Intelligent Medicine

Highlights from Dr. Hoffman's New Zealand bike tripDo you prefer whey protein isolate or concentrate?My liver enzymes went up taking a statin drug. My doctor recommends I take milk thistle. What are your thoughts?If any supplement protocols are out of stock, should we make substitutions?

What are your thoughts on peptides?So it's not possible to get enough protein from plants only?What about the downsides to animal protein?Are there any negative reports on the usage of extra virgin olive oil?Is it true that the nutritional value of farmed seafood is the same as wild caught?

Dr. David Clarke, president of the Psychophysiologic Disorders Association, details the link between stress and chronic pain and the scope of brain-generated symptoms. Clarke says many patients have symptoms not explained by disease or injury, estimating about 20% of U.S. adults (about 50 million) live with chronic pain, with costs estimated at $650 billion, and notes clinicians are often not trained to evaluate psychosocial stressors. He describes clues that pain is brain-generated (e.g., multiple long-lasting or shifting symptoms, lack of objective nerve damage) and a broad symptom spectrum from migraines and IBS to pelvic pain and rashes. Clarke discusses adverse childhood experiences, triggers, personality traits, and repressed emotions, cites randomized trials showing “pain relief psychology” can reduce pain and change MRI findings, and shares resources including a clinician directory, self-assessment quiz, and the Curable app. 

Dr. Hoffman continues his conversation with Dr. David Clarke, president of the Psychophysiologic Disorders Association.

How Continuous Glucose Monitors Can Optimize Metabolic Health—and Where GLP-1 Drugs Fit: Emergency physician-turned-preventive/metabolic medicine specialist Dr. Paul Kolodzik of Metabolic MD reveals how continuous glucose monitors (CGMs) are a tool not only for diabetics but also for non-diabetics and pre-diabetics to personalize diet, sleep, and exercise by seeing real-time glucose patterns instead of relying on fingersticks or A1c averages. Kolodzik describes CGM use in his clinic (two-week diagnostic wear, then therapeutic guidance), highlights insulin resistance, fasting insulin testing, glucose variability, and the role of low-carb eating, intermittent fasting, and strength training to improve metabolic syndrome, triglycerides, and fatty liver. They discuss CGM sourcing/cost, device mechanics and accuracy, possible future noninvasive wearables, and GLP-1/GIP weight-loss drugs, emphasizing supervised, limited-dose use with protein and lifestyle changes to avoid muscle loss and weight regain. A free PDF of Kolodzik's book is offered HERE.  

Dr. Hoffman continues his conversation with Dr. Paul Kolodzik of Metabolic MD.

Nutritionist Leyla Muedin discusses nutrition and menopause, defining menopause as 12 months without a period and noting it can occur naturally or due to surgery/medical procedures. She links declining estrogen to increased cardiometabolic risk, endothelial dysfunction, vascular aging, musculoskeletal pain, and higher risks with early menopause (including cardiovascular disease, chronic kidney disease, and dementia), and notes many estrogen-modulated conditions are associated with gut dysbiosis. She emphasizes lifestyle—especially nutrition—as key, highlighting anti-inflammatory, minimally processed eating and warning against ultra-processed foods, refined carbs, and excess omega-6. She cites research that high adherence to a Mediterranean diet improves markers like heart rate, lipids, triglycerides, CRP, and overall cardiometabolic risk, and mentions omega-3s lowering triglycerides while modestly raising HDL and LDL. She reviews diet approaches for hot flashes, suggests reducing caffeine, alcohol, sugar, and carbs, notes some women require (bioidentical) HRT, and describes clients improving symptoms with dietary change.

Half of US adults are interested in GLP-1 agonists for weight lossIs spelt matzoh better than traditional wheat matzoh for Passover?Is a dry red wine preferable to sweet wine or grape juice?Is Einkorn flour a better alternative to modern wheat?Which liver support supplements are best for alcoholic issues?

I was diagnosed with Exocrine Pancreatic Insufficiency. Which digestive enzymes are best to take?I still have pain and tingling after a shingles outbreak. What can I take for it?So many protein shakes contain carrageenan, but isn't it a carcinogen?My 5-year-old grandson has pancolitis.  Do you have any recommendations?What do you think of an organic acids test for chronic fatigue?How can I find the cause of my atopic dermatitis?  

Oral Health, Inflammation, and Periodontal Disease: Dr. William Levine, a board-certified periodontist and chief scientist at Peri Active Oral Rinse, offers a deep-dive on periodontal disease as an infectious inflammatory condition with autoimmune-like tissue destruction. It affects over 50% of U.S. adults over 35 and rises with age. He details bidirectional links between gum disease and systemic conditions, including cardiovascular disease, stroke, diabetes, and some dementias, and notes signs such as bleeding, pain, swelling, loose or shifting teeth, and gum recession. Levine explains plaque, dysbiosis, and biofilms, emphasizing mechanical plaque removal to preserve a healthy oral microbiome. Standard care includes scaling and root planing, possible surgery, and lasers; antiseptic rinses like chlorhexidine can be harsh and limited against biofilms. Levine describes a plant-bioactive rinse (gotu kola, echinacea, elderberry) designed to reduce harmful bacteria, penetrate gums, lower inflammation, and promote repair; xylitol may help via saliva stimulation. He also addresses smoking, dry mouth, fluoride toothpaste, interdental cleaning, and osteoporotic drugs' dental risks.

Dr. Hoffman continues his conversation with Dr. William Levine, a board-certified periodontist and chief scientist at Peri Active Oral Rinse.

Herbal Medicine, Quality Control, and Adulteration Prevention: Mark Blumenthal, founder and executive director of the American Botanical Council (ABC), recounts his entry into herbalism via vegetarianism in 1968, off-grid living, and starting a wholesale herb business in 1974 before shifting to nonprofit education, research, advocacy, and quality control. The discussion covers the evolution from teas and tinctures to standardized extracts, the complexity and synergy of multiple constituents, and how standardization supports quality control and therapeutic consistency. Blumenthal explains ABC's Botanical Adulterants Prevention Program and its free, peer-reviewed resources addressing global fraud, plus GMP requirements and laboratory methods for identity, contamination, and potency testing. He discusses herbs including ashwagandha, turmeric/curcumin and adulteration risks, maca, nigella, and milk thistle, and outlines ABC resources, HerbClip, and membership options at herbalgram.org.

Dr. Hoffman continues his conversation with Mark Blumenthal, founder and executive director of the American Botanical Council (ABC).

Registered dietitian nutritionist Leyla Muedin discusses a New England Journal of Medicine paper (July 2024, cited via Holistic Primary Care) warning about drug-induced magnesium depletion, especially from diuretics, proton pump inhibitors (e.g., Nexium, Prilosec), and certain antibiotics. She notes magnesium is often not routinely measured despite links between deficiency and cardiovascular, metabolic, and neurological problems, including arrhythmias (AFib, long QT, torsades), endothelial dysfunction, and longer ICU stays. Prevalence estimates range from 7–11% (up to 20%) in hospitalized patients and 2–4% among outpatients, with higher rates among long-term PPI and diuretic users. She reviews symptoms and causes, explains limits of serum magnesium testing, highlights associations with diabetes, alcohol use, low potassium and calcium, and outlines evaluation options and oral repletion approaches, favoring better-absorbed forms like magnesium glycinate over oxide due to diarrhea risk.

A discussion of the book "Rethinking Diabetes" by Gary TaubesCORRECTION: Transcatheter Mitral Valve Replacement (TMVR)The impact of hops on the microbiomeA listener's suggestion on avoiding microplastics

What do you think of continuous blood pressure monitors?Should certain supplements be taken at different times of day or apart from each other?My pediatrician couldn't provide a list of calcium-rich foods for my kids with dairy intoleranceWhat are your thoughts on the HPV vaccine?Remembering a long-ago debate with a Quackbuster

Harvard-trained psychiatrist Dr. Georgia Ede is the author of "Change Your Diet, Change Your Mind: A Powerful Plan to Improve Mood, Overcome Anxiety, and Protect Memory for a Lifetime of Optimal Mental Health." She links diet to the mental health crisis and dementia risk. Ede explains that conventional psychiatric training ignored nutrition, and she later incorporated dietary strategies alongside medication and psychotherapy after personal health experiences. She emphasizes focusing on metabolic and nutritional quality—especially stabilizing blood sugar and insulin—rather than simplistic plant-vs-animal messaging. She argues some animal foods are needed for brain nutrients like B12 and EPA/DHA. She discusses ketogenic diets as a way to lower insulin, produce ketones, improve brain energy, and reduce inflammation, citing case reports and a study of hospitalized patients where many improved and 44% reached remission. She critiques nutrition epidemiology as unreliable and outlines three “quiet” dietary tiers: whole-food low-glycemic, ketogenic, and carnivore, plus practical issues like electrolytes and gradual transition.

Dr. Hoffman continues his conversation with Harvard-trained psychiatrist Dr. Georgia Ede, author of "Change Your Diet, Change Your Mind: A Powerful Plan to Improve Mood, Overcome Anxiety, and Protect Memory for a Lifetime of Optimal Mental Health." 

Dr. Bret Scher, medical director of the Coalition for Metabolic Health, discusses making metabolic health the foundation of medicine amid rising obesity and type 2 diabetes and reports that 93% of Americans have suboptimal metabolic health. Scher defines metabolic health using markers including glucose, insulin, triglycerides, HDL, blood pressure, and waist size, and cites evidence linking insulin resistance to heart disease, stroke, cancer, psychiatric illness, and other complications. They discuss simple self- and lab-assessments (waist-to-height ratio, fasting insulin with glucose/HOMA-IR, triglyceride-to-HDL ratio, CGMs). Scher critiques the Eat Lancet report for assuming one optimal diet, reliance on low-quality nutrition epidemiology, potential nutrient shortfalls, and environmental oversimplification, while supporting newer dietary guidelines that allow lower-carb approaches. Part two covers contradictory nutrition studies, distinctions between low-carb and ketogenic diets, emerging “metabolic psychiatry” and ketogenic therapy for mental illness and cognitive decline, limits and rebound risks of GLP-1 drugs, and Coalition efforts to improve school food and influence policy.

Dr. Hoffman continues his conversation with Dr. Bret Scher, medical director of the Coalition for Metabolic Health.

The Havana Syndrome coverup—for years, bizarre symptoms were labeled “mass hysteria”, until a covert CIA op secured a portable device capable of delivering brain-scrambling sound pulses; A report card on this year's flu shot; Omega-3s combat “neuroticism”, dementia—they also tame depression and improve cognitive function and memory in adolescents; A caller with duodenitis wants to know if she should follow advice to take Prilosec for the rest of her life; Is the shingles vaccine worth taking? 

Robotic pets make life easier for patients with dementia; Risks, benefits of “natural” ED formulas; Sorting out those pricey new injectable osteoporosis drugs; Daily multivitamin delays biological aging; Study challenges notion that aging means inevitable decline; Breastfeeding confers weight loss benefits—to moms; Can you avoid a colonoscopy with a new colon cancer blood test? Color blindness may hide warning signs of cancer.

Leyla Muedin, a registered dietician nutritionist, shifts the discussion beyond cholesterol and statins to “hidden” cardiovascular risks from insufficient vitamin K and folate intake. Citing Cleveland Clinic and other research, she notes a high prevalence of vitamin K deficiency in the U.S. and widespread inadequate folate intake globally, including low folate levels among women of reproductive age. She explains that vitamin K2 may help inhibit arterial and soft-tissue calcification via activation of matrix GLA protein, with studies linking higher K2 (MK-7) intake to lower coronary heart disease risk and slowed coronary artery calcification. Folate supports vascular function through homocysteine metabolism, with evidence associating higher folate intake with lower cardiovascular mortality, emphasizing active 5-MTHF over folic acid due to conversion limitations in many people. She also notes statins can downregulate vitamin K metabolism and encourages discussing risks, benefits, and supplements with a doctor.

Want to reverse the declines of ageing? Check your attitude.What are good supplements to take before and after a CT angiogram or any CT with contrast?Can vitamin E increase the risk of hemorrhagic stroke?Is turmeric more bioavailable than curcumin? How much should I use?

More on vitamin E studies.How do I know which ingredients to avoid in my shampoo and soaps?I have lower back pain that came out of the blue!What's the best vitamin C to take for a 78-year-old?Which brand of PEA is the most bioavailable?

Hal Cranmer, co-owner of A Paradise for Parents assisted living homes in Arizona, details improving senior care beyond “warehousing.” Cranmer describes his path from Air Force pilot to assisted living operator and explains changes he implemented over 12 years, emphasizing meaningful exercise (walks, strength training, yoga, multitasking drills) and an “exercise with oxygen therapy” bike. He highlights excessive polypharmacy in seniors and advocates deprescribing, supplement and hormone support when medically ordered, and avoiding sedating drugs used as chemical restraints. Cranmer details a low-glycemic, low-carbohydrate, ketosis-oriented nutrition approach inspired by Dr. Dale Bredesen, reporting significant weight loss and diabetes medication reduction in residents. He discusses COVID practices that preserved family contact and outdoor time, reporting no COVID deaths in his homes, and describes cognitive training via one-on-one Zoom-based brain exercises and personalized memory games.

Dr. Hoffman continues his conversation with Hal Cranmer, co-owner of A Paradise for Parents assisted living homes in Arizona.

Dr. Jacob Teitelbaum, integrative medicine physician, researcher, and best-selling author, has cutting edge strategies for improving sleep. He emphasizes circadian rhythms, time changes, and jet lag. He details reducing stress and “FOMO” from news and social media, prioritizing sleep by cutting nonessential activities, and the health risks of short sleep, including increased heart attack risk, obesity risk, and impaired immunity, plus the role of deep sleep and the glymphatic system. Teitelbaum recommends a dark, cool room, limiting blue light (eye masks, warm/yellow lighting), bedtime routines, sustained-release melatonin, chamomile tea, herbal blends, lavender, magnesium, and addressing issues like sleep apnea (including positional strategies), restless legs (ferritin testing, iron, magnesium), nocturnal hypoglycemia (protein snacks, phosphatidylserine), reflux (bicarbonate, bed elevation), and selective low-dose medications when needed. They also cover daylight saving time adjustment and travel strategies such as shifting schedules, melatonin timing, hydration, and morning light exposure. 

Dr. Hoffman continues his conversation with Dr. Jacob Teitelbaum, integrative medicine physician, researcher, and best-selling author.

Dismal prediction that, by 2050, 60% of women will suffer from cardiovascular disease; Yes, it's true that childhood and adolescent obesity, once rare, is now soaring; Treatments for osteopenia; Dentists continue to write prescriptions for potentially deadly antibiotic; A man, in love with his Chatbot, commits suicide to join her in the virtual world; Olive oil is calorie dense—but its consumption results in weight loss; Can “bio-regulator peptides” stave off kidney failure?

Will RFK Jr.'s efforts to promote nutrition education in medical schools stall? Doctors-in-training embrace “culinary medicine”; As Administration relaxes their regulation, PFAS compounds shown to accelerate biological aging; Is there a cure for ringing in the ears? Biopsies reveal microplastics in 90% of prostate cancers; Can you trust the results of your on-line gut microbiome test? Can sunlight tame autoimmune disease? Birdwatchers have enhanced brain regions for attention and perception. Can one have dental x-rays and a brain MRI on the same day?

Resveratrol + Copper Research, Plus Grain-Free Strategies for Stalled Weight Loss: Leyla Muedin, a registered dietitian nutritionist, answers listener emails. She reviews a small India study (BJC Reports, published September 30, 2025) in which 10 glioblastoma patients awaiting surgery received resveratrol (5.6 mg) and copper (560 ng) four times daily for about 11.6 days, compared with 10 controls; the combination generated reactive oxygen species that deactivated cell-free chromatin particles in the tumor microenvironment and reduced cancer hallmarks. Asked whether this could be prophylactic against cancer, she says it is unknown and requires replication in larger studies, advising supplement use be discussed with a practitioner. She then addresses grain elimination for stalled weight loss: replace grains with more meat and non-starchy vegetables, think beyond typical breakfast foods by using leftovers, and use small portions of starchy vegetables (e.g., squash or potato) if starch helps sleep. She recommends investigating root causes of anxiety and poor sleep and suggests moderation for foods like oatmeal.

A correction from a previous podcast episodeCongratulations on 40 years!Quinoa is not a grain—it's a pseudograinWhen did poisoning our food fall under 'defense'? How does MAHA reconcile this?

I have increased pressure in my eyes, leading to glaucoma. Is there any way to avoid this?Can the long-term effects of chemo cause insomnia and nausea?What do you think of flow drops?  I avoid red meat. Would I still get the same benefits from seafood and turkey?What's the best way to take Endefen powder?

Free Speech, Cancel Culture, and the Mental Health Benefits of Speaking Up: Clinical psychologist Dr. Chloe Carmichael, author of “Can I Say That? Why Free Speech Matters and How to Use It Fearlessly,” frames free expression as a mental health and problem-solving issue amid rising polarization, self-censorship, and cancel culture. Carmichael says authentic speech deepens cognition, aids emotional regulation, and strengthens social support, while chronic suppression can lead to repression, denial, anxiety, depression, and resentment. She describes fear and professional risk after publicly opposing child masking during COVID and argues that labeling speech as “violence” distorts reality, though true threats and incitement differ from words. She distinguishes self-censorship from healthy restraint, offers the WAIT test (Want, Appropriate, Inoculate, Trust), and discusses groupthink, innovation, misinformation debates, time-place-manner limits, and examples from corporate and university settings.

Dr. Hoffman continues his conversation with clinical psychologist Dr. Chloe Carmichael, author of “Can I Say That? Why Free Speech Matters and How to Use It Fearlessly.”

Nutritional Support for Brain Health: Lifestyle, Curcumin, Magnesium, and Key Nootropics: Nutrition educator/formulator Neil Levin from Protocol for Life Balance details nutritional support for brain health amid skepticism about “brain-boosting” supplements, citing a preprint randomized controlled trial using a multifaceted lifestyle plan (diet, exercise, sleep) plus targeted supplementation that reportedly improved and even reversed symptoms in people with mild cognitive impairment. They contrast lifestyle strategies with costly, side-effect-prone injectable “plaque-buster” Alzheimer's drugs and notes debate about whether amyloid is a root cause or byproduct. The conversation highlights inflammation and oxidation as major aging-related brain threats and reviews supplements including a brain-targeted curcumin (discussing bioavailability, delivery methods, blood–brain barrier crossing, and claims of lowering beta-amyloid protein), magnesium L-threonate for CNS delivery, phosphatidylserine and acetylcholine support (including huperzine), ginkgo and gotu kola, glutamine/GABA pathways, creatine, omega-3s (DHA/EPA and algae sources), B vitamins, acetyl-L-carnitine, alpha-lipoic acid, and cocoa flavanols, plus concerns about supplement industry enforcement.

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. 

The MAHA backlash over RFK Jr.'s about-face on glyphosate; Amid the partisan divide, Making America Healthy Again cuts across party lines; New study confirms effectiveness of personalized lifestyle interventions for reversing dementia; After an allergic reaction to the Covid shot, is it safe to take other vaccines? Some GLP-1 users are developing scurvy; Six lifestyle hacks that augment weight loss drugs' cardio benefits.