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Dr. M’s SPA Newsletter Volume 16 Issue 12 – Creatine and Microbiomes


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Creatine and Microbiomes

A new 2026 Cell Metabolism study explores a compelling and increasingly central idea in modern biology: the gut/brain/immune/metabolism axis is not just associative, it is mechanistic. Specifically, Dr. Lu and colleagues investigate how the gut microbiota can directly influence depressive behavior by reshaping systemic and neural metabolism. This is another in a long running list of papers describing the amazing work that bacterial commensal microbes do for us. In this case, our minds and moods.

“Although peripheral-brain crosstalk regulates energy metabolism, its role in depression remains unclear. Here, we used metabolic profiling to reveal elevated fecal creatine alongside reduced plasma and cerebrospinal fluid creatine in both patients with depression and mouse depression models. Exogenous creatine produced antidepressant-like effects mediated by gut microbiota. Bifidobacterium pseudolongum was identified as a significantly reduced gut bacterial species in depression, correlating with impaired creatine absorption. Subsequent supplementation with Bifidobacterium enhanced the antidepressant effects of creatine. Mechanistically, B. pseudolongum-derived acetate promoted the creatine transporter (Slc6a8) expression in intestinal epithelial cells via histone acetylation. The Slc6a8 mediated the antidepressant-like effects of creatine. Neuronal creatine deficiency influenced energetic metabolism and neurophysiological function. In patients with depression taking antidepressants, co-administration of creatine and Bifidobacterium increased plasma creatine levels and reduced depression scores. These findings identify the Bifidobacterium-creatine combination as a promising antidepressant strategy and highlight the critical role of gut-brain energy metabolism in depression.” “The brain, as an energy-intensive organ, relies on precise metabolic regulation to maintain synaptic plasticity, neurotransmitter synthesis, and stress response systems. Accumulating evidence implicates energy metabolism dysregulation as a hallmark of depression. Neuroimaging studies using positron emission tomography (PET) have identified marked glucose hypometabolism in the medial prefrontal cortex (mPFC) of patients with depression. Cerebral mitochondrial dysfunction and ATP imbalance have been mechanistically linked to depression progression. Notably, emerging studies emphasize the bidirectional interplay between peripheral metabolic signals and central energy regulation, which is fundamental to neural metabolism. Clinical observations such as fatigue, appetite dysregulation, and unexplained weight fluctuations in patients with depression further suggest systemic metabolic disturbances spanning peripheral organs and the CNS..” (Lu et. al. 2026)

This is next-level medicine. Mental health can no longer be framed as a disorder of genetics, experience, or circumstance alone. This work opens a clearer window, showing how the microbiome participates as an active partner, shaping brain function through the metabolites it helps produce and deliver. Compounds like creatine are no longer just peripheral players. They become signals, fuel, structure, and information, bridging gut and brain, metabolism and behavior…. and more

Enjoy,
Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 11 – Magnesium

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Magnesium

Magnesium is a major cofactor in over 300 enzymatic reactions in the body, less a supplement than a piece of physiologic infrastructure. It is required for energy production (ATP), insulin signaling, protein synthesis, blood pressure regulation, and proper muscle and nerve function, essentially touching every major system we care about.

And it goes deeper: magnesium is necessary for the creation and protection of DNA and RNA and for the production of glutathione, one of our most important intracellular antioxidants/detox mechanisms. About half of our magnesium is stored in bone and most of the rest in soft tissues, with less than 1% circulating in the blood, tightly regulated by the kidneys, so the serum level we commonly measure is a very limited window into total body status….

Enjoy,
Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 10 – Covid 6 Years Later


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Covid 6 Years Later

What Should We Remember

The COVID Post-Mortem: What We Missed (and What We Still Can Fix)

We ran the largest public health experiment of our lifetime.

We failed.

Not everywhere.

Not always.

But in the places that mattered most, children, truth, and upstream health, we got it wrong.

And if we don’t name it clearly, we’ll do it again.

The First Mistake: Forgetting the Child

When the world shut down, we told ourselves it was temporary.
Two weeks.
Flatten the curve.
Regroup.
Then two months became a season.
A season became a year.
For some kids, it became a disappearance.
Over 230,000 children vanished from the school system across 21 states.
Not lost like keys.
Lost like opportunity.
Lost like trajectory.

And here’s the uncomfortable truth:
The kids who disappeared were not the kids with options.

The well-resourced adapted:
Private schools
Learning pods
Reliable internet
Parental support
They bent. Some even thrived.

The vulnerable?
They absorbed the shock.
Education lost → structure lost → nutrition lost → safety net lost.
and more….

Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 9 – Leadership


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Brene Brown – Leadership

Tools to Teach Your Children and SELF

“Stand firmly enough to lead, loosely enough to listen.”

Strong Ground by Brené Brown published in 2025

Breaking down this new book by the excellent Brene Brown, we find that strong leaders don’t eliminate tension or risk. They hold it. And this is key! What does the hold look like? How does it show up to the team?

The theme in my mind is “toughness with tenderness”

Clarity is kindness. Vagueness is avoidance dressed as politeness.
You can be both confident and uncertain. That’s not weakness, it’s reality.
Values are not what you believe. They’re what you do under pressure.
Most leadership failures are emotional avoidance, not strategic failure.
Accountability without empathy is cruelty. Empathy without accountability is chaos.
People don’t disengage because work is hard, they disengage because trust erodes.
The goal is not control. The goal is grounded presence in uncertainty.
You can’t build brave cultures with armored leaders.
Paradox is not a problem to solve, it’s a condition to manage.
If you’re always comfortable, you’re not leading. You’re maintaining.

I especially, like the last one. Discomfort is the path to growth in all things. Think euthermia for temperature, not a recipe for human cellular health or plants for that matter. Temperature through environmental swings are keys to protein elaboration for handling the cold and the heat. The lack of swing equates to a lack of adaptability…. and a piece on the Stakeholder.

Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 8 – Systems Biology


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THE FUNCTIONAL MEDICINE STORY
DR. JEFF BLAND

“Change occurs from the outside in”
Dr. Bland

Medicine has a habit of believing it has arrived. Every generation of physicians looks around the room, surveys the white coats and microscopes and MRI machines, and quietly assumes the puzzle is mostly solved. History laughs at that assumption. The truth is that medicine is always mid-sentence in a very long story.

Dr. Jeff Bland has spent decades helping rewrite that sentence.

In a recent conversation on The Root Cause Business of Medicine Podcast, Dr. Bland’s life work comes into focus. Not as a rebellion against medicine, but as an expansion of it. His influence on nutrition science, biochemical individuality, and what we now call functional medicine has helped move the field away from the narrow idea that disease is simply something to suppress or worse just name. Instead, he has pushed a more interesting question forward: why did the disease appear in the first place?

That sounds obvious. It is so far from obvious that most physicians do not ask the question.

Bland’s career sits at the intersection of nutrition, biochemistry, genetics, and what he calls systems biology. Over the decades he has authored more than 100 peer-reviewed papers and written many books aimed at both clinicians and the public. But numbers don’t tell the story. What matters is the conceptual shift he helped introduce.

For most of modern medical history, the dominant model has been reductionist. And reductionism is the scientific approach of breaking complex systems into their smallest parts. It has given us antibiotics, vaccines, and surgical techniques that save lives every day. But it has also left a blind spot. When we zoom too far in, we sometimes lose the map of the entire ecosystem.

Human biology is not a machine made of replaceable parts. It is a network.

It is supremely interconnected…. and a literature review
Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 7 – Biological Fitness


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Elk Antlers – What a Story

After returning from Jackson Hole, Wyoming this week, I was struck by the beauty of the Elk refuge, a place where thousands of elk relax in the winter lowlands. Staring at them, I pondered a question: why do the elk shed their antlers yearly? Seems like a lot of wasted energy in a resource scarce world.

The answer, mating.

Nature has a peculiar sense of theater. When reproduction is the goal, evolution doesn’t whisper, it builds costumes, props, and entire stage productions. Sometimes expensive ones. Across the mammalian world, attracting a mate often requires a spectacular display of biological investment. Energy is spent not just surviving, but advertising survival.

The elk might be the most dramatic example.

Every year, a male elk grows a massive set of antlers, sometimes weighing 30–40 pounds. These structures are not permanent. They are built from scratch annually, making them one of the fastest-growing tissues in the entire animal kingdom. At peak growth, antlers can elongate nearly an inch per day. To accomplish this feat, the animal diverts enormous metabolic resources into bone growth, calcium mobilization, and vascular supply.

Then, after the breeding season, the antlers are shed and the process begins again.
From an engineering standpoint, it seems wildly inefficient. Why build something so energetically expensive only to discard it months later?

Because in evolutionary terms, reproduction is the ultimate metric of success. If an animal fails to reproduce, its genes disappear from the story entirely, Darwinian failure.

Antlers function as a biological billboard: I am strong enough to waste energy….and more
Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 6 – Children


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Why Don’t They Win

There are moments, usually late, usually quiet, when honest thinking can be had. When you zoom out and see the ecosystem around children not as a collection of caring institutions, but as a set of incentive machines. And incentive machines, unlike grandmothers, do exactly what they’re built to do.

MAKE MONEY

Tonight I sat with some difficult thoughts about the state of primary services for children in the United States. The deeper I look, the clearer it becomes that money, not well-being, drives most decisions shaping a child’s life. And the imbalance is not trending in a positive direction.

Children Continue To Lose From My Viewpoint

Approximately two-thirds of a child’s daily nourishment comes from school food programs, which too often rely on ultra-processed, calorie-dense, nutrient-poor products. Outside of school, the dominant food environment is similarly saturated with highly engineered foods that optimize profit, shelf life, and palatability rather than health. Kids are micronutrient starved, but calorically overfed. Biological systems begin to fray early. Biochemistry no longer meets cellular needs. Children develop disease and we are asked to medicate or worse rationalize away that this is NORMAL…..

Enjoy Dr. M

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