Dr. M's Women and Children First Podcast

“It is your reaction to an adversity not the adversity itself that determines how your life’s story develops.” Dieter Uchtdorf WHY? What are the Underpinnings of Disease? What have we really learned over the last one to two hundred years of medicine? We left an era where infections killed the majority of children and adults, especially during childbirth and the first 5 years of life. Science gave us antimicrobial medicines and vaccines that altered this landscape and humans began to live decades longer. Medicine had conquered disease. However, it was not so. Insidiously, these victories were met with new problems called diseases of aging - heart disease, asthma, autoimmunity, diabetes, cancer, obesity, dementia and others...... and a literature review. Enjoy, Dr. M

The Book that I never published. It is time for me to take another look at the mother child story in book form. In 2019, I embarked on a project of writing a book about maternal health and WHY it matters tremendously that we address the issues driving offspring dysregulation. The time since has ushered in an era of podcast guests that in some instances have solidified my beliefs on knowns while also shattering some beliefs leading to new ideas. Over the coming weeks, I am going to relook at this topic. Part of this project is going to be taking a page out of the Derek Sivers' book writing style, brevity and meaning are paramount. I am naturally hyper verbose and my writing style follows this reality. Thus, I am going to fight my natural style and desires in an effort to make this book shorter, much shorter and still powerful in delivery. Here goes! WHY? The story of normal maternal health and how we are disrupting it in modern America.......Also a Literature review and recipe of the week! Enjoy, Dr. M

Enuresis, Encopresis and Constipation This week I sit down with Dr. Steve Hodges to discuss bedwetting, constipation and more. Dr. Steve Hodges is a Urological surgeon and expert in the field of enuresis, encopresis and child urological health. He received his BA in classical and ancient studies from Duke University before completing medical school and residency at Wake Forest University in North Carolina. He completed further Pediatric fellowships in Urology at the University of San Diego and again at Wake Forest. From there his career is one of exploration, questioning and seeking new answers to old questions. He has authored multiple books including It’s No Accident, Emma and the E Club: An Epic Episode About Eliminating Enuresis and Encopresis, and the MOP book anthology. He is widely published in top Urological Journals. Today we sit down to dissect the issues of enuresis(Bedwetting), encopresis (self stooling) and chronic constipation. The exploration is exactly what we need, root cause analysis and treatments based on the reasons not the symptoms. Please enjoy my conversation with Steve Hodges, Dr. M

Unraveling the Mysteries of the Amygdala: A review of a section of the book Behave by Robert Sapolsky In the world of neuroscience, Robert Sapolsky stands as a luminary, a maestro of unraveling the intricate dance of our brain's circuitry. Among the many deep dives that he delves into, his perspective on the amygdala resonates profoundly for me. The amygdala emerges not as a mere anatomical curiosity as he decides that rather than reducing the amygdala to a simplistic seat of fear and aggression, he highlights its diverse functions, emphasizing its involvement in the vast array of behaviors and experiences. It is a narrative view of the why the brain developed as it did to aid us in the fight against pathogens, predators and stress. Sapolsky's take on the amygdala is nothing short of revelatory, akin to a seasoned detective peeling away layers of a perplexing case. There are diverse neuronal pathways in this almond-shaped structure nestled deep within our temporal lobes and they have profound purpose. The amygdala emerges not merely as a primal seat of fear and aggression, but as a nuanced orchestrator of our emotional lives. All mammals have emotional responses that are split second to threat, joy and relationship. This is mediated......Plus a section on DNA and memory. Finally, a recipe. Enjoy, Dr. M

Literature Review 1) In a first of its kind study in mice, we see concrete evidence for how the mitochondria in obese individuals are a root cause of disease based on nutritional input. This fascinating animal translational study gives us insight into how a high fat diet is also a major component of mitochondrial damage through fission and fragmentation leading to worsened cell bioenergetics. The cells have reduced fatty acid oxidation or fat burning capacity due to a single gene's actions. The end result is a tilt toward fat cell production, fat storage and fat cell inflammation which are associated with diabetes and insulin resistance and ultimately metabolic syndrome. This starts to explain the paradox that is obesity where the person has a ton of stored energy, but has limited capacity to utilize it. It is like having a gas tank of fuel with a gas line that only allows for 1/10th of the flow required for optimal function. Science Daily has an excellent review of this paper. Link below.  2) Women's brains change during pregnancy as per a new study. The authors looked at brain changes before and after birth as well as with or without a vaginal delivery route. Their study findings noted transient changes in some brain regions as well as permanent changes in other brain regions that turn on self-reflection and empathy for others...... and a recipe of the week. Enjoy, Dr. M

This week I sit down with Dr. Stan Gabryszewski to discuss allergies from multiple angles. Dr. Gabryszewski graduated from Princeton University with a degree in Molecular Biology before attending Columbia University for his MD as well as a PhD degree in Cellular, Molecular and Biomedical Studies. He then completed his pediatric residency and is a senior allergy immunology fellow at the Children's Hospital of Philadelphia where he now teaches and performs research in the lab of Dr. David Hall. His research is focused on better understanding the epidemiologic and immunologic features among pediatric allergic disorders, in particular the food allergies IgE-mediated food allergy and eosinophilic esophagitis. In this conversation, Stan and I sit down to discuss his recent paper in Pediatrics entitled, Patterns in the Development of Pediatric Allergy. This article is a much needed look at the true prevalence of allergy and allergic diseases in children. We discuss the statistics as well as the thoughts behind the why this is occurring. The upstream reasons are very important, hard to tease out but worthy of discussion. Please enjoy my conversation with Stan Gabryszewski, Dr. M His recent paper in pediatrics.

Teenagers and tweens are a challenge to any parent as they embark on their identity development. These are years filled with angst, joy, love and pain, as our kids develop physically, mentally, and emotionally. As we attempt to guide but not control, we struggle watching them make and maybe repeat obvious mistakes. We, so dearly, want them to make the right choices (in our mind) and respect their bodies. What can we do to help? Dictating to teens will never work. They are more likely to sabotage their own lives in order to prove that they are in control. The tighter parents squeeze, the more the adolescent rebels. I think of this stage of parenting as motivational interviewing.... and a literature review. Enjoy, Dr. M

Micro/nano-plastics (MNP) - the new ultra threat to our health In a first of its kind study, a group out of Italy has found quite disturbing results in the hearts of a few hundred tested individuals. From the study: 257 patients completed a 35 month study where they detected polyethylene in the 59% of the patient's heart's carotid artery plaque. In addition, 12% of the patients had detectable amounts of polyvinyl chloride. "Electron microscopy revealed visible, jagged-edged foreign particles among plaque macrophages and scattered in the external debris. Radiographic examination showed that some of these particles included chlorine." (Marfella et. al. 2024) Individuals with micro/nanoplastics in the carotid atheroma were at significantly higher risk for myocardial infarction, stroke, or death than those without detectable MNP. The hazard ratio is 4.5 which is to say that the risk is 4.5 X higher for the plastic exposed people.....plus a literature review. Enjoy, Dr. M

This week I sit down with Dr. Stephen Porges, He is a Distinguished University Scientist at Indiana University where he is the founding director of the Traumatic Stress Research Consortium. He is Professor of Psychiatry at the University of North Carolina, and Professor Emeritus at both the University of Illinois at Chicago and the University of Maryland. He served as president of the Society for Psychophysiological Research and the Federation of Associations in Behavioral & Brain Sciences and is a former recipient of a National Institute of Mental Health Research Scientist Development Award. He has published more than 400 peer-reviewed papers across several disciplines including anesthesiology, biomedical engineering, critical care medicine, ergonomics, exercise physiology, gerontology, neurology, neuroscience, obstetrics, pediatrics, psychiatry, psychology, psychometrics, space medicine, and substance abuse. In 1994 he proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological state in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders. ​ He is the author of multiple books on his Polyvagal Theory: including the Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation, as well as Polyvagal Safety: Attachment, Communication, Self-Regulation. His newest book cowritten with his son is called Our Polyvagal World, How Safety and Trauma Change Us. Dr. Porges is the creator of a music-based intervention, the Safe and Sound Protocol ™ (SSP), which is used by therapists to improve social engagement, language processing, and state regulation, as well as to reduce hearing sensitivities. This is such a fascinating conversation. He brings the worlds of psychiatry and anthropological physiology into union for us to understand the why of trauma reactions and the future unwinding that is now possible. This is a must listen to conversation if you know anyone with trauma history. Please enjoy my conversation with Professor Porges, Dr. M His recent paper in Frontiers in Integrative Neuroscience Website for Dr. Porges Newest Book - Our Polyvagal World

Allergy Season and School - What is your plan? Spring is coming and maybe even here already in Carolina. School is in full swing for kids and they are filled with joy and excitement. They are back outside enjoying sports and play. For the parents of allergy suffering kids, this is a time for check ups, medicines and the countless forms required by school. I know! What a pain! The goal for parents and educators is to limit missed or unproductive school days due to asthma and allergies and to get the most out of the learning environment for all children. My goal is to help children be symptom free or as close as possible while also focusing on reducing mucous development which is a direct precursor to bacterial sinus and ear infections....and more Enjoy, Dr. M

To Forgive The act as defined as I see it - to release consciously another person from your negative feelings based on an event that was hurtful toward you from them whether it is perceived on your part or known by both parties. What I find fascinating is that often the act of forgiveness may have to push past an unconscious threat injury in order to take root. This is to say that we can be harmed at a conscious and an unconscious level. The unconscious harm is understood at the vagal nerve level which is a primitive emotional safety response state that all mammals have that developed a long time ago. This is the essence of polyvagal theory which states that when humans feel safe, their nervous system supports the homeostatic functions of health, growth and restoration, while simultaneously become accessible to others without feeling or expressing threat and vulnerability. (Porges S. 2022) Thus, the opposite exists, when humans are threatened, their nervous system supports a break in homeostasis that can be short lived or long persistent based on the severity and chronicity of the harm. This break can lead to persistent mental and physical health challenges..... and a section on sleep followed by the recipe of the week. Enjoy, Dr. M

This week we sit down with Dr.  John Warner, an Emeritus professor of Pediatrics at the Imperial College of London in the United Kingdom and also at the University of Cape Town in South Africa. We discuss his recent paper entitled: Strategies and Future Opportunities for the Prevention, Diagnosis, and Management of Cow Milk Allergy. Dr. Warner completed his undergraduate medical training in the School of Medicine, University of Sheffield and his initial pediatric experience was at the Children''s Hospital, Sheffield in the United Kingdom. He moved to London as Professor of Pediatrics and Head of Department at Imperial College St Mary's hospital campus.  He is also Hon Professor of Pediatrics in the University of Cape Town. In 2008 he became Director of Research for the Women and Children's Clinical Programme Group, Imperial College Healthcare NHS Trust (ICHT). He was the lead for pediatrics in both the Biomedical Research Centre in ICHT and the NW London CLAHRC (Collaboration for Applied Health Research and Care) and was President of the Academic Pediatrics Association. Professor Warner's research has focused on the early life origins of asthma and related allergic and respiratory disorders.  He has published over 500 papers in scientific journals on these topics.  He was Editor in Chief of the journal Paediatric Allergy and Immunology from 1997-2010 and chairman of the paediatric section of the British Society for Allergy and Clinical Immunology for 5 years until 2010.  He was also a member of the Speciality and Training committee of the World Allergy Organisation and a past Trustee of the charity known as The Anaphylaxis Campaign.  He was a member of the Advisory Committee for Novel Foods and Processes of the Food Standards Agency for 12 years until 2012 and was recognised for his work in food allergy research by the award of an OBE in 2013.   Please enjoy my conversation with Professor Warner, Dr. M

Pregnancy is a super important time. Do not take by inhalation, ingestion or other exposure anything that is a potential toxin for the body. Things to avoid: 1) Caffeine - in low to minimal doses, it is clear that caffeine is safe for pregnant women and their offspring. Caffeine easily crosses into the placenta and thus the baby's circulation. In utero babies cannot metabolize caffeine well putting them at risk with increasing exposure. The data does not support the same reality for more moderate to high doses. Caffeine is known to raise blood pressure and heart rate in all users in variable numbers based on metabolism capabilities...... plus a literature review and a recipe. Enjoy, Dr. M

Measles Overview Again From the CDC: As of this week, there have been 35 cases of measles, the Centers for Disease Control and Prevention (CDC) reported including seven direct importations of measles by international travelers and two outbreaks with more than five cases each. Most of these cases were among children and adolescents who had not received a measles-containing vaccine (MMR or MMRV), even if age eligible. (Site) In 2023, there were 58 total cases. A far cry from the 1274 cases in 2019, but still a sign that risk persists for some unvaccinated and immune compromised people. What is measles - a refresher? Measles is a serious, highly contagious and potentially deadly viral infection. It is caused by an RNA paramyxovirus. It is spread by contact with droplets from an infected person's nose, mouth or throat. Sneezing and coughing can aerosolize the droplets and increase the range of infectious spread. Enjoy, Dr. M

Dr. Kate Kresge is the Head of Medical Education at RUPA Health and host of the Root Cause Medicine Podcast. Dr. Kate collaborates with clinicians to bring leading-edge root-cause medicine information to the world through bootcamps, courses, podcasts, articles and more. Before joining RUPA, Dr. Kate was the founding Director of Functional Medicine at Sanare Today, a multi-location practice on the east coast of the U.S. that combines therapy, coaching, natural medicine and more to help people thrive. Dr. Kate’s training in naturopathic medicine began at Bastyr University where she learned how to approach a patient through a prevention focused lens. She focuses on therapies like biofeedback, micronutrient cofactor support and nutrition, allowing her to emphasize root-cause treatments that are both low-cost and effective in order to help keep functional medicine accessible to all. Today, we look at ADHD and the upstream levers that can be pulled on to help reduce the symptom burden. What are the nutritional, lifestyle and other mitigating factors for symptom amelioration? How does Dr. Kate approach a child and the family? What is a meal plan and so much more. Please enjoy my conversation with Kate Kresge. Dr. M

APOE4 and the history of human disease Apolipoprotein E, discovered in 1973, is derived from a polymorphic gene called ApoE that encodes for a signaling protein on a class of fatty proteins that primarily carry cholesterol and other molecules around the body. We find ApoE primarily on VLDL, very low-density lipoproteins and HDL, High density lipoproteins. It primarily helps to shuttle cholesterol from the periphery of the body back to the liver. ApoE proteins are also involved in neuronal signaling, neuroinflammation and glucose metabolism making them especially critical for brain activity. This is becoming a critical part of the story for understanding dementia and neurodegeneration. (Williams T. 2020) ApoE is most famous for an isoform, APOE4/4, being highly associated with Alzheimer’s dementia in modernity. Unfortunately, as we do with many things in medicine, we have been focused on this genetic protein variant as a net negative in humans because we look at things as black and white. Either good or bad. A binary choice. Rubish! ..... Enjoy, Dr. M

Light and It's Impacts on Health - Circadian Rhythms Circadian comes from the latin Circa Diem or about the day I have long believed that indoor sedentary behavior is profoundly bad for us beyond just the lack of movement and outdoor natural education. Today, we will look at another major concern: light. We will also get into a circadian rhythm post looking at Dr. Panda's work. A final addition of a recipe of the week. Enjoy, Dr. M

ADHD without Drugs - This is a reboot of this podcast from 2022 as it aligns with the podcasts of Dr. James Greenblatt and Dr. Kate Henry Sandy Newmark, MD is the Director of Clinical Programs at the University of California at San Francisco's Osher Center for Integrative Health. He is an Integrative Pediatrician and a Professor in the Department of Pediatrics at UCSF with the title of Osher Foundation Endowed Chair in Clinical Programs in Integrative Medicine. To me, he is an amazing teacher and onion peeler in the world of attention deficit. I met Sandy back in 2006 as he was the lead Pediatric teacher in the University of Arizona's Integrative Medicine Fellowship. He immediately made an impact in my career as a leader in this new way of seeing the world of medicine. His bio lists: Dr. Sanford Newmark specializes in integrative neurodevelopmental pediatrics including autism, ADHD, and related conditions. Dr. Newmark lectures widely on both autism and ADHD and has authored three chapters in integrative medicine textbooks. He is the author of the book “ADHD Without Drugs, a Guide to the Natural Care of Children with ADHD.” His online video, “Do 2.5 Million Children Really Need Ritalin? An Integrative Approach to ADHD,” has been viewed over 4.5 million times. Know this, this is an hour of your life that you will want to dedicate to Dr. Newmark's thoughts. Especially, if you or your child has ADHD. Enjoy my conversation with Dr. Newmark, Dr. M

Literature Review 1) Cancer is now a unique risk factor for Cardiovascular disease according to recent research. This is being discussed as a point of emphasis for those that have been diagnosed with cancer as the knowledge is a wake up alarm to the biological underpinnings of these disparate immune based diseases. (Melchiori R. et. al. 2023) If you have a strong family history of cancer and heart disease as I do, this data needs to be understood for a prevention lens focus. In a few weeksx I will be discussing APOE genotypes for understanding these realities. 2) In a translational model, sulphurophane increases mitochondrial biogenesis.....Plus a continuous glucose monitor experiment and more from Alison Gopnik's book. Enjoy, Dr. M

{display_podcast] Attention Deficit and Upstream Personalized Treatments This week we sit down with Dr. James Greenblatt, a pioneer in the field of integrative medicine/psychiatry. He obtained his MD and completed his psychiatry residency at George Washington University School of Medicine. This training was followed by a fellowship in child and adolescent psychiatry at Johns Hopkins Medical School. He has been studying and educating providers on functional psychiatry for 4 decades. Dr. Greenblatt has served as the Chief Medical Officer at Walden Behavioral Care in Waltham, MA for nearly 20 years, and is an Assistant Clinical Professor of Psychiatry at Tufts University School of Medicine and Dartmouth College Geisel School of Medicine. His focus is on the scientific evidence for nutritional interventions in psychiatry and mental illness. This is the essence of going upstream to right the wrongs of the biochemical pathways of the brain. He is the author of eight books, including the best-seller, Finally Focused: The Breakthrough Natural Treatment Plan for ADHD. His updated edition of Answers to Anorexia was released in October 2021 and his newest book, Functional & Integrative Medicine for Antidepressant Withdrawal is available now. Dr. Greenblatt is the founder of Psychiatry Redefined, an educational platform dedicated to the personalized, evidence-based treatment of mental health. Psychiatry Redefined offers continuing online education, CME-approved courses, and webinars, and boasts the most comprehensive and scientifically-based professional fellowship for mental health providers, The Psychiatry Redefined Fellowship in Functional & Integrative Psychiatry. Please enjoy my conversation with Dr. James Greenblatt. Dr. M