Tag Archives: prevention

Dr. M’s Women and Children First Podcast #116: Russell Greenfield, MD – The Art of Listening

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Welcome back to Dr. M’s Women and Children First.

One of the recurring themes on this podcast is that the future of medicine won’t be discovered through faster-paced healthcare alone. It will be discovered by slowing down, listening more carefully, and embracing a patient-centered approach that seeks to understand the whole person—not just the disease. Ultimately, the future of medicine begins with a better question: How do we truly hear a patient’s story so that we can better serve the person sitting in front of us?

Today’s guest has spent his entire career helping answer that question.

Our conversation today centers on one of the most overlooked aspects of healing: why so many people struggle to begin the healing process in the first place—and more importantly, how we, as clinicians, parents, and patients, can help that process finally move forward.

Dr. Russell Greenfield is a board-certified emergency medicine physician and a Diplomate of the American College of Lifestyle Medicine whose career has been dedicated to transforming healthcare from a disease-centered model into one focused on whole-person health. He has served as Medical Director of Integrative Medicine for major health systems, including Novant Health and the Weisiger Cancer Institute, held national leadership positions within the Veterans Health Administration’s Whole Health Initiative, and continues to advise organizations across the country that are reimagining what healthcare can become.

What makes Dr. Greenfield’s journey especially unique is that he was one of the select physicians chosen to complete a residential fellowship under the mentorship of Dr. Andrew Weil at the University of Arizona—the birthplace of academic integrative medicine. At a time when very few physicians were willing to challenge the traditional boundaries of healthcare, Dr. Greenfield immersed himself in a model that recognized nutrition, movement, sleep, stress, relationships, purpose, and environment as fundamental pillars of health, while embracing the remarkable advances of modern medical science.

For me, this conversation is especially meaningful because many of us in medicine are asking the same question: How do we move upstream? How do we stop waiting for chronic disease to develop and instead create the conditions where health can flourish?

Today we’ll explore the art of becoming an experienced listener in service of the patient before us. We’ll discuss why curiosity often matters more than certainty, why healing frequently begins long before the prescription pad comes out, and how understanding a person’s story can unlock opportunities that laboratory tests and imaging studies alone may never reveal.

Whether you’re a clinician, a parent, or simply someone searching for a deeper understanding of health, I think you’ll come away from this conversation with a renewed appreciation for one of medicine’s most powerful tools: listening.

Enjoy,

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 Women and Children First Podcast #114: Aimie Apigian, MD – Biology of Trauma

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Today’s podcast guest is Dr. Aimie Apigian, a physician who has become one of the leading voices in helping us understand the biology of trauma.

Dr. Aimie is double board-certified in Preventive Medicine and Addiction Medicine, with advanced training in biochemistry, public health, and functional medicine. She earned her medical degree from Loma Linda University, where her education also included behavioral health, child psychiatric therapy, play therapy, and addiction family counseling. Before medical school, she studied Cell and Molecular Biology at the University of Washington, where she worked in the laboratory of renowned cancer researcher Dr. Larry Loeb.

She is the national bestselling author of The Biology of Trauma, featuring a foreword by Dr. Gabor Maté. The book has appeared on the USA TODAY Best-Selling Book List and has received multiple national book awards.

What makes Dr. Aimie’s work unique is her ability to bridge neuroscience, functional medicine, attachment science, and trauma therapy into a practical framework that explains how our bodies store survival patterns after stress and adversity. Rather than viewing trauma as simply a psychological experience, she teaches that it is a biological state—one that can be identified, measured, and, importantly, healed.

She is the creator of the Biology of Trauma® framework, which integrates somatic therapies, parts work, nervous system regulation, and targeted biological interventions into a structured sequence designed to restore the body’s innate capacity for healing. She is also the founder of Trauma Healing Accelerated™ and the host of the popular Biology of Trauma® Podcast, where she has educated thousands of clinicians and individuals around the world.

Today, we’re going to explore what trauma actually is from a biological perspective, how it influences immune function, metabolism, chronic disease, and childhood development, and perhaps most importantly, what it truly takes to move from surviving to thriving.

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

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