Short-Chain Fatty Acids: Strengthen the Gut-Brain Health Connection with Butyrate

All SCFAs have wide-ranging therapeutic benefits, but in this article we’ll focus on butyrate as a therapeutic agent for gut and brain health. Butyrate is the food for the colonocytes, the thin layer of cells that comprises the lining of the large intestine. Within the intestinal environment, it protects and supports the mucosa, gut motility, and the commensal bacteria of the colon. Although butyrate is largely present in the gut, it can also have effects on the brain via the gut-brain axis, as well as by lowering inflammation, stabilizing DNA structure, and sequestering harmful metabolic by-products like ammonia.

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Trauma, Biological Embedding, and the Prevention of PTSD

Living in Sandy Hook, practicing medicine in Sandy Hook, my life – and the lives of all of us here – continue to be influenced by the 12/14/12 mass shooting. The day it happened, despite not losing a child in the tragedy, I was gutted, locked in grief. I also remember thinking that it couldn’t…

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Acne, the Skin Microbiome and Salicylic Acid Treatment

There has been a lot of published research lately around the role of our skin’s microbiome on overall immune health as well as the impact bacterial dysbiosis has on different diseases. The bacteria Cutibacterium acnes (C. acnes) — one of the most abundant strains of bacteria in most people’s facial microbiome — has long been associated with acne lesions. But, how does acne occur and how does our microbiome impact it?

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The Journey to “Evidence-Based” for Functional Labs

In the Functional Medicine space, we all desire to be described under the banner of “Evidence-Based.” What does that mean, and how do we get there? In this article I will attempt to address the laboratory component of this question from the perspective of a company in the middle of this ongoing journey. The value of self-critique and continual self-examination: There is a pattern I have witnessed in the Functional Medicine Lab industry that needs to be challenged from within. We develop tests, leverage them as much as we can, and then wait for competitors or critics to raise objections or questions. If those objections never come, we may be tempted to push forward without continuing to pursue both analytical and clinical validation. Continuous self-critique is critical!

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Beyond Breath Testing: Using the GI-MAP to Uncover the Other Players in SIBO

SIBO is on the top of everyone’s mind these days. In this sponsored blog by Dr. Amy Rolfsen, ND at Diagnostic Solutions Laboratory, we review why SIBO breath testing by itself just isn’t enough. To design an effective treatment protocol the first time, we need the whole picture of gut health, including digestion, immunity, commensals, pathogens, opportunists, and more. There are many useful scientific tidbits in this well-referenced blog, and I hope you read, comment, and share! Enjoy!

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Navigating an Elimination Diet: Creative Solutions to Common Challenges

Callout to clinicians:  Yes, we still prescribe the tried-and-true elimination diet for many people, although we’re aware that increased hypersensitivity can occur in a small subset of individuals. Read on to see how we’re identifying and customizing an elimination plan for these vulnerable individuals. – DrKF Have you ever noticed that you feel bloated after…

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Iodine Deficiency, Breast Health, and Hormone Balance

Iodine was discovered in 1811 by French chemist Bernard Courtois while processing ingredients for gunpowder. In extracting sodium salts from seaweed by treating it with sulfuric acid, he observed a purple vapor rising from the seaweed. This substance was eventually named iodine, from the Greek word for the color violet, ioeides. Iodine is an essential trace element necessary for the production of all hormones in the body and proper function in the immune system.[2] It plays a vital role in several aspects of health, including:

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Why We Need to Evolve the Evidence Base for Personalized Nutrition and Functional Medicine

I deeply appreciate this important topic brought to us by Dr. Michelle Barrow as she answers questions put to her by our Nutrition Programs Director, Romilly Hodges. This exchange was prompted by Dr. Barrow’s recent peer-reviewed publication – Transforming Personalized Nutrition Practice – a worthwhile read which came across Romilly’s desk earlier this year. After all, personalized nutrition is a core component of the Functional Medicine toolkit. As a profession (of both functional medicine and personalized nutrition practitioners), we need take steps to bridge the gap between currently-accepted evidence models and what is actually needed to support our practice. We need to ask the hard questions; and take the steps to build a better model. It’s something I have proposed before, and I am absolutely delighted to continue to champion. – DrKF

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Uterine Fibroids: Mechanisms, Treatment Challenges and the Power of Embracing a Functional Approach

Uterine fibroids are a huge, underappreciated issue. They are the most common gynecological disorder, affecting nearly half of women younger than 40 years old, and far more (~80%) for those older. Frankly, I don’t think we are doing enough to help these patients. Fibroids are the leading indication for hysterectomy in the US, accounting for 39% of all hysterectomies each year, and while some are asymptomatic, symptoms include heavy and prolonged periods, difficulty with intercourse, bowel dysfunction, non-cyclic pelvic pain, low back pain, urinary frequency and urgency, and constipation. Because not all fibroids cause heavy bleeding, their impact can be missed, think: refractory constipation or incontinence. Conventional treatments include pharmacotherapy, surgical interventions, and uterine artery embolization, however, these treatments leave much to be desired. Oral contraceptives are used to manage bleeding, and even after myomectomy, fibroids often recur and 10% of women will undergo hysterectomy within 5 – 10 years.

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Navigating Obesity in Immune Dysfunction

Everyone’s awareness about comorbidities, especially overweight and obesity, is heightened due to COVID-19. And in two recent WebMD polls, up to 47% of women and 55% of men report gaining weight during the lockdown – no surprise there – but this may imply patients may be more interested in achieving weight loss goals as part of their overall health care than in previous times. Except we know conventional weight loss programs that lead to a calorie deficit are woefully inadequate (even counterproductive), leading to poor resistance to infection and malnutrition, as Corey Schuler from Integrative Therapeutics explains in this blog below. Read on to learn about the immunometabolic changes brought about in obesity, how to counter them, and I for one, am super grateful Corey relays this encouraging fact: losing just 5% of body mass leads to significant benefits.

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Obstructive Sleep Apnea: Using Orofacial Myofunctional Therapy as a Part of a FxMed Approach to Treatment

Obstructive Sleep Apnea is a condition affecting up to 22 million Americans and close to 1 billion people worldwide.

This condition can have serious impacts on overall health and has been shown to be a contributing factor to:

heart disease
diabetes
stroke
cognitive decline
weight gain
daytime fatigue
anxiety
depression
chronic pain
teeth grinding
and chronic headaches

There are a variety of treatment options available to manage Obstructive Sleep Apnea including Positive Airway Pressure devices (the most common being CPAP), dental mandibular advancement appliances, and various surgeries, but there are also functional treatment approaches that can target the underlying causes of the disease.  

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Respiratory Health and the Microbiome: The Gut-Lung Axis

Respiratory conditions, both chronic and acute, are some of the most common issues seen in clinical practice. In 2016, chronic obstructive pulmonary disease (COPD) alone accounted for around 3 million deaths, and was the third leading cause of death worldwide. Asthma is one of the most common chronic diseases globally affecting nearly eight percent of people (over 24 million) in the US alone. Childhood onset of asthma can impair airway development, and persist into adulthood. Adult asthma may accelerate the decline of pulmonary function, and increase susceptibility to infection

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A Few Surprises About Ketogenic Diets and Their Effects on the Microbiota and Th17

As you know, here at drkarafitzgerald.com we like to push the boundaries of what we know, and sometimes this means being a little contrarian. In this blog, our Nutrition Director, Romilly Hodges CNS takes us on a tour of some of the emerging research on Th17 prompted by a new paper in the journal Cell, that postulated a reduction in Bifidobacteria may mediate some of the benefits of a ketogenic diet for epilepsy by reducing Th17.

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Eosinophilic Esophagitis (EOE): A Deeper Look at Antecedents, Triggers, and Mediators

My first EOE patient in the early 2000’s was fortunately, already diagnosed by a very savvy Yale gastroenterologist. I hadn’t heard of EOE at that time, but quickly learned about this highly challenging and potentially disabling mixed IgE allergic condition. It was clear immediately that functional medicine was the solution, and despite my lack of awareness of EOE, I had much to offer my first patient. Since then, we’ve seen more and more EOE patients in clinical practice, unfortunately, due to the meteoric rise of this condition. Fortunately, our tools continue to benefit.

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I am eternally grateful to our sponsors who, by advertising with us, enable me and my team to devote energy and time to writing and publication. All the companies who sponsor us are companies that I trust for myself and my patients and use regularly in my clinical practice. Please check out their websites! – Dr. KF

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