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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How Gut Health Impacts Cardiometabolic Disease

As research on gut barrier function and gut microbes (aka the gut “microbiota”) expands, more is realized about the interconnectedness of the human body.  One of the surprising areas is in the way that an unhealthy microbiota is a key driver of obesity, fatty liver disease, metabolic syndrome, type 2 diabetes, and cardiac risk.

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In Pursuit of Best Practice: Menopausal Hormone Therapy (MHT)

I have practiced medicine for more than 30 years. Throughout, I, like most of you, always wished I had more time to read. My wish came true! This past year, I had the opportunity to roll up my sleeves, dig in, and really understand the literature. Literature on what? In addition to being a cardiovascular disease (CVD) expert, I wanted to continue my growth and development as a hormone expert. I wanted to know everything I could about hormones, hormones in health and disease, hormones in both men and women, hormone dosing, delivery systems, and monitoring, such that I could educate myself, fellow clinicians, and patients. And that is exactly what I have done.

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A few additional treatment possibilities in COVID19 (SARS Cov-2) addressing furin-like cleavage and pyroptosis (caspacin-1 activation of inflammasome NLRP3)

The cytokine storm seen in SARS Cov1 and Cov2 might be due to chronic pyroptosis activation. However, known activators of NLRP3 in SARS-CoV differ from CoV2.  While SARS Cov1 and COVID19 are genetically very similar, the extraordinarily high rate of infectivity of COVID19 is unique. Prepublication research suggests the cause might be a unique furin-like cleavage site on the spike protein of Cov2 that was absent in Cov1.  

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Eosinophilic Esophagitis in a 16yo Female: A Case Report

Allie was 16 years old when she first presented in my office with episodic abdominal pain in the lower right quadrant, onset 6 weeks prior, ranging from 2 to 10 on a visual analog pain scale (0=no pain, 10=worst possible pain). Her pain was not associated with reflux, fever, or blood in her stools. Allie had a prior diagnosis of eosinophilic esophagitis (EE), however treatment with diet and a proton pump inhibitor had not been successful.

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Plasmalogen Deficiency, Dementia, and Death with Dr. Dayan Goodenowe

Dr. Goodenowe invented a technology platform in 1999 that has been used to analyze thousands of human samples from around the world. Through collaborations with international researchers and doctors, Dr. Goodenowe has become an expert on the biochemical basis of neurological diseases including Alzheimer’s, Parkinson’s, multiple sclerosis, autism, bipolar disorder, and schizophrenia. Prodrome Sciences uses Dr. Goodenowe’s technology and discoveries to develop blood tests and dietary supplements for the early detection and prevention of disease.

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Best Content of 2019

As we look back over the wealth of content we have shared this past year, we have been so humbled by your feedback and engagement. Below, we highlight our most-read and listened-to articles and podcasts over the past 12 months.

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The Lp(a) Conundrum

Lp(a): What do with DO with it? It’s an unequivocal CV risk marker, and its pathogenic mechanisms are multiple and far-reaching. Yet it’s notoriously refractory to treatment – pharma and FxMed. Get the low-down in this month’s blog: The Lp(a) Conundrum. As you will read in the blog opener, figuring out this conundrum is near and dear to my heart. Shout out to Ann Sims, RD, LD, CDE, CLS for support writing and providing references. Ann also suggested I podcast on NFFM with lipidologist Dr. Thomas Dayspring- we’re coordinating that as I type, so stay tuned. I’d love to hear from you on this one: how are you approaching Lp(a) in practice? Thank you! ~DrKF

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