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Metabolic and functional medicine articles in a clinician-scientist register. Each note carries a plain-language summary and the full text with its sources. Pick a topic and scroll.
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5 notesInsulin resistance: the silent axis of metabolism
In short: When the body stops listening to insulin, blood sugar rises. You can act early.
Physiology, ectopic lipid, metabolic syndrome, and what high-level evidence supports doing.
Read note →Sleep and metabolism: the circadian axis and cardiometabolic risk
In short: Poor sleep affects blood sugar, appetite and weight.
Sleep restriction and fragmentation, insulin sensitivity, appetite and risk of type 2 diabetes.
Read note →Skeletal muscle as a metabolic organ
In short: Muscle is the greatest ally of your blood sugar and your longevity.
Glucose uptake, sarcopenia, strength and mortality, myokines, and what the evidence allows us to state.
Read note →Subclinical thyroid: when to investigate, treat and wait
In short: Not every abnormal thyroid result on a test needs medication.
Biochemical diagnosis, TSH stratification, the TRUST trial and caution against overtreatment.
Read note →Estrobolome: microbiome, estrogen and what the strains really do
In short: The gut helps recycle estrogen. Hormonal probiotics promise more than they deliver.
Beta-glucuronidase, dysbiosis, clinical associations and strains graded by level of evidence.
Read note →Metabolism and Blood Sugar
6 notesDiets compared: Mediterranean, low carb, ketogenic, carnivore and low histamine
In short: Five diets, five levels of evidence. The Mediterranean has trial outcomes; the carnivore, only anecdote.
A comparison that separates what changes outcomes from what is a trend, from the Mediterranean to the carnivore and low histamine.
Read note →Retatrutide, semaglutide and tirzepatide for weight loss
In short: Semaglutide and tirzepatide are already approved and have been compared head to head; retatrutide is still investigational.
Three generations of mechanism and three levels of proof, from proven outcome to phase 3 promise.
Read note →Iron, HFE and overload: what ferritin says and what it does not
In short: High ferritin is not always iron excess. Understand it before treating.
Iron homeostasis, hepcidin, ferritin as an acute-phase reactant, and when phlebotomy is indicated.
Read note →Hepatic steatosis (MASLD): fat in the liver as a metabolic signal
In short: Fat in the liver is a warning from the metabolism, not just the liver.
Metabolic dysfunction-associated steatotic liver disease, cardiometabolic risk, diagnosis and management.
Read note →Skeletal muscle as a metabolic organ
In short: Muscle is the greatest ally of your blood sugar and your longevity.
Glucose uptake, sarcopenia, strength and mortality, myokines, and what the evidence allows us to state.
Read note →Insulin resistance: the silent axis of metabolism
In short: When the body stops listening to insulin, blood sugar rises. You can act early.
Physiology, ectopic lipid, metabolic syndrome, and what high-level evidence supports doing.
Read note →Hormones and Women's Health
8 notesGrowth hormone in adults: cancer and replacement, without the myth
In short: Physiological replacement in proven deficiency is treated as safe; the fear of cancer comes from excess and anti-aging use.
Undoing the two exaggerations about GH, the fear of cancer and the promise of rejuvenation, with the evidence in between.
Read note →Testosterone and cardiometabolic risk
In short: Low testosterone tracks with metabolic risk, but replacement is not for everyone.
Hypogonadism and metabolic syndrome, a sober reading of TRAVERSE and current guidelines.
Read note →Subclinical thyroid: when to investigate, treat and wait
In short: Not every abnormal thyroid result on a test needs medication.
Biochemical diagnosis, TSH stratification, the TRUST trial and caution against overtreatment.
Read note →Testosterone replacement in women: evidence and fad
In short: The only indication with evidence is hypoactive sexual desire after menopause; energy, mood and anti-aging have no basis.
Where testosterone in women has evidence, where it becomes a hormone-optimization fad, and what is safe.
Read note →Panhypopituitarism without the myth: multiple deficiencies are not always panhypo
In short: Panhypo is central pituitary failure. Several primary deficiencies, usually driven by age, are not panhypo.
How to separate central panhypopituitarism from primary endocrine deficiencies that are multifactorial and driven by age.
Read note →Testosterone and the heart: cardiac enlargement, clotting and what the evidence allows
In short: Replacing testosterone does not enlarge the heart the way anabolic steroid abuse does, and the cardiovascular scare came from weak studies. Safe when indicated and monitored.
The fear of the enlarged heart and the clot, separated from abuse and anchored in TRAVERSE, with clotting treated honestly.
Read note →Testosterone, hormone replacement and sexual health: a clinical FAQ
In short: An FAQ from the Harvard course on testosterone, hormone replacement and sexual health, from men to women, from heart to mind.
Questions and answers on testosterone, menopause and sexual health, answered from indexed primary sources, separating indication from fad.
Read note →Estrobolome: microbiome, estrogen and what the strains really do
In short: The gut helps recycle estrogen. Hormonal probiotics promise more than they deliver.
Beta-glucuronidase, dysbiosis, clinical associations and strains graded by level of evidence.
Read note →Gut and Digestion
2 notesGut barrier, mucosal immunity and endothelial dysfunction
In short: Leaky gut has real science and a lot of commercial exaggeration.
Junctions, zonulin, metabolic endotoxemia, and where mechanism ends and commercial diagnosis begins.
Read note →The gut under evidence: SIBO, calprotectin and gluten without the fad
In short: SIBO, gluten and inflammation: what the test really shows and what it does not.
What the tests establish and what they do not; celiac disease, gluten sensitivity, FODMAPs and nocebo.
Read note →Energy, Sleep and Mitochondria
2 notesCoenzyme Q10 and mitochondrial function: evidence versus fad
In short: CoQ10 has real use in the heart, but it became a fad for energy.
From the Q-SYMBIO trial to the meta-analyses on statin-induced myalgia, separating foundation from promise.
Read note →Sleep and metabolism: the circadian axis and cardiometabolic risk
In short: Poor sleep affects blood sugar, appetite and weight.
Sleep restriction and fragmentation, insulin sensitivity, appetite and risk of type 2 diabetes.
Read note →Science and Innovation
2 notesFrom genome to therapy: cancer, CRISPR and mRNA vaccines
In short: Cancer, CRISPR and mRNA: what is already real and what is still a promise.
Precision oncology separating the approved from the investigational, with somatic versus germline governance.
Read note →AI in drug discovery: from target to clinical signal
In short: How AI accelerates drug discovery, from target to patient.
Machine learning in the discovery pipeline and the governance that separates learning from decision.
Read note →Sports Metabolism
4 notesSports metabolism: energy systems, metabolic flexibility, and what the evidence supports
In short: How the body makes energy during exercise, why lactate is fuel and not a foe, and where metabolic optimization has a basis and where it becomes a fad.
How the body produces energy during exercise, why lactate is fuel and not a villain, and where metabolic optimization has a basis and where it becomes a fad.
Read note →Sports supplements: what is truly ergogenic and what is marketing
In short: Only a handful of supplements change performance: caffeine, creatine, buffers and nitrate. The rest is fad, cost and risk.
Among hundreds of products sold to athletes, only a handful change performance. The rest is fad, cost and contamination risk.
Read note →Protein and hypertrophy: how much, when, and from what source, according to the evidence
In short: Protein builds muscle, but above roughly 1.6 g per kg per day the surplus does not become extra muscle. Daily distribution matters more than post-workout haste.
Protein is the macronutrient that builds muscle, but more is not better. Above a ceiling, the surplus does not become extra muscle, and distribution across the day matters more than post-workout haste.
Read note →Relative energy deficiency in sport (RED-S): when training too much and eating too little makes you ill
In short: Chronically eating less energy than training expends harms hormones, bone, immunity and the mind, in women and men, and worsens performance.
Chronically consuming less energy than training expends does not improve performance. It breaks down hormones, bone, immunity, and the mind, in both women and men.
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