Newsletter

Dr. M’s SPA Newsletter Volume 15 Issue 19

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For parents of special needs children, I honor you today.

I witness your strength every day in clinic.

You rise to meet challenges that many cannot begin to imagine, truly. You navigate medical appointments, therapy sessions, school meetings, and the unpredictable rhythms that come with raising a child with special needs.

Often without pause, without adequate rest, and without the recognition you deserve. For those single parents carrying this day to day reality, a double level of gratitude for you.

I want to pause for a moment and say what is too rarely said: you are extraordinary. Truly extraordinary.

Your love is not passive, it is an active force. It shows up at 2 AM when a child can’t sleep, in the quiet patience during a meltdown, in the persistence to advocate for services in a dysfunctional system requiring resilience summoned when the system says “no” but you know your child needs a “yes.”…. and a discussion of nutritional dark matter.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 18

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Breastmilk is Dynamic

Cellular and transcriptional diversity over the course of human lactation

This recent 2022 paper in the Proceedings of the National Academy of Sciences by Dr. Nyqiust and colleagues is a site for sore eyes.

It offers a remarkable, high-resolution portrait of how the cellular landscape of human breast milk (hBM) shifts over time. The authors capture something both scientifically rich and uniquely human: the dynamic, living composition of milk as it adapts to the changing needs of mother and child.

The abstract: “Human breast milk is a dynamic fluid that contains millions of cells, but their identities and phenotypic properties are poorly understood. We generated and analyzed single-cell RNA-sequencing (scRNA-seq) data to characterize the transcriptomes of cells from hBM across lactational time from 3 to 632 d postpartum in 15 donors. We found that the majority of cells in hBM are lactocytes, a specialized epithelial subset, and that cell-type frequencies shift over the course of lactation, yielding greater epithelial diversity at later points. Analysis of lactocytes reveals a continuum of cell states characterized by transcriptional changes in hormone-, growth factor-, and milk production-related pathways. Generalized additive models suggest that one subcluster, LC1 epithelial cells, increases as a function of time postpartum, daycare attendance, and the use of hormonal birth control. We identify several subclusters of macrophages in hBM that are enriched for tolerogenic functions, possibly playing a role in protecting the mammary gland during lactation. Our description of the cellular components of breast milk, their association with maternal–infant dyad metadata, and our quantification of alterations at the gene and pathway levels provide a detailed longitudinal picture of hBM cells across lactational time. This work paves the way for future investigations of how a potential division of cellular labor and differential hormone regulation might be leveraged therapeutically to support healthy lactation and potentially aid in milk production.” (Nyquist et. al. 2022)

And more information on breastmilk immunology and a recipe.

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 17

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Inflammaging from a Population View

In a landmark study published in Nature Aging on July 7, 2025, researchers challenge a cornerstone of modern gerontology by showing that inflammaging, chronic, age-associated low-grade inflammation, is not universal across all human populations. The abstract states the following: “Inflammaging, an age-associated increase in chronic inflammation, is considered a hallmark of aging. However, there is no consensus approach to measuring inflammaging based on circulating cytokines. Here we assessed whether an inflammaging axis detected in the Italian InCHIANTI dataset comprising 19 cytokines could be generalized to a different industrialized population (Singapore Longitudinal Aging Study) or to two indigenous, nonindustrialized populations: the Tsimane from the Bolivian Amazon and the Orang Asli from Peninsular Malaysia.

We assessed cytokine axis structure similarity and whether the inflammaging axis replicating the InCHIANTI result increased with age or was associated with health outcomes. The Singapore Longitudinal Aging Study was similar to InCHIANTI except for IL-6 and IL-1RA. The Tsimane and Orang Asli showed markedly different axis structures with little to no association with age and no association with age-related diseases. Inflammaging, as measured in this manner in these cohorts, thus appears to be largely a byproduct of industrialized lifestyles, with major variation across environments and populations.” (Franck et. al. 2025)

The research team analyzed 19 cytokines in over 2,800 individuals from four diverse populations: two industrialized cohorts: Italy’s InCHIANTI and the Singapore Longitudinal Aging Study (SLAS); two non-industrialized, Indigenous groups: the Tsimane of the Bolivian Amazon and the Orang Asli of Peninsular Malaysia.

In Italy and Singapore, the industrialized regions noted classic inflammaging signatures with inflammatory markers like IL‑6, TNF-α, and CRP increased with age, and correlated strongly with age-related chronic diseases such as cardiovascular and kidney disease….. and more on inflammaging…

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 16

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A Rooted Approach to Modern Medicine: The Vision Forward

My emerging and chronically iterating philosophy of medicine is a rising structural entity rooted between ancient healing wisdom and modern scientific insight. It is layered with root cause immunometabolomic thinking and built upon anthropological foundations. As a pediatrician, educator, and onion peeling thinker, I believe that a medical approach grounded in compassion, prevention, and the pursuit of root causes is the way forward. Medicine is not just about treating disease but about reshaping the very terrain in which illness arises. This can and must start with our women and children.

At the heart of this vision is a belief in the power of systems biology and our deep interconnectedness. The human body cannot be understood or healed through isolated parts or siloed provider experiences. We must move beyond symptom suppression and toward an understanding of the why behind disease. Why does a child struggle with allergies, ADHD, or autoimmune illness? What factors in the environment, diet, stress response, or microbial ecosystem have altered their trajectory? Why are the governmental and NGO leaders not guiding us towards a benevolent goal of whole child health? These are the questions that shape and guide our practice….and a literature review.

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 15

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Systemic Maternal Inflammation and Neurodevelopment: The Role of IL-6 and IFN-γ in Autism Spectrum Disorder

I just returned from Estes Park, Colorado where I presented a lecture on the Growing Brain/Mind – a tour through the underpinnings of childhood neurological changes that we call Autism. The timing is perfect for this article to be written.

In an era when chronic disease in children is rising at an unprecedented pace, the search for root causes must include an honest inquiry into the conditions present during fetal development. The review article by Majerczyk and colleagues, Systemic Maternal Inflammation Promotes ASD via IL-6 and IFN-γ, brings forward a critical piece in this puzzle that I began to explore a few years ago when writing a book. It connects the dots between maternal immune dysregulation and long-term neurodevelopmental outcomes, specifically autism spectrum disorder (ASD). Through a synthesis of clinical data and animal research, the authors make a compelling case for the centrality of two inflammatory messengers, interleukin-6 (IL-6) and interferon-gamma (IFN-γ), in shaping fetal brain development during gestational stress. The key words here being GESTATIONAL STRESS, the recurring scientific theme for ASD development, not vaccines… and some literature reviews.

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 14

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As I have told many of my patients, I would write immediately when NC sees its first Measles case.

Well, North Carolina has its first measles case: The North Carolina Department of Health and Human Services has confirmed a case of measles in a child who was visiting Forsyth and Guilford counties. The child became ill while traveling to NC from another country where measles outbreaks have recently been reported. To protect the individual and their family’s privacy, no additional information about this individual will be released. This is the first confirmed case of measles in the state in 2025. NCDHHS is recommending all unvaccinated individuals ages one year and older receive measles vaccination to protect themselves and those around them. (NCDHHS)

So, it is finally in NC. If you are still on the fence of whether to vaccinate, the issue is now truly pressing.

From the CDC:

U.S. Hospitalizations in 2025

12% of cases hospitalized (148 of 1227)

Percent of Age Group Hospitalized

Under 5 years: 20% (72 of 355 cases) 50% of the total hospitalized. Highest risk bucket.

5-19 years: 8% (35 of 455)

20+ years: 10% (40 of 404)

Age unknown: 8% (1 of 13)

Deaths 3

And a story on Insurance Hell.

Enjoy,
Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 13

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Literature Review

1) An exciting phase three trial with the CETP inhibitor Obicetrapib has shown serious promise for ASCVD and Alzheimer’s Disease (AD). “In BROADWAY, a pre-specified AD sub-study was designed to assess plasma AD biomarkers in patients enrolled in the BROADWAY trial and evaluated the effects of longer duration of therapy (12 months) with a prespecified population of ApoE3/4 or 4/4 carriers. The sub-study included 1727 patients, including 367 ApoE4 carriers. The primary outcome measure was p-tau217 absolute and percent change over 12 months. Additional outcome measures included neurofilament light chain (“NFL”), glial fibrillary acidic protein (“GFAP”), p-tau181, and Aβ42/40 ratio absolute and percent change over 12 months. NewAmsterdam observed statistically significant lower absolute changes in p-tau217 compared to placebo over 12 months in both the full ITT population (p<0.002) and in ApoE4 carriers (p=0.0215).” (NAMS)

Obicetrapib has shown significant LDL and Lp(a) lowering effects as well in early trials. I will be watching this discovery closely as it may be a game changer for these diseases. “In the BROADWAY trial, more than 2,500 participants with established heart disease or genetic high cholesterol were given either Obicetrapib or a placebo, in addition to their regular cholesterol medications. After 12 weeks, those on Obicetrapib had dropped their LDL cholesterol by 32.6 per cent and Lp(a) by 33.5 per cent on average – many achieved guideline-recommended targets for the first time.” (Sci Tech Daily) The drop in Lp(a) is the profound result as this is a massive risk factor for ASCVD and to date is not moveable by statins and most used meds.

2) GLP1 drugs and risk for macular degeneration?… and more

Dr. M

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