiome Initiative.

Diets rich in fruits and vegetables preserve brain function—but in vulnerable persons with the ApoE4 “Alzheimer's gene”, more meat staves off decline, contradicting years of recommendations to minimize animal protein; Supplements for adrenal insufficiency; “Forever chemicals” may weaken teen's bones—but menopausal hormone replacement therapy decisively fends off osteoporosis; Legionnaire's disease strikes poor and affluent alike in New York City; Doctors propose warning labels for GLP-1 drugs on account of this under-appreciated danger.

Pentagon plans widespread testosterone screening for troops; New study claims arthroscopic surgery for age-related degenerative changes of knees is worthless; Widely touted “precision” proton therapy doesn't outperform conventional radiation treatment for prostate cancer; Comparing the effectiveness of gummies and liquids vs. tablet or capsule forms of supplements; Supplements to lower LDL; Lithium orotate for Alzheimer's prevention; Novel ultrasound treatment may target inflammation in osteoarthritis; Researchers explore antiviral treatments for multiple sclerosis.  

Vitamin B12 Deficiency--The “Aging” Symptoms You Shouldn't Ignore: Leyla Muedin, a registered dietitian nutritionist in New York City, discusses vitamin B12 deficiency as a common problem that can mimic normal aging, noting adults need only about two micrograms daily to support red blood cells, nerves, and DNA. She reviews the history of liver treatment for pernicious anemia and explains that deficiency remains common in older adults, vegans/vegetarians, and people with impaired absorption due to low stomach acid, autoimmune gastritis, weight loss surgery, or medications such as metformin and proton pump inhibitors. Symptoms can develop slowly and include fatigue, weakness, shortness of breath, numbness/tingling, poor balance, memory issues, and brain fog; she advises medical evaluation and B12 testing rather than assuming aging or relying on wellness-clinic injections when levels are normal. She emphasizes B12 is primarily in animal foods, so vegans need supplements, and notes broader nutrient shortfalls she sees in vegan clients.

Does coffee really dehydrate you? A deeper dive on this important topicHelp for nighttime urinationPlease discuss aortic dissection

How do I find a preventive cardiologist in northern New Jersey?What is the best supplement for dissolving bone spurs?What is the half-life of vitamin D, either by supplement or sun exposure?What do you think about mushroom coffee? Does it have any health benefits?Please discuss how strontium affects DEXA scan results

Dr. David Chernoff, Chief Medical Officer of Setpoint Medical, discusses electrically driven vagus nerve stimulation (VNS) as a “neuroimmune modulation” approach to autoimmune and inflammatory disease. Chernoff explains the vagus nerve's sensory role in monitoring organs and signaling the brainstem and spleen to regulate immune responses, and how precise stimulation can reduce pro-inflammatory cytokines without immunosuppression. Setpoint's miniaturized, wireless, MRI-compatible implant is placed in an outpatient 45-minute neck procedure and delivers one minute of daily stimulation titrated to an upper comfort level; long-term safety is supported by prior surgical experience and a 242-patient blinded RA study with two-year data, leading to FDA approval for rheumatoid arthritis. The discussion covers add-on use with medications, potential steroid tapering, reimbursement, and research in Crohn's disease, relapsing MS (vision and remyelination), and other conditions, including psoriatic arthritis, lupus, and neurodegenerative diseases.

Dr. Hoffman continues his conversation with Dr. David Chernoff, Chief Medical Officer of Setpoint Medical.

 Mushrooms for Sleep and Cognitive Support: Jim LaValle, a clinical pharmacist, author, and board-certified clinical nutritionist, details Wakunaga/Kyolic's new Specialty Series mushroom products and related health strategies. He reveals a sleep formula with reishi, L-theanine, valerian, and Aged Garlic Extract aimed at calming stress and supporting better sleep. The formula for cognition includes lion's mane for memory support and aronia berry antioxidants. He also emphasizes Aged Garlic Extract's heart benefits. 

Dr. Hoffman continues his conversation Jim LaValle, a clinical pharmacist, author, and board-certified clinical nutritionist.

Carnitine, with acknowledged muscle and brain benefits, may find a new role in supporting cancer immunity; Calcium and vitamin D's bone-building impact may be limited; Internal visceral fat may accelerate brain aging, MRI study finds; The remarkable benefits of a newly-discovered mitochondrial booster—urolithin A (Mitopure®️).

Is it safe to stop statins “cold turkey”? Can the supplement ingredient HMB counteract age-related muscle loss? Researchers may have discovered the key to development of a true fat-burning weight loss medication; Can a mammogram yield clues about cardiovascular risk? Their bottom line threatened by GLP-1 weight loss drugs, BIg Food tweaks portion sizes, adds spices and flavorings to pique blunted appetites; Vitamins A & D may improve lung health for asthma sufferers; When it comes to thyroid medication prescribing, treat the numbers or treat the patient? 

Registered dietitian Leyla Muedin discusses a Frontiers in Microbiology paper suggesting certain probiotics may help sequester heavy metals. The study, sponsored by the Italian company Probiotical and conducted with University of Ghent and University of Piedmont Orientale, researchers used in vitro testing and the SHIME gut simulator to assess Lactiplantibacillus plantarum, Lactobacillus crispatus, and Lactobacillus acidophilus against cadmium, lead, chromium, and mercury. L. plantarum and L. crispatus reduced metal bioavailability primarily in the simulated colonic phase, while L. acidophilus showed minimal detoxification; mercury was least reduced (~10%). An ex vivo mouse-intestine system found probiotic pre-incubation of metals preserved epithelial integrity and reduced inflammatory responses. Leyla notes limitations: corporate funding, only three strains tested, and no in vivo or human trials, though the findings support further animal and clinical research.

Dealing with the heat - Europeans' disdain for air conditioningI have scaly and bumpy areas on my scalp that itch!Did homeopathic human growth hormone increase my cholesterol?

Which is more effective, vitamin K2 or K4?How long can I take L-tryptophan as a sleep aid?  What about 5-HTP?Is there any remedy for frequent nighttime urination?What are some suitable supplements I can take for exercise recovery?

Immune Regulation, Omega-3 Nuance, and Himalayan Tartary Buckwheat with Dr. Austin Perlmutter, chief science officer of Big Bold Health. He details immune regulation as a nuanced, multidimensional system shaped by diet and lifestyle rather than simple “boosting.” Perlmutter explains Big Bold Health's focus on immunometabolism, educating about immune complexity, and conducting studies on nutraceuticals, including use of CGMs and clinical trials. He discusses why eating fish often outperforms refined fish-oil supplements, noting conventional processing (heat, bleaching, deodorizing, esterification) and loss of other lipids and nutrients. Perlmutter highlights specialized pro-resolving mediators (resolvins, protectins, maresins) and vitamins A and D as potentially better preserved in minimally processed oils, and reviews typical omega-3 intake and target ranges. The conversation also covers immunosenescence/inflammaging and Big Bold Health research on sprouted Himalayan Tartary Buckwheat, its high polyphenols (rutin, quercetin), microbiome effects, and studies including epigenetic aging clocks and brain outcomes.

Dr. Hoffman continues his conversation with Dr. Austin Perlmutter, chief science officer of Big Bold Health. 

AI and Generative Biology: Authoring Life, Redesigning Healthcare, and Building Guardrails: Physician and molecular biologist Dr. Adrian Woolfson, co-founder of Genyro, a biotechnology company specializing in synthetic genome design and construction, and author of “On the Future of Species: Authoring Life by Means of Artificial Biological Intelligence,” discusses the convergence of AI with synthetic/generative biology that could make biology programmable and enable genome design and construction beyond traditional gene editing. Woolfson argues that the technology is morally neutral but is arriving rapidly and requires public awareness, governance, and guardrails due to risks, including misuse by authoritarian regimes and biological warfare. He discusses evolution's trade-offs and why he favors limiting human applications to curing disease and extending healthy longevity, while opposing germline modification; he explains germline vs somatic editing and cites the flawed, unethical case of a Chinese scientist attempting inherited HIV resistance. They examine sickle cell disease cures costing $2–$3 million, scalability issues, and trade-offs like malaria protection, and highlight non-medical benefits such as engineered crops, biomaterials, desalination, and DNA-based information storage.

Dr. Hoffman continues his conversation with physician and molecular biologist Dr. Adrian Woolfson, co-founder of Genyro, a biotechnology company specializing in synthetic genome design and construction, and author of “On the Future of Species: Authoring Life by Means of Artificial Biological Intelligence.”

Europeans swelter through historic heat wave—but many resist air conditioning due to ingrained cultural attitudes; Break a sweat to beat the heat; Evidence that aged garlic extract curbs atherosclerosis risk; How to stave off age-related muscle atrophy; Probiotic-infused underwear to nourish the skin microbiome? Niacin augments glioblastoma treatment; Creatine for depression.

Melatonin can reduce chronic pain; Ultra-processed foods are becoming a worldwide scourge; Do biopsies spread cancer? Sauna benefits for staving off dementia; What may cause blood sugars to deteriorate in a heretofore well-controlled diabetic? Causes of excessive sleepiness.

Bone Health Beyond Calcium: Vitamin D, K, Protein, Medications, and Metabolic Risks: Registered dietitian nutritionist Leyla Muedin discusses factors affecting bone health, osteopenia/osteoporosis, and limitations of bone mineral density as a measure of bone strength. She emphasizes optimizing vitamin D via 25-hydroxy D testing (aiming roughly 55–85 and avoiding over 100), ensuring vitamin K for proper calcium placement, and addressing malabsorption from GI conditions, food intolerances, or inflammation. She notes long-term proton pump inhibitor use can impair calcium and magnesium absorption and increase osteoporosis risk. Diet considerations include avoiding overly grain-heavy, acid-forming patterns and ensuring high biological value protein; she also mentions heavy metals affecting bones. Additional assessment includes magnesium and DHEA sulfate, plus resistance and balance training (ideally three times weekly). She highlights research linking hyperinsulinemia/type 2 diabetes/cardiovascular disease to fragility fractures despite normal or higher bone density, proposing carbohydrate restriction, fasting, and ketosis to improve bone remodeling via osteocalcin and mitochondrial function.

Carnivore diet controversiesWhat is a normal oxygen saturation?  Mine has been 92-93 lately?  Is that okay?

I've worked for many years on my feet and had surgery on both knees.  How much glucosamine should I take?Can you discuss oral vs. IV chelation?  How do you determine which is appropriate?How important is nitric oxide, and how can I increase mine?Are there any supplements I should stop taking before getting blood tests?

Cardiovascular Protection Beyond Statins--Nattokinase, Vitamin K2 MK-7, and Clinical Cardio Six: Neil Levin of NOW Foods/Protocol for Life Balance details cardiovascular protection beyond cholesterol-lowering drugs, emphasizing nutrient sufficiency, therapeutic “nutraceutical” dosing, and physician partnership with testing. They discuss nattokinase from fermented natto (typical 2,000 fibrinolytic units/day), describing research on reduced fibrinogen, improved blood viscosity and microcirculation, blood-pressure normalization, and higher-dose data suggesting benefits for arterial thickness and lipids without excessive blood-thinning. They review vitamin K: K1 for normal coagulation (risk with Coumadin relates to day-to-day variability) and K2 for calcium metabolism, highlighting MK-7's longer half-life and potency versus MK-4 and recommending pairing K2 with vitamin D. Levin outlines PFLB Clinical Cardio Six (D3, L-carnitine, hawthorn leaf/flower, solubilized grape seed extract, CoQ10, MK-7), ingredient sourcing/testing, omega-3 benefits, red yeast rice context, and controversy around vitamin E meta-analyses.

Dr. Hoffman continues his conversation with Neil Levin, the Senior Nutrition Education Manager and a product formulator for NOW(r) Foods and Protocol for Life Balance. 

Urolithin A (Mitopure) and Mitochondrial Renewal--Muscle, Immune, and Skin Benefits: Jen Scheinman, MS, RDN, CDN, Director of Science Communications at Timeline details urolithin A and Timeline's branded supplement Mitopure. She describes urolithin A's discovery through pomegranate research and worm studies showing a 45% lifespan increase. She discusses human research including improved walking distance and clinical outcomes in muscle endurance and strength. Urolithin A is presented as supporting mitochondrial health by promoting mitophagy—recycling damaged mitochondria—distinct from other mitochondrial supports like CoQ10 and NAD precursors. They explain most people cannot produce enough urolithin A from foods because only 30–40% convert precursors via the microbiome and it would require about six cups of pomegranate juice daily. Dosing discussed is 500–1,000 mg/day via gummies, capsules, or powder, with effects developing over months. She reviews emerging research on immune aging, preclinical work on brain and neurodegenerative conditions, and topical urolithin A for skin.

Dr. Hoffman continues his conversation with Jen Scheinman, MS, RDN, CDN, Director of Science Communications at Timeline. 

“The quick and the dead”: 80+ “Supermovers” show slowed cognitive decline; Dietary polyphenols help overcome vascular effects of prolonged sitting; Pros and cons of ketamine therapy for depression; Time-restricted eating alters microbiome to promote weight loss; Magnesium—what research reveals about better sleep, stress resilience, and whole-body wellness.

CBD may slow Alzheimer's progression by tamping down brain inflammation; Fifty million dollar settlement in Gardasil Classic action; Urethral stricture as a side effect of ablation for enlarged prostate; Zero-sugar diet may have unanticipated adverse health consequences; Are there drug-free alternatives for atrial fibrillation? Can you reverse lactose intolerance with a skin patch?

Vitamin K2 (MK-7) and Coronary Artery Calcification: Insights from a 2-Year Trial: Nutritionist Leyla Muedin discusses a two-year randomized clinical trial in JAMA Cardiology from Maastricht University Medical Center reporting that daily vitamin K2 (menaquinone-7, MK-7) at 360 mcg slowed progression of coronary artery calcification (CAC) in 180 patients with confirmed atherosclerotic cardiovascular disease and baseline CAC 50–400 Agatston units. Compared with placebo, consistent MK-7 use was associated with 29% lower CAC progression and 42% less arterial calcium mass progression, though CAC still increased in both groups; stenosis increases were numerically lower with MK-7 but not statistically significant. Leyla notes many participants were on statins and were smokers, highlighting that statins can raise CAC by stabilizing soft plaque via calcification. The trial suggests MK-7 may slow calcification in newer plaques, may improve arterial elasticity via matrix GLA protein activation, is inexpensive and safe, but clinical event reduction remains unproven; Leyla suggests considering MK-7 (possibly 360 mcg) with vitamin D, magnesium, and dietary measures.