Metabolic medicine is a fascinating paradigm to treat the individual patient. The individualization of care, everyone agrees, is the future of medicine, but the assessment and use of readily available patient parameters--things easily obtainable today--is still rare. Dr. Michael Rothman joins us today to discuss metabolic medicine and how he uses it in his clinical practice MD Wellness in New Jersey. Board-certified in internal medicine and emergency medicine, Dr. Rothman employs a unique approach that tracks dynamic clinical and laboratory measures, such as urinary pH, to determine the underlying imbalances in his patients. The identification and correction of dualities is one of the core principles of this approach. These dualities are familiar to most physicians, but not usually thought of as directly treatable entities. Distinctions like sympathetic and parasympathetic, anabolic and catabolic, acid and alkaline comprise some of the foundational categories. Dr. Rothman proposes specific life-style changes and the judicious use of lipid compounds to correct these measures with the goal of restoring health rather than masking symptoms. He also discusses one of his greatest influences, Dr. Emanuel Revici, a legendary physician in his time whose reputation and prescient work has largely been forgotten. Learn more about Dr. Rothman from his website at mdwellnessmd.com and his Amazon five-star rated book Edibolic Stress. 

Dr. Ritchie Shoemaker returns to discuss the diagnosis and management of a condition he discovered as a physician-researcher, chronic inflammatory inflammatory syndrome (CIRS). CIRS is important because it is a scientifically-validated condition that affects millions of Americans, most often in the form of chronic illness after mold exposure. (One out of every two buildings in the United States is water-damaged.) Genetically vulnerable patients develop a wide range of symptoms including fatigue, depression, muscle soreness and other symptoms and are often misdiagnosed by the medical establishment as having fibromyalgia, chronic fatigue syndrome or a psychiatric condition. In our first conversation, Dr. Shoemaker discussed how he came to discover this mysterious illness as a family medicine doctor in Maryland. In this second part, we turn our attention toward all things clinical including the case definition of CIRS, the main symptoms, biomarkers, genetic susceptibility, visual contrast sensitivity testing and the treatment protocol. To learn more, we highly recommend his books Mold Warriors and Surviving Mold and his website survivingmold.com. 

Ritchie Shoemaker, M.D. is a recognized leader in the field of biotoxin-related illness. Dr. Shoemaker was a primary care physician in Pocomoke, Maryland who began treating a mysterious illness in 1996 related to a Pfiesteria outbreak in the Chesapeake Bay. His subsequent journey in patient care, advocacy and scientific research led him to identify a common underlying pathway called the Chronic Inflammatory Response Syndrome (CIRS). CIRS is the end-result illness that occurs after exposure to biotoxins in genetically susceptible individuals. Dr. Shoemaker identified the same clinical symptoms, vision problems and alterations in blood work reflecting underlying inflammatory and immune irregularity in patients who became chronically ill after exposure to a wide range of biotoxins from Pfiesteria, blue-green algal blooms in Florida, tick bites and, most prevalent, mold from water-damaged buildings. He is the author of Mold Warriors and Surviving Mold. Dr. Shoemaker is joining us for a two-part interview. In this first segment, he discusses the events that led to his discovery of CIRS. The second segment will focus on the clinical work-up of CIRS. Learn more at Dr. Shoemaker's website survivingmold.com

Our guest today is Stuart McGill, PhD. Professor McGill is a Professor of Spine Biomechanics at the University of Waterloo. He has over 400 scientific publications including three text books: Low Back Disorders, Back Mechanic and Ultimate Back Fitness and Performance. Professor McGill will be discussing low back pain evaluation and management with us today. You can learn more at his website backfitpro.com.