The Root Cause Medicine Podcast

Rupa Health
  • 4.8 (564)
  • Medicine
  • Updated Weekly

In each episode, we’ll meet renowned medical experts, specialists and pioneers who’ve influenced the way certain conditions and diseases are understood and treated. We focus on giving you the information you need to understand the root cause, symptoms and treatments available for specific medical conditions.

  1. 3d ago

    Immunometabolism: What Your Immune System Can Teach You About Metabolic Health

    What if metabolism and immune function aren’t separate systems, but part of one continuous conversation? In this episode of the Root Cause Medicine Podcast, Dr. Jeffrey Bland joins Kate Kresge to explore immunometabolism, the study of how immune activity and cellular metabolism influence one another. They discuss how inflammation can affect energy use across tissues, why metabolic health is about far more than weight, and how systems biology is changing the way clinicians think about chronic disease. (O'Neill 2016) Dr. Bland also introduces emerging inflammatory indices—including the Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI)—that can be derived from components of a routine CBC with differential. (Islam 2024) The conversation explores their potential role as contextual markers of inflammatory activity, while emphasizing how Journeys can help to automate CBC calculations and help create customized reports for practitioners using blood labs values, history, symptoms and more.  The episode closes with a practical look at nutrition, polyphenol-rich foods, lifestyle medicine, large-scale health data, and the growing potential for personalized care. Clinical Takeaways from This EpisodeImmunometabolism connects immune signaling with cellular energy use. Immune cells alter their metabolic activity when activated, and immune-derived signals can influence the function of tissues throughout the body. (O'Neill 2016)Chronic inflammation is a systems-level process. Rather than viewing inflammation as an isolated problem within one organ, immunometabolism highlights communication among adipose tissue, the liver, brain, muscles, immune cells, and other tissues. (Burak 2024) (Juárez-Rojas 2024)A CBC may contain more information than clinicians traditionally use. SII and SIRI combine routinely measured blood-cell populations into indices being studied as markers of systemic inflammatory and immune activity. (Islam 2024) They should be interpreted in clinical context rather than used independently to diagnose disease or dictate treatment. (Mangoni 2024)Lifestyle interventions affect multiple biological systems at once. Dr. Bland discusses dietary patterns rich in diverse plant compounds alongside movement, sleep, and stress management as components of a broader approach to metabolic and immune health. (Koelman 2022)Practitioners can order Dr. Jeff Bland’s Immunometabolic Journey on Fullscript.com Guest Introduction Dr. Jeffrey Bland is a longtime leader in functional and systems-based approaches to health and one of the influential voices behind the development of functional medicine. His work focuses on translating complex biology—including immunology, metabolism, nutrition, genetics, and systems medicine—into clinically meaningful ways of thinking about health. In this conversation, he brings that systems perspective to immunometabolism and explores how clinicians may begin connecting familiar laboratory data with a deeper understanding of immune and metabolic function. FAQ What is immunometabolism?Immunometabolism examines the two-way relationship between immune function and metabolism. Immune cells require energy to perform their functions, and changes in their metabolic state can influence inflammatory signaling and communication with other tissues. (O'Neill 2016) What are SII and SIRI?SII and SIRI are calculated indices derived from blood-cell counts commonly included in a CBC with differential. They have been studied across several clinical populations as markers associated with systemic inflammatory and immune activity, but they are nonspecific and should be interpreted alongside the broader clinical picture. (Islam 2024) Can SII or SIRI diagnose chronic inflammation?No single index can establish the cause or clinical significance of inflammation on its own. These measures may provide additional context, but symptoms, medical history, other laboratory findings, medications, acute illness, and underlying conditions can all influence blood-cell counts. (Mangoni 2024) Why does mitochondrial function come up in a discussion about immunity?Immune activation changes cellular energy demands. Because mitochondria and other metabolic pathways help determine how cells generate and use energy, cellular metabolism is closely connected with immune-cell behavior. (O'Neill 2016) How can practitioners order a CBC with SIRI and SII calculations included?Ordering a CBC and other biomarkers included in the Immuno-Metabolic Journey from Dr. Jeff Bland allows for automatic calculation of SIRI and SII, as well as recommending next steps for clinicians depending on findings.  Timestamps 02:22 — What immunometabolism means Why immune function and metabolism can no longer be viewed as separate biological systems. 06:15 — From “angry fat” to systems biology How communication between immune cells and adipose tissue helped shape modern thinking about immunometabolism. 09:31 — Immunometabolism and root-cause thinking Looking upstream from organ dysfunction toward the processes that may be influencing it. 17:23 — Metabolism is more than weight Cellular energy production, mitochondria, inflammation, and why metabolic function affects the entire body. 22:01 — What a routine CBC may reveal Moving beyond gross abnormalities to explore patterns within the CBC with differential. 23:20 — Introducing SII and SIRI How researchers combine neutrophils, lymphocytes, platelets, and monocytes into inflammatory indices. 34:06 — Translating biomarkers into whole-person care Nutrition, polyphenols, movement, sleep, and stress management enter the conversation. 39:27 — Why food complexity matters Dr. Bland uses buckwheat to illustrate the diversity of plant polyphenols. 46:38 — Big data and personalized medicine How large health datasets may help researchers identify more individualized biological patterns. 54:43 — Owning your health Dr. Bland closes with a message about agency, personalization, and creating healthier patterns over time. Want to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care. Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine. CitationsBurak, M. F., Stanley, T. L., Lawson, E. A., Campbell, S. L., Lynch, L., Hasty, A. H., Domingos, A. I., Dixit, V. D., Hotamışlıgil, G. S., Sheedy, F. J., Dixon, A. E., Brinkley, T. E., Hill, J. A., Donath, M. Y., & Grinspoon, S. K. (2024). Adiposity, immunity, and inflammation: Interrelationships in health and disease—A report from the 24th Annual Harvard Nutrition Obesity Symposium, June 2023. The American Journal of Clinical Nutrition, 120(1), 257–268. https://www.sciencedirect.com/science/article/abs/pii/S0002916524004556Islam, M. M., Osoydan Satici, M., & Eroglu, S. E. (2024). Unraveling the clinical significance and prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and delta neutrophil index: An extensive literature review. Turkish Journal of Emergency Medicine, 24(1), 8–19. https://pubmed.ncbi.nlm.nih.gov/38343523/Juárez-Rojas, J. G., Reyes-Barrera, J., & Medina-Urrutia, A. X. (2024). Adipose tissue immunometabolism: Unveiling the intersection of metabolic and immune regulation. Revista de Investigación Clínica, 76(2), 65–79. https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0034-83762024000200001Koelman, L., Egea Rodrigues, C., & Aleksandrova, K. (2022). Effects of dietary patterns on biomarkers of inflammation and immune responses: A systematic review and meta-analysis of randomized controlled trials. Advances in Nutrition, 13(1), 101–115. https://pmc.ncbi.nlm.nih.gov/articles/PMC8803482/Mangoni, A. A., & Zinellu, A. (2024). The diagnostic role of the systemic inflammation index in patients with immunological diseases: A systematic review and meta-analysis. Clinical and Experimental Medicine, 24(1), Article 27. https://link.springer.com/article/10.1007/s10238-024-01294-3O'Neill, L. A. J., Kishton, R. J., & Rathmell, J. (2016). A guide to immunometabolism for immunologists. Nature Reviews Immunology, 16(9), 553–565. https://pubmed.ncbi.nlm.nih.gov/27396447/Zeevi, D., Korem, T., Zmora, N., Israeli, D., Rothschild, D., Weinberger, A., Ben-Yacov, O., Lador, D., Avnit-Sagi, T., Lotan-Pompan, M., Suez, J., Mahdi, J. A., Matot, E., Malka, G., Kosower, N., Rein, M., Zilberman-Schapira, G., Dohnalová, L., Pevsner-Fischer, M., … Segal, E. (2015). Personalized nutrition by prediction of glycemic responses. Cell, 163(5), 1079–1094. https://www.cell.com/cell/fulltext/S0092-8674(15)01481-6

    Immunometabolism: What Your Immune System Can Teach You About Metabolic Health

  2. Aug 17

    One Hidden Immune Trigger Everyone Misses: A Complex Autoimmune Case Study

    What happens when a patient with multiple autoimmune conditions has already addressed the obvious contributors—but continues to experience flares? In this Root Cause Medicine Podcast case study, Dr. Kate Kreske sits down with clinical nutritionist and IFM-certified practitioner Robyn Puglia to explore a complex case involving polyautoimmunity and persistent immune dysregulation. The patient had already worked with multiple practitioners and undergone extensive evaluation, including assessments related to gut health, food reactivity, mold, and stress. Yet something was still being missed. Robyn explains how additional testing shifted her attention away from the gut and toward an unexpected area: the respiratory tract. She walks through how those findings changed her clinical thinking, why complex cases sometimes require practitioners to reconsider their assumptions, and what happened when the care plan was adjusted based on this new information. The conversation offers an important reminder for practitioners: deeper testing can sometimes provide useful clues, but results need to be interpreted within the broader clinical picture rather than treated as a diagnosis on their own. Key TakeawaysHow Robyn approaches highly complex patients who have already addressed many common contributorsWhy gut health should not automatically be assumed to be the primary driver of every autoimmune presentationHow testing identified a respiratory microbial pattern that had not been clinically obviousWhy laboratory findings are most useful when interpreted alongside symptoms, history, prior testing, and the overall clinical pictureHow unexpected findings can change clinical decision-making in complex casesWhy an individual case can illustrate clinical reasoning without establishing that the same testing or intervention will produce similar outcomes in other patients Episode Highlights When the obvious answers have already been explored Robyn describes her practice as serving patients at the “zebra” or even “unicorn” stage—people who have often seen multiple experienced practitioners and already addressed common areas such as nutrition, metabolic health, circadian rhythms, stress, and gut health. Looking beyond the gut in autoimmunity The featured patient had four autoimmune conditions and continued experiencing immune dysregulation and flares despite significant previous investigation and improvement. Rather than assuming the gastrointestinal tract remained the primary contributor, Robyn expanded the investigation. An unexpected respiratory finding Testing suggested a respiratory tract microbial pattern despite the absence of obvious respiratory symptoms. This finding shifted Robyn's clinical hypothesis and became an important part of how she approached the case. Practitioner TakeawayWhen a complex patient has already addressed the most plausible contributors but continues to experience symptoms, repeating the same investigation may not provide the missing answer. Consider stepping back and asking whether another system, exposure, infection, or contributor deserves evaluation. At the same time, avoid allowing a single specialized test result to become the new explanation for the entire case. Use testing to inform clinical reasoning alongside the patient's history, symptoms, conventional evaluation, and other relevant findings. Want to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care. DisclaimerThe views expressed on this podcast are those of the hosts and the guests, and they don't necessarily reflect the views of FullScript or any affiliated organizations. This podcast is for informational and educational purposes only, and it's not intended to be medical advice. For your safety, always check with your healthcare provider before making any changes to your healthcare routine.

    One Hidden Immune Trigger Everyone Misses: A Complex Autoimmune Case Study

  3. Aug 13

    TG6, Lymphocyte Patterns and Early Autoimmunity

    What if some of the immune activity we’re looking for isn’t showing up where we expect to find it? In this episode, I sit down with Robyn Puglia of Cyrex Laboratories to explore TG6, lymphocyte patterns, and early autoimmunity—and specialized testing many practitioners may not realize is available through Cyrex Array 3, the Lymphocyte Map, and Array 5. We look at neurological manifestations of gluten-related disease, what different immune cell populations may add to the clinical picture, and how autoantibodies can sometimes appear before autoimmune disease is diagnosed. The bigger question: Can seeing more of the immune story help us ask better questions about what may be driving a complex presentation? What You’ll LearnWhy gluten reactivity isn’t always a gut story. TG6 has been studied in gluten-related neurological disorders, particularly gluten ataxia. (Hadjivassiliou 2019) We discuss why neurological symptoms may belong in the gluten conversation and what Cyrex Array 3 is designed to investigate beyond conventional celiac markers. (Mearns 2019)What your lymphocyte count may not tell you. T cells, B cells, natural killer cells, and their subsets have different jobs. Robyn explains how the Cyrex Lymphocyte Map looks at these populations and how patterns may help practitioners decide what to investigate next.Why autoimmunity may start before the diagnosis. Disease-associated autoantibodies can precede clinical disease in several autoimmune conditions. (Ma 2017) We explore Cyrex Array 5, tissue-associated autoantibodies, and what these earlier immune signals may—and may not—tell us. (Frazzei 2022) Meet Robyn PugliaRobyn Puglia’s work with celiac disease, neurological symptoms, autoimmunity, and complex chronic illness pushed her to ask what the immune system might be telling us beyond a routine workup. Today, as Vice President of Practitioner Education at Cyrex Laboratories, she teaches practitioners how to think about specialized immune testing without treating an abnormal biomarker as a diagnosis. FAQWhat is TG6, and why does it matter?Most practitioners know tissue transglutaminase 2 (TG2) from celiac testing. Tissue transglutaminase 6 (TG6) has been studied in gluten-related neurological disorders, particularly gluten ataxia. (Hadjivassiliou 2019) TG6 isn’t part of routine guideline-supported celiac screening, but it highlights an important point: gluten-related immune disease can have extraintestinal manifestations, including neurological symptoms. (Mearns 2019) (Rubio-Tapia 2023) What is Cyrex Array 3?Array 3 evaluates antibody reactivity to multiple wheat-associated antigens and transglutaminases, including TG6. It provides a broader look at wheat-associated immune reactivity than conventional celiac serology. It shouldn’t replace established evaluation for celiac disease or wheat allergy; the value of additional biomarkers depends on the clinical question and the evidence supporting their intended use. (Rubio-Tapia 2023) (Leonard 2017) What can the Lymphocyte Map show?The Cyrex Lymphocyte Map examines populations and subsets of T cells, B cells, and natural killer cells. Instead of asking whether one value is simply high or low, Robyn looks at the pattern and asks what might explain it. Infection? Medication effects? Immune dysfunction? Another clinical process? The pattern isn’t the diagnosis. It helps sharpen the investigation. Can autoimmunity start before the diagnosis?Yes. In several autoimmune diseases, researchers have detected disease-associated autoantibodies before patients meet formal diagnostic criteria—sometimes years earlier. (Ma 2017) Cyrex Array 5 evaluates multiple tissue-associated autoantibodies that Robyn discusses in this context. But an autoantibody isn’t a crystal ball. Its significance depends on the specific marker, the patient, and the evidence supporting its clinical use. (Ma 2017) Does Cyrex offer all of these tests?Yes. Cyrex offers the specialized tests discussed in this episode, including Array 3, the Lymphocyte Map, and Array 5, along with additional testing related to mucosal immunity and barrier function. The important question isn’t, “How much can I test?” It’s “What am I trying to understand, and will this result change what I do next?” Timestamps02:42 — The patients who pulled Robyn deeper into immunology How celiac disease and unexplained illness changed her approach to complex patients. 11:41 — TG6: When gluten becomes a brain conversation Why gluten-related immune activity isn’t necessarily confined to the gut. 13:49 — Are we asking enough questions about wheat? The thinking behind Cyrex Array 3 and its broader look at wheat-associated antigens and transglutaminases. 28:29 — What if autoimmunity starts before the diagnosis? Tissue-associated autoantibodies, Array 5, and preclinical autoimmunity. 33:49 — Your lymphocyte count isn’t the whole story T cells, B cells, natural killer cells, and the Cyrex Lymphocyte Map. 39:25 — The abnormal result is where the investigation starts How immune patterns can generate better clinical questions. 44:20 — Stop looking for one perfect root cause Robyn’s “aggregate gains” approach to complex illness. 50:49 — What else can we see in the immune system? Tissue autoantibodies, mucosal immunity, and barrier biomarkers. 57:42 — When neurological symptoms change the workup Why brain symptoms may require a broader metabolic, vascular, and immune picture. Want to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care. DisclaimerThe views expressed on this podcast are those of the hosts and the guests, and they don't necessarily reflect the views of FullScript or any affiliated organizations. This podcast is for informational and educational purposes only, and it's not intended to be medical advice. For your safety, always check with your healthcare provider before making any changes to your healthcare routine. CitationsFrazzei, G., van Vollenhoven, R. F., de Jong, B. A., Siegelaar, S. E., & van Schaardenburg, D. (2022). Preclinical autoimmune disease: A comparison of rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis and type 1 diabetes. Frontiers in Immunology, 13, 899372. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9281565/Hadjivassiliou, M., Croall, I. D., Zis, P., Sarrigiannis, P. G., Sanders, D. S., Aeschlimann, P., Grünewald, R. A., Armitage, P. A., Connolly, D., Aeschlimann, D., & Hoggard, N. (2019). Neurologic deficits in patients with newly diagnosed celiac disease are frequent and linked with autoimmunity to transglutaminase 6. Clinical Gastroenterology and Hepatology, 17(13), 2678–2686. https://www.cghjournal.org/article/S1542-3565(19)30278-2/fulltextLeonard, M. M., Sapone, A., Catassi, C., & Fasano, A. (2017). Celiac disease and nonceliac gluten sensitivity: A review. JAMA, 318(7), 647–656. https://jamanetwork.com/journals/jama/article-abstract/2648637Ma, W. T., Chang, C., Gershwin, M. E., & Lian, Z. X. (2017). Development of autoantibodies precedes clinical manifestations of autoimmune diseases: A comprehensive review. Journal of Autoimmunity, 83, 95–112. https://www.sciencedirect.com/science/article/abs/pii/S0896841117303542Mearns, E. S., Taylor, A., Thomas Craig, K. J., Puglielli, S., Cichewicz, A. B., Leffler, D. A., Sanders, D. S., Lebwohl, B., & Hadjivassiliou, M. (2019). Neurological manifestations of neuropathy and ataxia in celiac disease: A systematic review. Nutrients, 11(2), 380. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412791/Rubio-Tapia, A., Hill, I. D., Semrad, C., Kelly, C. P., Greer, K. B., Limketkai, B. N., & Lebwohl, B. (2023). American College of Gastroenterology guidelines update: Diagnosis and management of celiac disease. The American Journal of Gastroenterology, 118(1), 59–76. https://pubmed.ncbi.nlm.nih.gov/36602836/

    TG6, Lymphocyte Patterns and Early Autoimmunity

  4. Aug 6

    The Missing Piece in Youth Sports: Building Healthy, High-Performing Teen Athletes

    What does it take to help young athletes perform at their best—not just today, but for decades to come? In this episode of Root Cause Medicine, Dr. Kate Kresge sits down with emergency medicine physician and functional medicine practitioner Dr. Erik Peterson to discuss a whole-person approach to adolescent athletic performance. Drawing from more than 20 years in emergency medicine, his background as a collegiate athlete, and his work caring for young competitors, Dr. Peterson explains why optimizing performance starts with supporting the developing body rather than simply pushing it harder. The conversation explores how nutrition, sleep, recovery, body composition, metabolic health, and resilience influence athletic success during adolescence. Dr. Peterson also shares why he believes healthcare providers, coaches, and parents have an opportunity to improve long-term health by focusing on foundational physiology during these critical developmental years. Beyond sports performance, this episode is also a conversation about the evolution of medicine—from treating illness in the emergency department to helping people stay healthy through proactive, root-cause care. Listen If You... Treat adolescent athletes in your practiceCoach youth sportsParent a competitive athleteWork in sports medicine, functional medicine, pediatrics, or primary careWant to better understand the foundations of long-term athletic performance What You'll Learn How Dr. Peterson gets his athletes results using only food, supplements and lifestyleCommon mistakes young athletes make when trying to optimize performanceWhy body composition and metabolic health matter more than weight aloneThe important role parents and coaches play in creating healthy performance habitsDr. Peterson's journey from emergency medicine physician to functional medicine practitioner Who Is Dr. Erik Peterson? Dr. Erik Peterson is a board-certified emergency medicine physician who has practiced emergency medicine for more than two decades while also leading a precision medicine practice focused on performance optimization, men's health, women's health, and preventive care. A former collegiate athlete, he combines his experience in acute care with evidence-informed lifestyle medicine to help athletes and active individuals optimize health, resilience, and long-term performance. Learn more about his program at https://firstcallperformance.com/  Key Takeaways Performance is Built Outside the Gym: Training is only one part of athletic success. Nutrition, sleep, recovery, stress management, and overall metabolic health create the foundation that allows athletes to adapt and perform. (Mountjoy 2023) (Cunha 2023)Adolescence Is a Critical Opportunity: The teenage years represent an important period for developing healthy habits that influence performance, injury risk, and long-term health. (Blyth 2025) Parents and Coaches Matter: The adults surrounding young athletes often shape their relationship with food, training, recovery, and health. Creating supportive environments can have lasting effects beyond sports. (Baceviciene 2023)Functional Medicine Complements Performance Care: Looking upstream at nutrition, biomarkers, lifestyle, and physiology may help identify opportunities to support athletic performance while promoting long-term wellness. (Haller 2023)  Want to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care. Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine. Sources:  Baceviciene, M., Jankauskiene, R., & Rutkauskaite, R. (2023). The comparison of disordered eating, body image, sociocultural and coach-related pressures in athletes across age groups and groups of different weight sensitivity in sports. Nutrients, 15(12), 2724. https://www.mdpi.com/2072-6643/15/12/2724Blyth, F., Haycraft, E., Peral-Suarez, A., & Pearson, N. (2025). Tracking and changes in the clustering of physical activity, sedentary behavior, diet, and sleep across childhood and adolescence: A systematic review. Obesity Reviews, 26(6), e13909. https://onlinelibrary.wiley.com/doi/10.1111/obr.13909Cunha, L. A., Costa, J. A., Marques, E. A., Brito, J., Lastella, M., & Figueiredo, P. (2023). The impact of sleep interventions on athletic performance: A systematic review. Sports Medicine – Open, 9(1), 58. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10354314/Haller, N., Behringer, M., Reichel, T., Wahl, P., Simon, P., Krüger, K., Zimmer, P., & Stöggl, T. (2023). Blood-based biomarkers for managing workload in athletes: Considerations and recommendations for evidence-based use of established biomarkers. Sports Medicine, 53(7), 1315–1333. https://pubmed.ncbi.nlm.nih.gov/37204619/Mountjoy, M., Ackerman, K. E., Bailey, D. M., Burke, L. M., Constantini, N., Hackney, A. C., Heikura, I. A., Melin, A., Pensgaard, A. M., Stellingwerff, T., Sundgot-Borgen, J. K., Torstveit, M. K., Jacobsen, A. U., Verhagen, E., Budgett, R., Engebretsen, L., & Erdener, U. (2023). 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). British Journal of Sports Medicine, 57(17), 1073–1097. https://pubmed.ncbi.nlm.nih.gov/37752011/

    The Missing Piece in Youth Sports: Building Healthy, High-Performing Teen Athletes

  5. Jul 30

    How to Build a Thriving Practice Without Burning Out

    How to Build a Thriving Practice Without Burning Out One of my favorite parts of hosting the Root Cause Medicine Podcast is introducing you to practitioners who are making a real difference—not only in the lives of their patients, but in the lives of other clinicians. Today's guest is Lesli Bitel, a registered dietitian whose career has taken a path that many practitioners may recognize pieces of. She began in clinical practice, spent years in leadership roles across the pharmaceutical and diagnostics industries, and eventually found her way back to patient care with an entirely new perspective. Today, she helps practitioners build businesses that allow them to do their best work without burning themselves out along the way. Because the reality is, most of us were trained to care for patients. Very few of us were taught how to build a practice that can sustainably support both our patients and ourselves. In this conversation, Lesli shares how her experience in business transformed the way she thought about practice ownership. We talk about why marketing doesn't have to feel uncomfortable, how thoughtful systems can create more time for patient care, and why building a successful practice isn't about doing more—it's about building one that's aligned with your values. Whether you're just starting your practice or looking for a more sustainable way to grow, I think you'll come away from this conversation with practical ideas—and maybe a little reassurance—that it's possible to build a thriving practice without losing sight of why you became a clinician in the first place. In This Conversation Lesli's journey from aspiring clinician to healthcare executive and back to patient careWhat years in corporate healthcare taught her about running a successful practiceWhy so many practitioners feel confident clinically but overwhelmed by the business side of medicineHow marketing can become an authentic extension of patient educationSimple systems that create more time, less stress, and better patient experiencesThe connection between practice design, boundaries, and practitioner well-beingBuilding a practice that reflects your strengths, values, and vision for your career A Few Takeaways I'll Be Thinking About Authentic marketing starts with clarity, not self-promotion.Good systems free you to spend more time doing what only you can do.Sustainable growth should support your life, not just your business. Who Should Listen? This episode is for any clinician who has ever wondered: How do I build a practice that actually feels sustainable?How can I grow without sacrificing patient care?Is there a way to market my practice that still feels authentic?What does long-term success really look like? Whether you're starting your first practice or reimagining an established one, I think you'll find something valuable in Lesli's story. Episode Timeline 00:00 — Welcome and introduction 02:30 — Lesli's journey into healthcare 05:00 — Lessons from corporate healthcare 10:00 — Why clinicians struggle with practice ownership 18:00 — Rethinking marketing 28:00 — Systems that support sustainable growth 39:00 — Burnout, boundaries, and practice design 48:00 — Building a practice around your values 55:00 — Final reflections Want to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care. Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.

    How to Build a Thriving Practice Without Burning Out

  6. Jul 17

    Root, Leaf, Extract: What Matters in Ashwagandha

    Dr. Holly Lucille is joined by Ellie Abraham, PhD, to explain why two ashwagandha supplements may not be the same, even when they list the same ingredient. (Thalhamer 2024) This conversation covers differences between root and leaf extracts, withanolide standardization, botanical identity testing, certificates of analysis, and manufacturing quality. It also emphasizes that a well-made product may still not be appropriate for every patient. (NCCIH 2025) Clinical Takeaways Plant part matters. Ashwagandha root, leaf, and combined extracts may have different chemical profiles and should not automatically be treated as interchangeable. (Chaurasiya 2008)Higher is not always better. The most concentrated product is not necessarily the safest or most effective. Clinical relevance depends on the extract, dose, intended use, and supporting research. (Thalhamer 2024) (NCCIH 2025)Quality testing matters. Botanical authentication, contaminant testing, certificates of analysis, and cGMP compliance can help confirm that a product meets its specifications. (ECFR 2026)Quality does not equal clinical fit. Patient history, medications, allergies, diagnoses, and potential interactions must still be considered. (NCCIH 2025) Guest: Ellie Abraham has a PhD in plant biology and a background in analytical chemistry, ethnobotany, botanical testing, and dietary supplement quality control. She explains how manufacturers and laboratories verify botanical identity, plant part, standardization, contaminants, and product documentation. Clinician FAQ 1. Are all ashwagandha supplements the same? No. Products may differ in plant part, extraction method, dose, standardization, chemical profile, and manufacturing quality. (Thalhamer 2024) 2. Why does ashwagandha root versus leaf matter? The root and leaf  of ashwagandha contain different combinations of plant compounds. These differences may affect the product’s clinical properties, supporting research, and safety profile. (Chaurasiya 2008) 3. What does “standardized to 5% withanolides” mean? It means withanolides account for approximately 5% of the tested material. It does not identify each individual withanolide or describe the rest of the extract. (Thalhamer 2024) 4. Is a higher withanolide percentage better? Not necessarily. A higher percentage does not automatically mean that a product is safer or more effective. The appropriate concentration depends on the extract, dose, intended use, and supporting research. (Thalhamer 2024) 5. Can ashwagandha cause liver injury? Rare cases of liver injury associated with ashwagandha products have been reported. The exact cause and individual risk factors remain uncertain, but practitioners should consider supplement use when evaluating unexplained liver symptoms or abnormal liver tests. (NCBI 2012) (Philips 2023) (Björnsson 2020) Timestamps / Key Moments 00:01:43 Ellie Abraham’s background in botanical testing 00:02:36 The ashwagandha leaf discussion in India 00:04:00 Differences between root and leaf 00:05:44 How botanical identity is verified 00:07:25 Why standardization matters 00:09:07 Why higher withanolides are not always better 00:10:56 Comparing two ashwagandha products 00:12:17 Red flags on supplement labels 00:14:42 When to request a certificate of analysis 00:16:27 Why cGMP compliance matters Botanicals and Compounds Discussed Ashwagandha root and leafWithanolidesGlycosidesWithanoneCurcumin and curcuminoids Quality Methods and Documents Discussed Botanical identity testingPlant-part verificationHPTLC chemical fingerprintingStandardization testingAdulterant screeningMicrobial and heavy-metal testingCertificates of analysisThird-party testingcGMP complianceBatch-to-batch consistencyBranded ingredient research Want to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care. Disclaimer The views expressed on this podcast are those of the host and guest and do not necessarily reflect those of Fullscript or affiliated organizations. This episode is for educational purposes only and is not medical advice. Dietary supplements may cause side effects or interact with medications. Patients should consult a qualified healthcare professional before changing their healthcare routine. References Björnsson, H. K., Björnsson, E. S., Avula, B., Khan, I. A., Jonasson, J. G., Ghabril, M., Hayashi, P. H., & Navarro, V. (2020). Liver injury due to ashwagandha: A case series from Iceland and the U.S. Drug-Induced Liver Injury Network. Liver International, 40(4), 825–829. https://pubmed.ncbi.nlm.nih.gov/31991029/Chaurasiya, N. D., Uniyal, G. C., Lal, P., Misra, L., Sangwan, N. S., Tuli, R., & Sangwan, R. S. (2008). Analysis of withanolides in root and leaf of Withania somnifera by HPLC with photodiode array and evaporative light scattering detection. Phytochemical Analysis, 19(2), 148–154. https://pubmed.ncbi.nlm.nih.gov/17879227/ECFR. (2026). Current good manufacturing practice in manufacturing, packaging, labeling, or holding operations for dietary supplements (21 C.F.R. Part 111). https://www.ecfr.gov/current/title-21/chapter-I/subchapter-B/part-111National Center for Complementary and Integrative Health (NCCIH). (2025). Ashwagandha. National Institutes of Health, U.S. Department of Health and Human Services. https://www.nccih.nih.gov/health/ashwagandhaNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2024). Ashwagandha. In LiverTox: Clinical and research information on drug-induced liver injury. https://www.ncbi.nlm.nih.gov/books/NBK548536/NCBI. (2012). Ashwagandha [Review of Ashwagandha]. PubMed; National Institute of Diabetes and Digestive and Kidney Diseases. https://www.ncbi.nlm.nih.gov/books/NBK548536/Philips, C. A., Valsan, A., Theruvath, A. H., Ravindran, R., Oommen, T. T., Rajesh, S., Bishnu, S., & Augustine, P. (2023). Ashwagandha-induced liver injury: A case series from India and literature review. Hepatology Communications, 7(10), e0270. https://pubmed.ncbi.nlm.nih.gov/37756041/Thalhamer, B., Himmelsbach, M., Schatzmann, B., Klampfl, C., & Buchberger, W. (2024). A feasible procedure to detect widespread wrong labeling of ashwagandha root extracts in dietary supplements. Exploration of Foods and Foodomics, 2, 460–470. https://www.explorationpub.com/Journals/eff/Article/101046

    Root, Leaf, Extract: What Matters in Ashwagandha

  7. Jul 10

    Food, Mold, Ticks, and the Immune System with Alletess Medical Laboratory

    Summary This episode explores the role of immune-mediated testing in the evaluation of complex, chronic symptoms that may not respond to conventional approaches. Dr. Jessica Christie is joined by Veronica Kent, CEO of Alletess Medical Laboratory, and Kristen Trainer, Registered Dietitian and Clinical Educator, to discuss food allergies, food sensitivities, mold exposure, Candida, Alpha-gal syndrome, elimination diets, and the evolving landscape of laboratory testing. The conversation examines the differences between IgE-mediated food allergies and IgG food sensitivity testing, when clinicians may consider specialized laboratory assessments, and the importance of combining laboratory data with a comprehensive patient history and individualized care plans. The guests also discuss laboratory quality standards, patient education, and why test interpretation should be viewed as one component of clinical decision-making rather than a standalone diagnostic tool. (Santos 2023) Clinical Takeaways from This Episode Not all adverse food reactions are food allergies. The episode distinguishes between IgE-mediated food allergies and other forms of food-related symptoms, including food sensitivities, while acknowledging that diagnostic approaches differ depending on the clinical presentation. (Sicherer 2018)Patient history remains foundational. Laboratory testing should be interpreted alongside symptoms, clinical history, dietary patterns, and physical examination rather than in isolation. (Santos 2023)Elimination diets require structured implementation. The guests discuss elimination and systematic food reintroduction as part of evaluating whether certain foods may contribute to symptoms, emphasizing individualized guidance and monitoring. (Santos 2023)Alpha-gal syndrome is an emerging clinical consideration. Tick-associated mammalian meat allergy is becoming increasingly recognized and may present with delayed allergic reactions that can be difficult to identify. (Platts-Mills 2025) (Thompson 2023)Environmental exposures may contribute to symptom burden. Mold exposure is discussed as one possible consideration in select patients presenting with persistent respiratory or inflammatory symptoms, although appropriate testing strategies remain an area of ongoing research and debate. (Cai 2024) Patient education is essential. Laboratory testing alone does not improve outcomes; patients benefit from clear interpretation, education, and individualized follow-up plans. (Santos 2025)Quality systems matter in laboratory medicine. The discussion highlights the importance of standardized laboratory procedures, quality assurance, and timely reporting in supporting clinical decision-making. (Pillai 2025)Guest Introduction Veronica KentVeronica Kent is the Chief Executive Officer and owner of Alletess Medical Laboratory. She has spent decades working in specialty laboratory medicine and oversees operations focused on allergy, immunology, and immune-based laboratory testing. During the episode, she discusses laboratory quality systems, emerging testing technologies, and the role of clinician education in laboratory medicine. Website: https://foodallergy.com Kristen Trainer, RDKristen Trainer is a Registered Dietitian and Clinical Educator at Alletess Medical Laboratory. She has worked with clinicians and patients for more than two decades, helping interpret laboratory results and develop individualized nutrition and elimination diet plans for patients undergoing food allergy and food sensitivity testing. Tests Discussed Note: Discussion of these tests during the episode should not be interpreted as endorsement or guideline recommendations. Clinical appropriateness depends on the individual patient and current evidence. IgE food allergy testingEnvironmental allergy testingComponent-resolved allergy diagnosticsIgG food sensitivity testingIgA food sensitivity testingCandida antibody testing (IgG, IgA, IgM)Candida immune complex testingMold antibody testingAlpha-gal IgE testingTick-borne immune testingCeliac disease testingTotal IgE testing Lifestyle & Clinical Strategies Mentioned Structured elimination dietsGradual food reintroductionIndividualized meal planningRotation dietsShopping list developmentFamily-based nutrition planningReducing environmental mold exposurePersonalized patient educationLong-term dietary follow-upCollaboration between laboratory professionals and clinicians Clinician FAQ 1. What is the difference between a food allergy and a food sensitivity?The discussion differentiates IgE-mediated food allergies, which may produce immediate immune reactions, from food sensitivities, which are proposed to involve different immune pathways and may present differently clinically. (Santos 2023) The role of IgG food sensitivity testing remains controversial and is not universally recommended by major allergy organizations. (Kelso 2018)  2. When should clinicians consider specialized allergy testing?According to the discussion, testing decisions should begin with a comprehensive patient history and symptom evaluation. Testing should be selected based on the suspected underlying mechanism rather than using broad screening panels indiscriminately. (Santos 2023)  3. What is component-resolved diagnostics?Component-resolved diagnostics evaluates specific proteins within an allergen rather than testing only the whole allergen, potentially providing additional information regarding sensitization patterns in certain allergic conditions. (Santos 2023)  4. What is Alpha-gal syndrome?Alpha-gal syndrome is an IgE-mediated allergy associated with tick bites that may result in delayed allergic reactions after consuming mammalian meat or products derived from mammals. Recognition of this condition has increased in recent years. (Platts-Mills 2025) (Thompson 2023) 5. How are elimination diets used?The guests describe elimination diets as a structured process involving temporary removal of selected foods followed by gradual reintroduction while monitoring symptoms under clinician supervision. (Santos 2023)  6. Why is patient education emphasized?The episode stresses that laboratory testing is only one part of patient care and that interpretation, counseling, dietary guidance, and follow-up are necessary to help patients implement meaningful changes. (Santos 2025) 7. Why does laboratory quality matter?Standardized testing procedures, accreditation, quality control, and timely reporting all contribute to reliable laboratory results that clinicians can incorporate into patient care. (Chaudhry 2023) 8. What future developments are discussed?The guests discuss advances including miniaturized laboratory technologies, capillary blood collection, microbiome research, and genetics as potential future areas of development in allergy and immunology testing. Timestamps / Key Moments 00:02:22 Veronica Kent and Kristen Trainer introduce Alletess 00:03:36 Food allergy, sensitivity, candida, mold, and tick-borne testing 00:04:54 How Alletess began as a specialized laboratory 00:08:16 Bridging the gap between lab results and patient care 00:09:27 How allergy and immunology testing has evolved 00:13:23 How elimination diets and reintroduction work 00:15:19 When mold-related illness testing may be warranted 00:17:38 Alpha-gal syndrome and missed tick-borne allergy cases 00:25:38 Common misconceptions about food allergy testing Want to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care. Disclaimer The views expressed on this podcast are those of the hosts and guests and do not necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to provide medical advice. Healthcare decisions should be made in consultation with a qualified healthcare professional. References Ahmed Shabbir Chaudhry, Inata, Y., & Nakagami-Yamaguchi, E. (2023). Quality Analysis of the Clinical Laboratory Literature and Its Effectiveness on Clinical Quality Improvement: A Systematic Review. Journal of Clinical Biochemistry and Nutrition, 73(2), 108–115. https://doi.org/10.3164/jcbn.23-22Cai, J., Yang, M., Zhang, N., Chen, Y., Wei, J., Wang, J., Liu, Q., Li, W., Shi, W., & Liu, W. (2024). Effects of residential damp indicators on asthma, rhinitis, and eczema among children: A systematic review and meta-analysis of the literature in the past 33 years. Building and Environment, 251, Article 111226. https://www.sciencedirect.com/science/article/abs/pii/S0360132324000684Kelso, J. M. (2018). Unproven diagnostic tests for adverse reactions to foods. The Journal of Allergy and Clinical Immunology: In Practice, 6(2), 362–365. https://pubmed.ncbi.nlm.nih.gov/29524991/Pillai, S. P., & Fox, E. (2025). Laboratory quality management system fundamentals [Review of Laboratory quality management system fundamentals]. Frontiers in Bioengineering and Biotechnology, 13. https://doi.org/10.3389/fbioe.2025.1578654Platts-Mills, T. A. E., Gangwar, R. S., Workman, L., & Wilson, J. M. (2025). The immunology of alpha-gal syndrome: History, tick bites, IgE, and delayed anaphylaxis to mammalian meat. Immunological Reviews, 332(1),

    Food, Mold, Ticks, and the Immune System with Alletess Medical Laboratory

  8. Jul 3

    Perimenopause as a Portal to Power with Dr. Aviva Romm

    What if the most powerful shift in how we practice medicine starts with one person deciding to do it differently? Aviva’s story is that kind of shift. Long before she ever sat in a medical classroom, she had already built a life as a midwife, herbalist, and mother of four who was deeply embedded in her community. Then, in what most of us would consider the busiest, most demanding years of life - years that often overlap with perimenopause - she made a radical decision: she went back to school. Back into training. Back into the system she wanted to help change. Not because something was broken, but because she saw what was missing. That’s what makes this episode different. It’s about what happens when women get to reframe the perimenopausal transition as one of the most powerful, generative, expansive years of their lives. Instead of accepting the status quo, Dr. Aviva Romm built an entirely different way of seeing things - one that doesn’t reduce symptoms to problems, but places them in context. One that connects sleep, stress, nourishment, physiology, and even relationships into a bigger picture of health. You can feel that perspective ripple through the entire conversation. It gently challenges the idea that you need more interventions, more testing, more fixing, and replaces it with something both simpler and harder: paying attention, understanding what your body is asking for, and supporting it instead of overriding it. By the end, something shifts. You’re not just thinking differently about perimenopause - you’re thinking differently about what’s possible during this phase of life. And maybe, like Aviva did, you start to wonder: what could change if perimenopause wasn’t seen as the end of something, but the beginning of something else entirely? Clinical Takeaways from This Episode A root-cause, whole-person approach to perimenopause may support more sustainable outcomes. Perimenopause often includes symptoms like sleep disruption, mood changes, and cycle irregularities, and may benefit from a broader, individualized care approach rather than a single intervention (Santoro et al., 2018).Stress physiology and HPA axis patterns may influence how symptoms show up. Chronic stress is associated with changes in inflammatory signaling and neuroendocrine regulation, which may shape mood, immune function, and metabolic health (Russell, 2019).Sleep is foundational—and CBT-I is an evidence-informed place to start. Cognitive Behavioral Therapy for Insomnia (CBT-I) is supported by clinical evidence and may help improve sleep quality without medication in many individuals (Rossman, 2019).Connection and community are not “extras”—they’re part of physiology. Social isolation has been associated with increased mortality risk, which reinforces the importance of connection as part of whole-person care (Naito et al., 2023).Thoughtful, targeted lab testing supports better clinical decision-making. Strategic use of labs—guided by symptoms and clinical context—may reduce unnecessary testing and help clinicians focus on meaningful data. Guest Introduction Dr. Aviva Romm, MD, is a Yale-trained physician, herbalist, and midwife with over four decades of experience in women’s health. She has trained hundreds of clinicians in integrative and functional medicine and is the author of multiple bestselling books, including Hormone Intelligence and The Adrenal Thyroid Revolution. Her work bridges conventional and integrative medicine in a way that centers women and their paths to thriving. Interested in advancing your clinical training? Explore Dr. Aviva Romm’s Women’s Integrative Functional Medicine Certification Program. Use code FULLSCRIPT26 in the “How did you learn about the course?” box to receive $1,000 off. FAQ: Clinician & Patient Questions on Perimenopause and Integrative Care What symptoms are common during perimenopause? Perimenopause may include:Sleep disruptionMood changesHot flashes or night sweatsChanges in menstrual cyclesThese are part of a normal physiologic transition, though symptom severity varies. Dr. Aviva uses a whole-person, root cause approach to successfully manage many of these symptoms. (Crandall, 2023). What can I do if I’m struggling with sleep in midlife? Cognitive Behavioral Therapy for Insomnia (CBT-I) is a well-studied, non-pharmacologic option clinicians may consider (Rossman, 2019). It may also help to evaluate:Stress levelsBlood sugar patternsSleep habits and environment How does stress actually affect my health? Chronic stress may influence:Hormone signalingImmune and inflammatory pathwaysMood and cognitive functionThese effects are mediated in part through the HPA axis and inflammatory signaling pathways (Russell, 2019). Key Moments from This Episode 02:30 – Aviva’s journey: from herbalist and midwife to Yale-trained medical doctor10:41 – Going back to medical school as a parent: what it really takes28:14 – Stress physiology and the root causes of chronic symptoms32:58 – Reframing perimenopause as a transition, not a decline35:17 – Building a real-world toolkit: sleep, nourishment, nervous system support41:01 – Botanical medicine in practice: motherwort and lemon balm57:28 – Hypervigilance, burnout, and how they show up in the body01:17:18 – The Yerkes-Dodson curve: finding your optimal stress zone01:19:41 – How to think about labs without overtesting Want to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care. Disclaimer The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine. Citations Crandall CJ, Mehta JM, Manson JE. Management of Menopausal Symptoms: A Review. JAMA. 2023 Feb 7;329(5):405-420. doi: 10.1001/jama.2022.24140. PMID: 36749328.Rossman J. Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia. Am J Lifestyle Med. 2019 Aug 12;13(6):544-547. doi: 10.1177/1559827619867677. PMID: 31662718; PMCID: PMC6796223.Russell G, Lightman S. The human stress response. Nat Rev Endocrinol. 2019 Sep;15(9):525-534. doi: 10.1038/s41574-019-0228-0. Epub 2019 Jun 27. PMID: 31249398.Naito R, McKee M, Leong D, Bangdiwala S, Rangarajan S, Islam S, Yusuf S. Social isolation as a risk factor for all-cause mortality: Systematic review and meta-analysis of cohort studies. PLoS One. 2023 Jan 12;18(1):e0280308. doi: 10.1371/journal.pone.0280308. PMID: 36634152; PMCID: PMC9836313.

    Perimenopause as a Portal to Power with Dr. Aviva Romm
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In each episode, we’ll meet renowned medical experts, specialists and pioneers who’ve influenced the way certain conditions and diseases are understood and treated. We focus on giving you the information you need to understand the root cause, symptoms and treatments available for specific medical conditions.

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