Tag Archives: children

Dr. M’s Women and Children First Podcast #19 Repost – Dr. Alessio Fasano – Intestinal Permeability, Microbiome and MIS

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In this podcast repost, we rediscover the work of Pediatric Gastroenterologist Dr. Alessio Fasano from the Massachusettes General Hospital Department of Pediatric Gastroenterology. In this conversation, we discussed the research on Intestinal Permeability, Microbiomes and MIS, Multi Inflammatory Syndrome in Children .
Dr. Fasano also directs the Mucosal Immunology and Biology Research Center and is associate chief for Basic, Clinical and Translational Research. Under his leadership, investigators are studying the molecular mechanisms of autoimmune disorders including celiac disease, and other-gluten-related disorders. He has been named visiting professor of pediatrics at Harvard Medical School. He authored the groundbreaking study in 2003 that established the rate of celiac disease at one in 133 Americans. Widely sought after by national and international media, Dr. Fasano has been featured in hundreds of interviews including outlets such as The New York Times, The Wall Street Journal; National Public Radio; CNN; Bloomberg News, and others.
He recently co authored an excellent book with Susie Flaherty called Gut Feelings. I highly recommend you purchase and read this book. It is an encyclopedia of information regarding gut health, the microbiome and much more.
Enjoy my conversation with Dr. Fasano,
Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 20 – Healthcare Policy

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Failing Them

Why Are We?

We are failing our children, the next generation.

I have been spending an inordinate amount of time studying cellular biology and mitochondrial function in order to understand worsening disease trends. Thus, I want to revisit a landmark study that is one of the most comprehensive assessments of pediatric health ever conducted in the United States. Rather than examining a single disease or health outcome, Dr. Forrest and colleagues integrated data from multiple nationally representative surveys, mortality databases, and electronic health records encompassing millions of children to evaluate whether the health of American children has changed over the past 17 years. The answer was strikingly consistent: across virtually every major health domain, children in the United States are becoming less healthy. The investigators examined mortality, chronic physical and mental health conditions, obesity, functional status, sleep, puberty, physical symptoms, and emotional well-being between 2007 and 2023. Nearly every indicator worsened over time.

“From 2007 to 2022, infants (<1 year old) were 1.78 and 1- to 19-year-old individuals were 1.80 times more likely to die in the US than in the OECD18. The 2 causes of death with the largest net difference between the US and OECD18 were prematurity and sudden unexpected infant death for infants 12 months or younger, and firearm-related incidents and motor vehicle crashes for 1- to 19-year-old individuals. From 2011 to 2023, the prevalence of 3- to 17-year-old individuals with a chronic condition rose from 39.9% to 45.7% within PEDSnet, and from 25.8% to 31.0% within the general population. Rates of obesity, early onset of menstruation, trouble sleeping, limitations in activity, physical symptoms, depressive symptoms, and loneliness all increased during the study period.” (Forrest et. al. 2025)… and literature review.

Enjoy,

Dr. M

 

Dr. M’s SPA Newsletter Volume 16 Issue 19 – Pain

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Pain

Do we listen to its signal?

Pain: Your Body’s Built-In Warning System

Pain is one of the body’s oldest and most important protective mechanisms. It isn’t your enemy. It is a messenger.

Imagine walking barefoot across your living room and accidentally kicking the corner of the coffee table. The sharp pain that shoots through your toe isn’t there to punish you, it is there to protect you. Within fractions of a second, nerves carry a signal to your brain, telling you that cells and tissue have been injured. Your body immediately encourages you to stop what you’re doing. Protect the area and allow it to heal.

This is acute pain, and it serves an essential purpose for both protection and survival.

The problem arises when we stop thinking of pain as information and begin viewing it as something that simply needs to be eliminated. Over the past several decades, this mindset has increasingly influenced modern medicine. Around the turn of the century, pain was widely promoted as the “fifth vital sign,” emphasizing the importance of recognizing and treating it. While this movement helped address the undertreatment of pain, it also contributed, in some settings, to an emphasis on suppressing pain rather than understanding why it existed in the first place.

From an evolutionary perspective, pain is not a design flaw, it is a sophisticated communication system. It evolved to capture our attention, protect us from further injury, and encourage behaviors that promote healing. When we focus solely on silencing the signal without investigating its source, we risk missing the very message our bodies are trying to deliver, and deliver it will.

Pain is information

Every pain signal is your body’s way of saying, “Something isn’t quite right.”

Sometimes the cause is obvious like a sprained ankle, a cut, a burn, or a broken bone.

Other times the message is much more subtle.

….

Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 14 – The Adult Chair


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The Adult Chair, the Adolescent Chair and the Child’s Chair

The Adult Chair by Michelle Chalfant is a practical framework for emotional maturity, self-awareness, and healing old patterns that unconsciously drive adult behavior. The central premise is that most people move through life reacting not from their grounded adult self, but from unresolved emotional states formed during childhood and adolescence. She organizes this idea into what she calls the “three chairs”: the Child Chair, the Adolescent Chair, and the Adult Chair.

The Child Chair represents the emotional self formed in early childhood. This is the place of vulnerability, fear, shame, abandonment, loneliness, and unmet needs. When people react from this chair, they often feel helpless, emotionally flooded, overly dependent on validation, or afraid of rejection. Many adult relationship conflicts, according to Chalfant, are actually wounded children (in adult bodies) interacting with each other while wearing grown-up clothing and carrying iPhones. Same child like nervous system. Better accessories. Think of the statement: lipstick on a pig, you cannot dress up dysfunction and make it disappear.

The Adolescent Chair reflects the defensive coping strategies people develop to protect the wounded child. This includes control, perfectionism, blame, avoidance, rebellion, people-pleasing, passive aggression, and emotional shutdown. The adolescent self seeks power and protection but often creates disconnection and conflict. Chalfant argues that many high-achieving adults unknowingly operate from this chair, appearing successful externally while internally driven by fear, insecurity, or the need for approval.

The Adult Chair is the goal….

Enjoy,
Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 13 – Birth Order


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Birth Order

Birth Order Is Biology, Not Birthright – so says a new paper in MedRxIV (Kramer et. al. 2026)

Here is a short field guide to how sequence shapes the immune system, and maybe the brain in children.

We’ve treated birth order like personality trivia.
First-borns are “responsible.” Youngest are “free spirits.” Middle children… well, we forgot them.

This paper suggests something more interesting: birth order is a biologic exposure.
Not destiny. Not diagnosis. But signal.

Across a very large dataset, the researchers mapped birth order against hundreds of diseases. The effects are small for any single child. But the pattern is consistent at a population level.
Children are not born into identical biology, even within the same family.
Each pregnancy changes the mother. Meaningfully. Immunologically. Successively.
Each fetus inherits a slightly different environment.
Epigenetics in full swing.
It turns out that sequence matters.

What Changes Across Pregnancies?

Three levers move, quietly, predictably:

1) The Maternal Immune System Learns
Pregnancy is not passive. It is negotiation. The first pregnancy = naïve immune system learning tolerance. Subsequent pregnancies = trained, adapted immune responses
That training alters: cytokine tone, antibody profiles, placental signaling
The fetus is downstream of all of it.

2) The Placenta Is Not a Copy-Paste Organ…
Dr. M

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 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

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