Patient Portal

Diabetes: diagnosis and classification

Professional module. The current diagnostic criteria, the spectrum of prediabetes, and the etiologic classification, with emphasis on not confusing type 1, type 2, and the monogenic forms, because classifying correctly changes treatment.

included in the course

Type 1 diabetes treatment

Professional module. Basal-bolus insulin therapy with analogues, carbohydrate counting, continuous glucose monitoring and hybrid closed loop, time-in-range targets and hypoglycemia management, anchored in current guidelines, because in type 1 diabetes control and safety are the same objective.

included in the course

Type 2 diabetes treatment

Professional module. How to treat type 2 diabetes today: lifestyle change and weight management, metformin, GLP-1 receptor agonists and dual agonists, SGLT2 inhibitors, and comorbidity-centered choice beyond glycemia, through to insulin initiation when necessary.

included in the course

Dyslipidemia: risk assessment and LDL targets

Professional module. How to stratify cardiovascular risk, define the LDL target by category and build treatment starting from the statin, with ezetimibe, PCSK9 inhibitors, ApoB, Lp(a) and attention to diabetic dyslipidemia, because the right target depends on each patient's risk.

included in the course

Diabetes and dyslipidemia update

Professional module, dated. The retirement of the cholesterol guideline cited in module 4 and the dyslipidemias document replacing it, the new risk assessment sequence with PREVENT, lipoprotein(a) once in a lifetime and selective ApoB, the return of numerical LDL and non-HDL goals, the early intervention populations the endocrinologist follows, the 2026 Standards of Care changes with emphasis on older adults, and the procedure that keeps a clinical course current in a controlled way.

included in the course

Thyroid dysfunction

Professional module. How to interpret TSH and thyroid hormones and manage the main thyroid disorders: from hypothyroidism and levothyroxine replacement to hyperthyroidism and Graves' disease, the thyroiditides, the subclinical forms, and the thyroid in pregnancy, anchored in the guidelines of the American Thyroid Association.

included in the course

Thyroid nodules and câncer

Professional module. How to assess the thyroid nodule, stratify risk by ultrasonography, indicate biopsy and interpret the Bethesda system, and manage differentiated carcinoma — from surgery to radioactive iodine, TSH suppression, and follow-up — including when active surveillance replaces immediate surgery.

included in the course

Thyroid update

Professional module, dated. The replacement of the references cited in modules 5 and 6, the structural separation of nodule and cancer with the nodule document still pending, the molecular axis entering the therapeutic decision structure in differentiated cancer, the 2026 gestational update with its declaration on evidence quality, the levothyroxine fasting rule moving from convention to randomised trial, and the maintenance procedure that closes the course.

included in the course

Obesity: fundamentals

Professional module. Obesity as a chronic relapsing disease, the limits of body mass index in the individual, energy homeostasis and the physiological defence of body weight, the 2025 criteria separating clinical from preclinical obesity, functional staging by damage rather than weight, and the minimum initial assessment set.

included in the course

Clinical and surgical obesity

Professional module. Thresholds for escalating beyond lifestyle, the mechanism and effect size of incretin receptor agonists, the demonstration of cardiovascular benefit on a major outcome, the updated 2022 surgical indications with the choice between gastric bypass and sleeve gastrectomy, the long term life expectancy evidence, and the content of lifelong follow up.

included in the course

Physical activity and endocrinology

Professional module. The insulin independent glucose uptake pathway that gives exercise therapeutic standing, dose parameters across volume, intensity and strength, safe prescribing in diabetes with hypoglycaemia risk stratified by drug class, muscle as an endocrine organ secreting myokines, relative energy deficiency in sport as an underdiagnosed condition, and pre-participation assessment proportionate to risk.

included in the course

Clinical nutrition and endocrinology

Professional module. The absence of a single optimal eating pattern and the shift of the clinical question toward adherence, remission of type 2 diabetes through structured weight management with the elements that cannot be omitted, the Mediterranean pattern on a major outcome with the methodological caveat of retraction and republication, what direct macronutrient comparison supports and overturns, the five items of a prescribable plan with protein targets, and a restrictive position on supplementation.

included in the course

Obesity update

Professional module, dated. The shift of development toward combining pathways and toward oral administration, triple agonism and the largest magnitude reported so far, what a phase 2 result does and does not license, weight regain after discontinuation and the chronic nature it imposes on therapy, the additional demands high magnitude places on lean mass and micronutrients, and a method for reading updates that outlives the current list of agents.

included in the course

Endocrine emergencies

Professional module. What separates an emergency from the rest of the course and why root cause investigation is here subordinate to stabilisation, the hyperglycaemic crises with the potassium before insulin rule, adrenal crisis as the emergency missed by not being remembered and the asymmetry that licenses treating before confirming, the ordering rules in thyroid emergencies, severe hypoglycaemia defined by function rather than by a number, and four cross cutting principles.

included in the course

Hyperprolactinaemia

Professional module. The tonic inhibition architecture that explains why so many conditions raise prolactin, the three pre-analytical traps that produce error in both directions, drug induced hyperprolactinaemia and the rule against stopping a psychotropic for a number, prolactinoma as the one pituitary adenoma with a pharmacological first line, and the contexts in which the treatment target changes.

included in the course

Neuroendocrine disorders

Professional module. The pituitary incidentaloma and its three questions in fixed order, acromegaly and the diagnostic delay that characterises it, the rigid sequence in hypercortisolism with exclusion of an exogenous source first, hypopituitarism and the glucocorticoid before levothyroxine rule, and mass effect with the visual symptom the patient does not notice.

included in the course

Adrenal gland disorders

Professional module. Why primary and secondary insufficiency are not the same disease and what the distinction determines, the diagnostic sequence with its timing and prior corticosteroid traps, replacement without a laboratory target and the risk of silent chronic overdose, the adrenal incidentaloma with its two independent questions, and congenital adrenal hyperplasia in adults with its difficult therapeutic balance.

included in the course

Endocrine hypertension

Professional module. Who to screen and why the yield justifies the cost in defined subgroups, primary aldosteronism and the hypokalaemia misconception that sustains underdiagnosis, the drugs that interfere with screening, lateralisation by venous sampling as the basis of the surgical decision, and the two ordering rules of phaeochromocytoma, biochemistry before imaging and alpha blockade before beta blockade.

included in the course

Growth disorders

Professional module. The chart as the principal test and velocity as the parameter of greatest value, the two variants of normal that account for most presentations, the reproducibility limits of the stimulation test and why it is not a binary test, indications for treatment beyond deficiency with expectation declared per indication, and Turner syndrome with the cardiovascular follow up that determines prognosis.

included in the course

Disorders of puberty

Professional module. Pubertal sequence as more useful information than chronology, the distinction between central and peripheral precocious puberty with its asymmetry of risk between the sexes, the indication for a GnRH analogue by combination of age and progression rather than by diagnosis, delayed puberty organised by gonadotrophins, and the genuinely hard problem of separating constitutional delay from congenital hypogonadism.

included in the course

Female endocrinology

Professional module. What the 2023 guideline changed in polycystic ovary syndrome and why adult criteria do not apply to adolescents, management organised by declared objective rather than a single treatment, functional hypothalamic amenorrhoea as the opposite condition in mechanism and the reason not to treat it with a contraceptive, and the menopausal hormone therapy decision with indication before window.

included in the course

Male and transgender endocrinology

Professional module. Why symptom and biochemistry are both required in hypogonadism and the sampling rules that change the result, the additional workup the secondary origin requires and that tends to be skipped, the narrow indication for testosterone therapy and the fertility conversation that precedes the first dose, what the cardiovascular safety trial answered and what it did not, and endocrine care of the transgender person with monitoring by regimen and screening by organ inventory.

included in the course

Osteoporosis and vitamin D

Professional module. The three points of entry to diagnosis and why requiring an abnormal scan leaves the patient who has already fractured undiagnosed, what the 2024 vitamin D guideline changed by advising against routine measurement in healthy adults, choice of agent by risk level, the two sequencing and discontinuation rules most frequently got wrong, and communicating rare adverse effects without producing abandonment.

included in the course

Bone metabolism disorders

Professional module. PTH as the test that divides hypercalcaemia into two non-overlapping groups, asymptomatic primary hyperparathyroidism and the surgical criteria that absence of symptoms does not exclude, hypoparathyroidism as the only axis treated without replacing the missing hormone and the counterintuitive target that follows, Paget disease, and the magnesium trap in refractory hypocalcaemia.

included in the course

Functional medicine foundations

Professional module. The systemic, root cause model, the causal grammar of antecedents, triggers and mediators, the Functional Matrix and its physiological nodes, lifestyle factors treated as prescribable intervention with dose and verification, an honest stratification of the evidence base, and the scope limits of the model.

included in the course

Intellectual lineage: biochemical individuality, orthomolecular medicine and integrative convergence

Professional module. The verifiable genealogy of functional reasoning, from Williams on biochemical individuality to Pauling on orthomolecular medicine, to formalisation by systems biology and to contemporary convergence with lifestyle, integrative and precision medicine. It includes the explicit record of historical applications that did not survive replication, and the declared position of this course on public inheritance, original authorship and open questions.

included in the course

The functional Timeline: antecedents, triggers and mediators

Professional module. The grounding of the Timeline in life course epidemiology, with the critical period and accumulation models and their distinct consequences for management, developmental plasticity as the mechanism, early adversity as an antecedent with a graded relationship, the practical four axis structure with vertical reading, recall bias and the asymmetry between false negative and false positive, and what the instrument does and does not produce.

included in the course

The Functional Matrix: the seven physiological nodes

Professional module. The epidemiological finding that justifies the matrix, its formal grounding in network medicine and disease modules, the operational definition of the seven nodes with characteristic dysfunction, markers and predictable neighbours, allostatic load as the transverse mediator at the centre, the five step sequence that ends in a prioritised plan, and the limits and misuses stated explicitly.

included in the course

The GOTOIT clinical method: the six steps

Professional module. Why a declared sequence rather than a consultation run on habit, the measurable cost of compressing collection, the two functions of telling the story back and the effect of the clinical relationship on outcome, joint prioritisation conducted through the three talk model, execution with a declared target and follow up as measurement based care, and the central clinical pearl of deliberately delaying diagnostic closure, holding the hypothesis open until the sequence has tested it, which is precisely what the method exists to sustain.

included in the course

The center of the Matrix and the therapeutic partnership

Professional module. Why the center of the matrix is not a humanistic ornament but a physiological claim, the mechanism that translates biography into biology through allostatic load, the antecedents that remain in the body as adverse childhood experiences, the therapeutic partnership as a clinical instrument measurable through the working alliance, clinician empathy and patient activation with a documented effect on outcome, and the central clinical pearl of treating the center as obligatory matter of the plan, revisited at every consultation with the same discipline given to a test, never confusing the therapeutic bond with the treatment it makes possible.

included in the course

Team based care: health coach, dentistry and clinical pharmacy

Professional module. Why the matrix exceeds what one clinician delivers in consultation time and demands team based care organized by the chronic care model, the health coach as the member who executes behavior change, the oral systemic connection that makes dentistry a medical partner, clinical pharmacy as the deprescribing and safety function of the plan, the coordination that separates a team from a pile of referrals, and the central clinical pearl of always referring with a shared plan and a named coordinator, because that is precisely what separates a team from a pile of referrals.

included in the course

Sleep and circadian rhythm as a therapeutic lever

Professional module. Why sleep is a first line lever and not a symptom to medicate, the demonstrated metabolic cost of sleep restriction and the mortality gradient of inadequate duration, circadian misalignment as a factor independent of duration, cognitive behavioral therapy as the first line intervention in chronic insomnia, the practical prescription of sleep by duration, timing, light and continuity, and the clinical pearl of investigating the cause and offering the behavioral lever before any hypnotic, because the correct sequence is what separates correcting a system from simply switching one off.

included in the course

Movement, stress and relationships

Professional module. Why movement, stress and relationships are three levers of the modifiable ring with hard outcome evidence despite being treated as soft factors, physical activity as a dose related to mortality and sedentary behavior as a partly independent risk, exercise as prevention of depression, stress converted from a load into a measurable intervention, social connection as a biological factor of magnitude comparable to classic risks, and the clinical pearl of prescribing these levers with a dose, a goal and a measurement, calibrated to the real constraints of time, money, safety and capacity of the person receiving the advice.

included in the course

Functional nutrition I: the PFCMVP framework

Professional module. Why functional nutrition prescribes by structure and not by slogans, the PFCMVP scaffold as an attributed didactic instrument, macronutrients assessed by quality and not merely by quantity, the MVP layer of micronutrients, volume and phytonutrients, the dietary pattern as the unit above the isolated nutrient, and the clinical pearl of prescribing nutrition by structure and by dietary pattern, anchored in assessment and in the food culture of the person eating, rather than reducing it to gram counting or to supplements.

included in the course

Functional nutrition II: ABCD assessment and physical exam

Professional module. Why the prescription of module 10 presupposes an assessment that supports it, the four domains of the ABCD method and why none suffices in isolation, anthropometry beyond the scale with waist circumference as a vital sign, the biochemical and clinical domain with its markers and handgrip strength, the dietary survey and its limit of under-reporting, the integration of the domains into a diagnosis of malnutrition, and the clinical pearl that closes the module, that of never trusting a single number, because weight, albumin and the dietary survey describe different states and it is the joint reading of the four domains that sustains the diagnosis.

included in the course

Functional nutrition III: therapeutic food plans

Professional module. Why the therapeutic diet is chosen by indication and not by fashion, the cardiometabolic Mediterranean and DASH patterns with outcome evidence, nutrition therapy in diabetes where there is no single diet, the low-FODMAP diet as a three phase process and a bridge to part 2, adherence as the factor that decides the result above the type of macronutrient, and the clinical pearl of choosing the plan by documented indication and of scheduling reintroduction from the outset, so that no restrictive diet becomes permanent by inertia.

included in the course

The DIGIN model and the five domains of GI dysfunction

Professional module. Why the gut is not one function but five interacting domains, the DIGIN scaffold as the organizer of part 2 analogous to the matrix, digestion and absorption and the fermentation that produces short-chain fatty acids, the microbiota and dysbiosis, the integrity of the barrier and intestinal permeability, the nervous system of the gut-brain axis and diet as the lever that modulates the whole, and the clinical pearl of walking through all five domains before deciding on conduct, so that none of them is treated as if it were the whole gut.

included in the course

Maldigestion and malabsorption: hypochlorhydria and pancreatic exocrine insufficiency

Professional module. Why maldigestion and malabsorption are distinct failures that the distinction orients, hypochlorhydria and the iatrogenic suppression of acid by proton pump inhibitors, the nutritional consequences of that suppression on vitamin B12 and magnesium, exocrine pancreatic insufficiency and its diagnosis, carbohydrate malabsorption with lactose intolerance as the model, and the clinical pearl of correcting the cause of malabsorption at the same moment the nutrient is replaced, because replacement alone merely postpones the return of the deficiency.

included in the course

Gut inflammation: inflammatory bowel disease as the model

Professional module. Why inflammatory bowel disease is the clearest model of the DIGIN immune domain, the rising epidemiology that points to modifiable triggers, the immunopathogenesis as a convergence of genetics, microbiota, barrier and immune response, environmental triggers and dietary fiber, fecal calprotectin as the marker that separates the functional from the organic, and the clinical pearl of measuring before naming, using fecal calprotectin to support the diagnosis of inflammation and never to label as functional a picture that carried red flags.

included in the course

Intestinal dysbiosis and restoring microbial balance

Professional module. Why dysbiosis is a functional imbalance and not a test number, what perturbs the microbiota and its resilience after the antibiotic, the prebiotics and fiber that feed rather than seed, the probiotics between promise and skeptical evidence, fecal microbiota transplant as proof of concept and its limits, and the clinical pearl of feeding the terrain with fiber and substrate before, or at the very least alongside, any capsule one intends to seed.

included in the course

Intestinal permeability and extraintestinal disease

Professional module. Why permeability is real physiology surrounded by marketing, the zonulin and leaky gut hypothesis, the link between permeability and extraintestinal and autoimmune disease, the serious limits of permeability tests such as serum zonulin, the barrier as a therapeutic target with a mechanism, and the clinical pearl of treating the barrier as a therapeutic target with a documented mechanism, without diagnosing leaky gut from a weak test or blaming it for every complaint.

included in the course

Disorders of gut brain interaction: irritable bowel syndrome

Professional module. Why the old functional disorders were renamed disorders of gut-brain interaction, the high prevalence and global burden that makes them everyday, the positive diagnosis by criteria with targeted exclusion of the organic, the low-FODMAP diet and beyond, neuromodulators and psychological therapies as treatment of the axis and not of what is in the head, and the clinical pearl of making a positive diagnosis by criteria, naming it to the patient as a real disorder of the axis and treating it with a defined plan, rather than dismissing the patient as functional or restricting and medicalizing without end.

included in the course

Adverse food reactions: allergy, sensitivity and intolerance

Professional module. Why the taxonomy of adverse food reactions orients the whole conduct, immune-mediated food allergy and its diagnosis, the non-immune intolerances including that of histamine, the contested territory of sensitivity and the IgG tests that do not work, the food challenge as the reference standard, and the clinical pearl of confirming the reaction by food challenge, which is the reference standard, before restricting the diet, and never by an IgG test that lacks validity.

included in the course

Celiac disease and gluten and wheat related disorders

Professional module. Why the gluten and wheat disorders form a spectrum that the distinction orients, the autoimmune celiac disease that requires its own diagnosis, the sequence rule of diagnosing before removing gluten, the non-celiac sensitivity in which fructan reproduces symptoms more than gluten, the gluten-free diet for those who need it and not for the fad, and the clinical pearl of always diagnosing before removing, keeping gluten in the diet until serology and biopsy are complete, because the reverse order makes the celiac diagnosis impossible.

included in the course

Elimination diets and dietary strategies for the gut

Professional module. Why the elimination diet is a method of phases and not a permanent lifestyle, the validated indications with eosinophilic esophagitis as the model, the mechanics of structured elimination in the low-FODMAP, the risks of restriction from nutritional inadequacy to orthorexia, the safeguards that keep the method under control, and the clinical pearl of conducting elimination always with a period, a target and a reintroduction date already set, so that a temporary method never becomes a life of restriction.

included in the course

Gut brain axis, enteric nervous system and vagal therapies

Professional module. Why the enteric nervous system is a second brain and the gut-brain axis is bidirectional and asymmetric, the four channels through which the gut speaks to the brain, the vagus nerve as the main route and its tone measured by heart rate variability, the cholinergic anti-inflammatory pathway that links the vagus to immunity, the vagal therapies that have a basis versus those that are promise, and the clinical pearl of treating the vagus by what the physiology actually sustains, with a measurable target and a calibrated expectation, neither selling it as hacking nor dismissing it as mysticism.

included in the course

SIBO, reflux disease and autoimmune gastritis

Professional module. Why small intestinal bacterial overgrowth is real but overdiagnosed and why the breath test that supports it is imperfect, what the evidence says about reflux disease against the myth of hypochlorhydria as the cause, autoimmune gastritis as a real cause of vitamin B12 deficiency that cannot be missed, and the clinical pearl of anchoring each picture in its own verifiable mechanism, neither selling low acid as the explanation and cure for everything nor missing true autoimmune gastritis.

included in the course

The 5R protocol: remove, replace, reinoculate, repair and rebalance

Professional module. The 5R protocol presented as what it is, an operational heuristic attributed to functional medicine to organize intestinal restoration, the five steps and the unequal evidence of each one, the repopulation with probiotics whose evidence is more uncertain than the publicity admits, the repair of the barrier with nutrients of limited support, and the clinical pearl of using the 5R as a roadmap of reasoning anchored in an identified cause, and not as a fixed recipe accompanied by a stack of supplements.

included in the course

Stool and microbiome testing: clinical interpretation

Professional module. Why there are two worlds of stool testing that should not be confused, the validated tests such as fecal calprotectin and occult blood that answer a defined clinical question, the positive diagnosis of irritable bowel syndrome that avoids the cascade of examinations, the commercial microbiome panel that returns a portrait without a clinical cutoff, and the clinical pearl of ordering only the test that answers a defined clinical question, without turning a dysbiosis index into a prescription of supplements.

included in the course

Mitochondrial physiology and bioenergetics in the Matrix

Professional module. Why the mitochondrion is the powerhouse of the cell and also a signaling hub, how energy is produced in the electron transport chain and oxidative phosphorylation, why the reactive oxygen species signal beyond damaging, the paradigm that places the mitochondrion at the center of disease and aging, and why mastering this physiology is the basis for treating the bioenergetic root of a wide spectrum of chronic conditions.

included in the course

The five patterns of mitochondrial dysfunction: assessment and laboratory

Professional module. Why functional medicine organizes mitochondrial dysfunction into five patterns instead of a single defect, the patterns of making and removing mitochondria in biogenesis and mitophagy, the patterns of shape and stress in dynamics and the integrated response, the convergence in oxidative stress, and how to use this lens to direct interventions of multiple action on the bioenergetic root.

included in the course

Fatigue as the model presentation and the mitochondrial food plan

Professional module. Why fatigue is multifactorial and mitochondrial dysfunction is one of its central and least recognized contributors, what the dietary lever is in metabolic flexibility, the place of fasting and the ketone bodies with their indications, the nutritional support directed at the energy pathways, and how to build a dietary plan that sustains mitochondrial function and restores energy at the root.

included in the course

Diagnostic and treatment decisions in fatigue

Professional module. How to structure the diagnostic roadmap of fatigue to investigate it in depth, what the alarm signs and the common causes to evaluate are, when fatigue becomes a defined syndrome with post-exertional malaise that requires a specific management, how to decide the therapy by correcting the correctable and sustaining bioenergetics, and how to direct the conduct to the root of fatigue.

included in the course

Bioenergetics and mental health: depression and anxiety

Professional module. Why mitochondrial dysfunction and brain metabolism participate in psychiatric disorders in a field in full expansion, how chronic stress marks the mitochondrion and connects allostatic load to mood, the axis between inflammation, metabolism and depression, the growing place of metabolic interventions such as the ketogenic diet, the solid base of lifestyle psychiatry, and how to integrate the bioenergetic levers into the care of mental health.

included in the course

Bioenergetics and neurodegenerative disease

Professional module. Why mitochondrial dysfunction and oxidative stress are central in the neurodegenerative diseases, what the mitochondrial cascade hypothesis in Alzheimer proposes, the promising concept of brain energy rescue in the face of hypometabolism, the powerful prevention based on modifiable risk factors, and how metabolic health across life protects the brain at the bioenergetic root.

included in the course

Chronic pain through the mitochondrial lens

Professional module. Why chronic pain is often a sensitization of the nervous system, the model of nociplastic pain with fibromyalgia as the prototype, the bioenergetic link between mitochondrial oxidative stress and pain with coenzyme Q10 as support, the evidence based multimodal management, and how to integrate the bioenergetic support into the management of chronic pain.

included in the course

Sleep, exercise and nutrigenomics in mitochondrial health

Professional module. Why sleep and the circadian rhythm regulate mitochondrial metabolism, exercise as the most potent mitochondrial stimulus, time-restricted eating that aligns food to the biological clock, nutrigenomics as a frontier of personalized nutrition, and how to integrate the genetic information into the levers of sleep, exercise and rhythm.

included in the course

Mind mitochondria connection: stress, allostatic load and resilience

Professional module. Why allostatic load translates the biological price of chronic stress, the bidirectional loop between the mind and the mitochondrion with its empirical evidence, the mitochondrion as an integrator of psychosocial and metabolic signals, the measurable cost of stress in cellular aging, the mind-body interventions that modulate inflammatory biology, and how to integrate them into the bioenergetic care in a compassionate and evidence based way.

included in the course

Compassionate care, empathy and mindfulness in clinical practice

Professional module. Why compassion in care has a definition and an effect, what the evidence shows about mindfulness, how the clinical relationship itself changes outcomes measurably, why the wellbeing of the caregiver is a clinical and systemic question, how mindfulness supports the clinician, and how to integrate compassion, the relationship and mindfulness into the care as dimensions of real effect.

included in the course

The HPATG axis: an integrated view of the hormonal axes

Professional module. Why the endocrine system is an integrated network and not a set of isolated glands, how the hypothalamus conducts the axes through feedback loops, why the stress axis connects and modulates the others, how sex and context individualize the hormonal physiology, and how the systems view directs the evaluation and the care of hormonal imbalances.

included in the course

Adrenal dysfunction and chronic stress: cortisol assessment

Professional module. Why the so-called adrenal dysfunction is best understood as dysregulation of the hypothalamus-pituitary-adrenal axis, how chronic stress shifts the cortisol rhythm from a healthy pattern to dysregulation, what allostatic load is and its systemic cost, how to read the cortisol rhythm across the day, and why the HPA axis is a modifiable and central target in functional care.

included in the course

Expanded thyroid assessment: beyond TSH

Professional module. Why the functional thyroid assessment reads beyond TSH, what subclinical thyroid dysfunction reveals, how the expanded panel shows the peripheral conversion of T4 into T3, why a normal TSH does not always mean euthyroidism of the tissues, and how to individualize the assessment and the care of the thyroid within the evidence.

included in the course

Peripheral conversion, autoimmune thyroiditis and cofactor nutrients

Professional module. How T4 is converted into active T3 in the tissues by the deiodinases, what shifts that conversion toward reverse T3, what the low T3 syndrome of non-thyroidal illness is, how to recognize the autoimmune thyroiditis of Hashimoto by the antibodies, and how nutritional support acts on the conversion and the thyroid autoimmunity.

included in the course

Testosterone deficiency and male endocrinology

Professional module. Why testosterone deficiency is a real and underdiagnosed condition, what functional hypogonadism and its holistic view are, how testosterone links to obesity and insulin resistance, how to diagnose with rigor by symptoms and confirmed testosterone, and how to balance lifestyle and therapy when indicated.

included in the course

Female hormone imbalances: cycle, polycystic ovary and premenstrual tension

Professional module. Why the menstrual cycle is a vital sign, how the balance between estrogen and progesterone organizes the cycle, what polycystic ovary syndrome is as an endocrine-metabolic condition, how to assess and manage it based on evidence, and how stress suppresses the cycle in functional hypothalamic amenorrhea.

included in the course

Perimenopause and menopause: a tiered approach

Professional module. Why perimenopause and menopause are natural transitions with real symptoms, what characterizes the phase of variability of perimenopause, how to structure a tiered approach from lifestyle to hormone therapy, why there is a window of opportunity for hormone therapy, and how to individualize the decision by risk, benefit and timing.

included in the course

Hormone therapy: routes, doses and monitoring

Professional module. Why the route of administration changes the safety profile of hormone therapy, how the oral and transdermal routes differ, why the type of progestagen matters, how the consensus guides the doses by the principle of the lowest effective dose, and how monitoring and the long-term data support individualized care.

included in the course

Psychological and emotional factors in hormonal physiology

Professional module. Why the mind and the hormones form a two-way street, how psychological stress translates into inflammation, why social relationships are a physiological factor, how mind-body practices modulate the physiology of stress, and why the biopsychosocial model is the right lens for hormonal physiology.

included in the course

Estrogen metabolism and hepatic biotransformation

Professional module. How the body biotransforms estrogens through hepatic hydroxylation, what the 2, 4 and 16 hydroxy metabolite pathways mean, how the gut estrobolome governs the recirculation of estrogens, how cruciferous vegetables and fiber modulate that metabolism, and why reading the biotransformation closes part 4 of the hormonal axes.

included in the course

Chronic inflammation and systemic immune dysfunction

Professional module. Why acute inflammation protects and must resolve while chronic low-grade inflammation causes disease, why chronic inflammation is a central and underappreciated driver of chronic disease, what the inflammation of aging is, why resolution is an active process whose failure perpetuates inflammation, and how metabolic inflammation links immunity to metabolism.

included in the course

Foundational and advanced inflammatory biomarkers

Professional module. How high-sensitivity CRP quantifies inflammation by cut-points, why it predicts cardiovascular risk, how biomarkers guide the therapeutic decision, why the proof of the target shows that inflammation is causal, and how the expanded panel, with homocysteine, reads the inflammatory root from several angles.

included in the course

Anti inflammatory dietary approaches

Professional module. Why the diet is a direct lever on inflammation, how the Mediterranean diet reduces the inflammatory markers, why the dietary pattern matters more than the isolated food, how the dietary inflammatory index makes the target measurable, and how polyphenols provide the active molecules of the anti-inflammatory pattern.

included in the course

Essential fatty acid therapeutics: doses and ratios

Professional module. Why the balance between omega-6 and omega-3 shapes the inflammatory tone, how omega-3 feeds the resolution of inflammation, how the omega-3 index makes the status measurable, why high-dose EPA reduces the cardiovascular risk, and how to individualize the dose of EPA and DHA to the goal.

included in the course

Food allergy, sensitivity and intolerance through the immune lens

Professional module. Why food reactions form a spectrum, how IgE-mediated allergy is diagnosed, what the mechanisms of food intolerance are, why IgG food panels are not recommended, and how food sensitivity is evaluated by elimination and reintroduction.

included in the course

Emerging immune science: alpha gal syndrome and postbiotics

Professional module. How trained immunity reveals the memory of the innate system, what alpha-gal syndrome and the meat allergy from the tick bite are, why alpha-gal is a delayed anaphylaxis to a carbohydrate, what postbiotics are in the consensus definition, and how their emerging applications broaden functional immunity.

included in the course

Anti inflammatory botanicals: boswellia, curcumin and ginger

Professional module. Why anti-inflammatory botanicals are evidence-based tools, how curcumin alleviates the symptoms of arthritis, how boswellic acids act by a distinct mechanism, what benefit ginger has in osteoarthritis, and why bioavailability and standardization determine the judicious use.

included in the course

Immunomodulators: medicinal mushrooms, beta glucans and polyphenols

Professional module. Why immunomodulators balance the immune response instead of only stimulating or suppressing it, how the beta-glucans of mushrooms engage the immune receptors, how mushrooms act through the gut-immune axis, how polyphenols regulate immunity, and why the clinical application calls for standardization and judicious use.

included in the course

Chronic and occult infections: borreliosis as the central case

Professional module. Why chronic and occult infections can contribute to chronic disease, how Lyme borreliosis is diagnosed and treated, what post-treatment Lyme disease syndrome is, why the so-called chronic Lyme calls for rigor in the face of the controversy, and what the science shows about the persistence of Borrelia.

included in the course

Microbiome and chronic infection: testing and interpretation

Professional module. How the microbiome exerts colonization resistance against pathogens, how it educates immunity, why dysbiosis increases the susceptibility to infection, how antibiotics disrupt the microbiome, and why the restoration of the microbiome can cure the infection where the antibiotic fails.

included in the course

Atopy and mast cell activation: clinical management

Professional module. How mast cells release histamine and other mediators, what the allergic march of atopy is, why mast cell activation syndrome calls for rigorous criteria, how histamine intolerance results from the imbalance with DAO, and how the functional approach treats triggers and diet.

included in the course

Autoimmune disease: case management and therapeutic sequencing

Professional module. Why autoimmunity is a loss of self-tolerance, how environmental triggers set it off, why intestinal permeability is the third leg of the model, how molecular mimicry links the trigger to the attack on self, and how functional case management addresses diet and the root levers alongside conventional care.

included in the course

Total toxic load and the five clinical patterns of toxicity

Professional module. Why the exposome is the environmental and modifiable half of chronic disease risk, how the body's chemical burden is ubiquitous and measurable, how environmental toxicants contribute to chronic disease, why persistent pollutants link the toxic load to metabolism, and how to read the total toxic load through the five patterns.

included in the course

Oral and dental assessment in toxic load

Professional module. Why the mouth hosts a microbiome that is part of the functional assessment, how periodontal disease feeds systemic inflammation, why oral health and metabolism reinforce each other, how the dental dimension and materials enter the load reading, and how saliva and the oral examination compose the assessment.

included in the course

Biotransformation: phases I, II and III and individual susceptibility

Professional module. Why phase I functionalizes the toxicant through cytochrome P450, how phase II conjureview criteria the metabolite for excretion, why glutathione is the central conjugate, how the Nrf2 network coordinates the phases and phase III transport, and how nutrition modulates the entire biotransformation.

included in the course

Reducing exposure: food, water, air and personal care products

Professional module. Why an organic diet reduces pesticide exposure, how avoiding packaging reduces bisphenol A and phthalates, why filtration improves water, how air quality reduces particulate matter, and why reducing exposure at the source is an effective lever on the toxic load.

included in the course

Microplastics, dental materials and electromagnetic fields

Professional module. Why human consumption of microplastics is measurable, how their possible effects are under study, why dental amalgam contains mercury, how radiofrequency electromagnetic fields are classified in group 2B, and why emerging exposures already reach the body and warrant monitoring with rigor and without alarmism.

included in the course

Nutritional strategies supporting endogenous detoxification

Professional module. Why crucifers induce the protective enzymes, how a clinical trial with broccoli sprouts increased the excretion of pollutants, why sulfur precursors sustain glutathione, how curcumin and polyphenols modulate biotransformation, and how these foods converge on the nutrigenomic activation of the Nrf2 pathway.

included in the course

Safe patient preparation: gut function and elimination pathways

Professional module. Why bowel regularity is the primary route of elimination, how fiber supports the exit, why gut barrier integrity is part of the preparation, how toxicants leave through several routes of urine and sweat, and why maintaining bile flow closes the excretion route before mobilizing the load.

included in the course

Nutraceuticals and botanicals in biotransformation: doses and protocols

Professional module. Why silymarin supports the liver, how green tea polyphenols modulate biotransformation, why resveratrol and alpha-lipoic acid sustain the redox defense, how botanicals broaden the support, and why all are adjuvants used with judgment on quality, dose, and individualization.

included in the course

Advanced laboratory testing in clinical toxicology

Professional module. Why biomonitoring measures the internal load, how blood lead is a validated biomarker, why urinary arsenic requires speciation, how commercial hair analysis has limited reliability, and why interpretation against reference values, with rigor and by a qualified professional, is what turns the number into information.

included in the course

PFAS and persistent organic pollutants: current evidence

Professional module. Why persistent organic pollutants bioaccumulate and biomagnify, how per- and polyfluoroalkyl substances expose nearly the whole population, why their persistence is almost indefinite, how they are associated with effects on cholesterol and the immune system, and why reducing at the source is the main lever for the pollutants that stay.

included in the course

Toxic metals: assessment and judicious chelation

Professional module. Why toxic metals have known mechanisms and effects, how lead and mercury are assessed by validated biomarkers, why the form of mercury guides the management, how chelation is the established treatment of confirmed poisoning, and why measuring with validated biomarkers precedes treating, always under specialist supervision.

included in the course

Neurotoxicity, endocrine disruption and mitochondrial damage

Professional module. Why the developing brain is especially vulnerable to toxicants, how endocrine disruptors interfere with hormones, why bisphenol A and phthalates are avoidable models, how the evidence points to low doses and critical windows, and why protecting the windows of vulnerability and reducing at the source is the priority.

included in the course

Sequencing and monitoring detoxification protocols

Professional module. Why detoxification is an evidence-based sequence and not a fad diet, how elimination is enhanced with judgment, why excretion is monitored in blood, urine, and sweat, how individual variation requires personalization, and why functional detoxification is a sequenced, monitored, and iterative process that closes part 6.

included in the course

Cardiometabolic pathophysiology in the functional Matrix

Professional module. Why cardiovascular, kidney, and metabolic risk is an integrated continuum, how insulin resistance is the central node, why the metabolic syndrome is the risk cluster, how inflammation is the connective tissue linking metabolism and vessel, and why adipose tissue is an active endocrine organ of the cardiometabolic matrix.

included in the course

Insulin resistance: early detection before diabetes

Professional module. Why prediabetes opens a window of early detection, how fasting insulin and HOMA estimate insulin resistance, why the TyG index and the triglyceride-to-HDL ratio identify it with common tests, how diagnostic criteria define the thresholds, and why insulin resistance begins years before the cutoff.

included in the course

Hypertension subtypes and a personalized approach

Professional module. Why not all hypertension is essential, how primary aldosteronism is a common and underdiagnosed subtype, why salt sensitivity is a distinct phenotype, how resistant hypertension requires structured evaluation, and why the personalized approach reads the subtypes and phenotypes integrated with the guideline targets.

included in the course

Metabolic syndrome: phenotypes and stratification

Professional module. Why metabolically healthy obesity is a phenotype, how normal weight can be metabolically obese, why the location of visceral and ectopic fat drives the phenotype, how fatty liver is the hepatic manifestation, and why the metabolic syndrome predicts cardiovascular risk while phenotypes refine stratification beyond BMI.

included in the course

Advanced lipid assays: particles, ApoB and Lp(a)

Professional module. Why LDL causes atherosclerosis, how apolipoprotein B counts the atherogenic particles, why the particle number can be discordant with cholesterol, how lipoprotein(a) is an independent risk measured once in a lifetime, and why remnant cholesterol completes the reading of the atherogenic load.

included in the course

Endothelial dysfunction and atherosclerosis reversal

Professional module. Why the endothelium is the first responder and its dysfunction is the initial step of atherosclerosis, how nitric oxide is the protective signal, why endothelial dysfunction predicts events, how intensive LDL lowering makes plaque regress, and why lifestyle reverses coronary disease.

included in the course

Gut metabolism axis: TMAO, microbiome and cardiovascular outcome

Professional module. Why the microbiome influences metabolism, how gut-derived TMAO is associated with cardiovascular risk, why carnitine from red meat becomes TMAO and promotes atherosclerosis, how short-chain fatty acids support metabolism, and why the gut-heart axis is a node modifiable by diet.

included in the course

Vascular inflammation and residual risk biomarkers

Professional module. Why atherosclerosis is an inflammatory disease, how a residual inflammatory risk remains beyond cholesterol, why high-sensitivity C-reactive protein measures it, how anti-inflammatory colchicine reduces events, and why treating elevated C-reactive protein reduces cardiovascular risk.

included in the course

Cardiometabolic nutrition: dietary patterns and nutraceuticals

Professional module. Why the Mediterranean diet reduces events, how the DASH diet lowers blood pressure, why carbohydrate quality and fiber improve outcomes, how omega-3 reduces events in hypertriglyceridemia, and why lipid-lowering nutraceuticals are judicious adjuvants to the dietary pattern.

included in the course

Exercise, body composition and metabolic reversal

Professional module. Why exercise is medicine, how cardiorespiratory fitness predicts mortality, why muscle is a secretory organ that shapes body composition, how weight loss can lead to remission of type 2 diabetes, and why lifestyle prevents diabetes. Course-closing module.

included in the course

Foundations of functional nutrition

Defines the object, scope and five operating principles of functional nutrition, distinguishes it from sufficiency based clinical nutrition without invalidating it, sets biochemical individuality and precision nutrition as the basis of management, and stratifies honestly the degree of support behind each class of claim in the field.

included in the course

Biochemical individuality and genotype

Establishes biochemical individuality as the unit of analysis of functional nutrition, separates genotype, phenotype and exposure as three independent sources of variation, calibrates the realistic magnitude of the genetic effect on the response to a nutrient, and sets the criterion that distinguishes actionable genetic information from the merely descriptive.

included in the course

Metabolic web and clinical nutrition matrix

Builds the web of metabolic interconnections as an instrument of reasoning, converts it into a fillable case matrix from the history, orders the nodes by intervention priority according to explicit criteria, and delimits the matrix as an organizer of reasoning rather than a diagnosis.

included in the course

Clinical nutrition history and timeline

Formalizes the longitudinal collection of antecedents, triggers and mediators into a dated timeline, separates temporal association from causal inference in the record, and sets the criterion of a chart re-auditable by a third party without loss of information.

included in the course

Scope, ethics and limits of prescription

Classifies a proposed conduct as education, nutritional prescription or medical act, delimits legal competence by professional category and by jurisdiction, anchors practice in the four principles of clinical ethics with attention to scope, and sets the criterion of mandatory referral in the presence of a red flag.

included in the course

ABCD assessment: structure and execution

Integrates anthropometry, biochemistry, clinical and dietary domains into one reproducible assessment protocol, anchors the diagnosis of malnutrition in consensual operational criteria, standardizes documentation, and separates the real finding from the measurement artifact.

included in the course

Anthropometry and body composition

Separates weight into clinically meaningful compartments, compares body composition methods by premise, measurement error and applicability, and anchors the decision in muscle mass and function and in central adiposity, not in weight alone.

included in the course

Laboratory testing and functional interpretation

Distinguishes the reference interval from the functional range, compares the single value to the patient own reference change value, adjusts nutritional markers for inflammation, and privileges the functional marker and the pattern read over the isolated value.

included in the course

Clinical signs of nutritional deficiency

Systematizes the nutrition focused physical exam, reads the signs of energy protein malnutrition and of micronutrient deficiency on the skin, appendages and mucosa, and treats the sign as a hypothesis to confirm, not as a diagnosis.

included in the course

Metabolic screening instruments

Distinguishes screening from assessment, describes what a good instrument measures, presents the validated reference instruments, and links every positive result to an action, extending the two step logic from malnutrition to metabolic risk.

included in the course

Dietary intake assessment

Distinguishes the methods of dietary intake assessment by the temporal window each one measures, describes the 24 hour recall, the food record and the frequency questionnaire, exposes under reporting as a systematic and differential error, and sets the good practices of validation and of recording the method.

included in the course

Energy metabolism and mitochondrial function

Presents the mitochondrion as a dynamic network exceeding ATP production, shows how gas exchange quantifies the substrate oxidised and under which assumptions, and describes the biogenesis programme, the energy charge sensor and the dual role of oxidants as signal and as damage.

included in the course

Carbohydrates: metabolism and prescription

Establishes source quality as the determinant ahead of quantity, explains the glycaemic response and its determinants, distinguishes index from load, presents carbohydrate availability as a periodisation variable, and closes on prescription anchored to training load.

included in the course

Proteins and amino acids

Separates the population requirement from the individual target, describes the determinants of the anabolic response by dose, quality and distribution, bounds the real effect of supplementation and its plateau, and treats ageing as the setting in which intake and stimulus form a single intervention.

included in the course

Lipids and fatty acids

Frames advice about fat as a substitution question, bounds what randomised evidence supports about saturated fat, separates industrial from ruminant trans fats, exposes the limited conversion of alpha linolenic acid, and closes on measuring status by a membrane marker.

included in the course

Acid base balance

Describes the three lines of pH defence and their time scales, sets the sequence for assessing an acid base disturbance, presents the potential acid load of foods and what it actually predicts, and separates low grade acidosis from the commercial claims the acid base hypothesis does not support.

included in the course

Hydration and fluid electrolyte balance

Establishes osmolality as the regulated variable and thirst as its effector, compares hydration status markers by temporal window, describes performance degradation from deficit, and treats exercise associated and general hyponatraemia as the opposite error with inverted management.

included in the course

Water soluble vitamins

Derives from saturable transport the plateau organising the class, bounds vitamin C between correcting deficiency and megadosing, presents folic acid fortification and its open questions, describes cobalamin deficiency and its masking by folate, and ranks the circulation, reserve and functional markers.

included in the course

Fat soluble vitamins

Derives the three consequences of fat solubility, reserve, insensitive marker and accumulation risk, sets the reference intakes and upper limit for vitamin D, bounds what the outcome trials showed, describes vitamin K and its dependent proteins, and establishes the rule that every dose leaves with a limit and a monitoring parameter.

included in the course

Macrominerals and electrolytes

Shows why serum calcium and magnesium assays mislead, bounds the real effect of calcium supplementation on fracture, treats sodium and potassium as a ratio rather than independent targets, and presents salt substitution as the direct test of moving both sides at once.

included in the course

Trace elements

Explains why regulated absorption makes the serum marker lag in this class, sets the rule of reading ferritin with an acute phase protein, exposes competition between zinc, copper and iron, and uses selenium and iodine to show that the relation to outcome is U shaped, with harm at both extremes.

included in the course

Methylation and one carbon metabolism

Couples the folate cycle to the methionine cycle, reads homocysteine as a crossroads marker with two exits, bounds what testing the most requested genetic variant justifies, presents choline and betaine as an alternative route with its own limit, and separates lowering the marker from lowering the outcome.

included in the course

Doses, upper limits and drug nutrient interactions

Consolidates the dose rule of this part: shows where an upper limit comes from and what it does not mean, locates where supplement harm concentrates, sizes the problem through emergency visits and liver injury, and organises drug nutrient interactions by the four points at which they occur.

included in the course

Digestive physiology and the DIGIN model

Presents the five domain model as a checklist rather than a validated mechanism, and walks through the functional reserve of digestion, the fasting motor pattern that cleans the intestine, the immune discrimination between tolerating and responding, and the enteric nervous system with visceral hypersensitivity.

included in the course

Intestinal permeability

Decomposes the barrier into layers with distinct failures, compares measurement methods and their unequal validity, separates the mechanistic model from its commercial translation, exposes the question of the direction of association with disease, and closes on the aggressors and sustainers that actually have support.

included in the course

Microbiota, dysbiosis and modulation

Shows that functional redundancy precludes a single ideal profile, exposes why population variation limits reading a commercial test, presents short chain fatty acids as the functional output, describes the barrier cost of the fibre gap, and bounds what the evidence requires of a probiotic.

included in the course

The five R protocol and mucosal repair

Walks the five steps declaring the evidence asymmetry between them: directed withdrawal as a diagnostic phase with mandatory reintroduction, replacement with objective indication, reinoculation by strain and symptom, repair as the weakest based step, and rebalance as the best supported among those omitted.

included in the course

Food allergy, intolerance and hypersensitivity

Organises adverse food reactions by the immune against non immune branch point, distinguishes allergy from intolerance by dose dependence, exposes why immunoglobulin G against foods is not diagnostic, presents the reversal of prevention advice, and treats exclusion as an intervention with adverse effects of its own.

included in the course

Coeliac disease and non coeliac gluten sensitivity

Presents coeliac disease as a systemic condition with predominantly non classical presentation, sets the mandatory order of investigating before withdrawing, standardises the terminology of the three wheat related conditions, bounds non coeliac sensitivity as a diagnosis of exclusion, and separates gluten from fermentable carbohydrate.

included in the course

Toxic exposure and total body burden

Sizes exposure by the sources of greatest magnitude and by the socioeconomic gradient, separates detection from harm in biomonitoring, exposes the low dose and non monotonic response argument with its debated status, prioritises the critical windows of development, and closes on the dietary intervention with before and after measurement.

included in the course

Biotransformation: phases I, II and III

Presents biotransformation as a coupled sequence whose first phase may activate rather than inactivate, describes enzyme regulation and variation by isoform, locates in phase II the endogenous substrate dependency where nutrition acts, and shows why without phase III the system halts at the penultimate step.

included in the course

Toxic metals: assessment and management

Establishes chemical form as the determinant of source, target, assessment matrix and management, resolves the fish benefit and risk tension by species, presents the absence of a lead threshold, the mandatory speciation of arsenic and the decades long accumulation of cadmium with its iron interaction.

included in the course

Nutritional support of detoxification

Presents the inducible transcriptional defence programme, exposes the most direct human proof of conjugation induction, explains why glutathione is sustained by synthesis rather than ingestion, bounds what oral supplementation delivers, and separates real dietary modulation from the commercial multi day protocol.

included in the course

Nutritional modulation of the immune response

Establishes the hierarchy placing energy and protein before any micronutrient, maps the micronutrients with defined immune roles, presents the metabolic reprogramming of the activated cell, separates mechanism from marker and from clinical outcome, and sets what can and cannot be claimed.

included in the course

Chronic low grade inflammation

Defines low grade inflammation by failed resolution rather than by intensity, presents metaflammation as a response to energy surplus, bounds what biomarkers support, exposes the trial establishing inflammation as a target independent of cholesterol, and closes on the dietary pattern with outcome evidence.

included in the course

Oxidative stress and antioxidant defence

Updates the definition of oxidative stress to disruption of redox signalling, presents the oxidant as a regulated second messenger, exposes hormesis and the human trial documenting high dose antioxidant interference with training adaptation, and resolves the antioxidant paradox by separating diet from extract.

included in the course

Autoimmunity and nutrition

Organises autoimmunity into three necessary conditions and places nutrition within the only modifiable one, declares the evidence level of each dietary hypothesis in the field, presents the most robust association and its exposure window, and shifts the focus for the already diagnosed patient to what actually delivers benefit.

included in the course

Gut brain axis and mental health

Describes the four parallel routes of the axis and the fragility of translation from animal models, maps the plausible pathways between diet and mood, presents the randomised trial with a symptomatic outcome and the meta analysis situating it, and separates the real axis from its commercial translation into tests and strain protocols.

included in the course

Endocrine system: integrated view

Establishes what a hormone assay actually measures given binding proteins, explains why an isolated draw fails in pulsatile axes with functional reserve, sets the symmetry between stimulation and suppression testing, and presents energy availability as an endocrine input distinct from balance.

included in the course

HPA axis, cortisol and stress

Shows that the axis encodes information in the pulsatile pattern rather than the mean concentration, sets the protocol that makes cortisol measurement interpretable, presents the diurnal slope and its causality caveats, describes allostatic load as a problem of temporal regulation, and dismantles the adrenal fatigue label.

included in the course

Thyroid and regulatory nutrients

Establishes the log linear relationship between TSH and free hormone and the joint reading of the pair, presents the U shaped iodine risk curve with the evidence from the ALSPAC cohort, organises the nutrients required by synthesis and conversion, delimits what selenium changes and does not change in autoimmune thyroiditis, and sets the algorithm for suspecting analytical interference.

included in the course

Sex hormones and nutrition

Establishes that the testosterone number depends on the method that produced it, presents SHBG as the link between insulin resistance, hepatic fat and available hormone, places nutrition as first line care in polycystic ovary syndrome, reviews the isoflavone evidence on reproductive hormones in men, and organises soy outcomes beyond the reproductive axis.

included in the course

Sleep, circadian rhythm and chrononutrition

Describes the molecular clock and the hierarchy between central pacemaker and peripheral oscillators, presents circadian misalignment as a metabolic insult of its own, shows the effect of two short nights on leptin, ghrelin and hunger, places meal timing within the scientific statement on cardiovascular prevention, and separates the restricted eating window from the caloric deficit that usually accompanies it.

included in the course

Nutrigenomics and nutrigenetics: foundations

Separates the two directions of the gene and diet relationship, sets the three conditions a genotype guided recommendation must satisfy before being offered, presents the largest randomised trial of genotype matched advice and its result, supplies the criteria for judging a genotype based claim, and places precision nutrition within metabolic disease.

included in the course

Polymorphisms of clinical relevance

Separates the variant that changes management from the one that merely associates with a trait, covering lactase persistence, caffeine metabolism read across two opposite outcomes, the alcohol flushing that identifies oesophageal risk with no test at all, and the meta analysis that found no effect of FTO genotype on response to intervention.

included in the course

Epigenetics and metabolic programming

Covers the experimental demonstration that maternal diet alters DNA marking, the Dutch famine cohort and the persistence of the methylation difference decades later, the dependence of the signature on the gestational window, developmental conditioning as a distinction between adaptation and pathology, and the association between methylation at birth and childhood adiposity with its limits.

included in the course

Precision nutrition and response stratification

Shows that the glycemic response to the same meal varies widely and predictably between people, separates what is genetic from what is modifiable in the postprandial response, shows that simple fasting phenotypes stratify better than genotype, delimits what precision in metabolic disease does not yet support, and sets the questions a personalization claim must answer.

included in the course

Functional foods and bioactive compounds

Defines the bioactive compound by the chemical structure that governs its fate in the organism, presents the real bioavailability of polyphenols, identifies the microbial metabolite as the agent and the variation between those who produce it and those who do not, contrasts the isolated compound at high dose with the dietary pattern that reduced an endpoint, and applies the antioxidant paradox to the commercial claim.

included in the course

Phytotherapy in functional nutrition

Frames the use of herbal medicines by safety and interaction, situates the herb drug interaction as a pharmacokinetic event with defined targets, presents liver injury from herbals and supplements adjudicated in a prospective network, exposes the regulatory gap with adulteration and label discordance, and closes with the population signal from emergency visits.

included in the course

Probiotics, prebiotics, synbiotics and postbiotics

Sets the consensus definitions of probiotic, prebiotic, synbiotic and postbiotic, shows why strain specificity defeats a claim made at the level of the category, describes what removing viability changes, separates the complementary synbiotic from the synergistic, and presents the individuality of colonisation and the delayed reconstitution after antibiotic.

included in the course

Amino acids and derivatives in supplementation

Repositions the amino acid as a functional unit rather than merely a nitrogen source, establishes total protein dose and its distribution as the principal lever, presents the leucine threshold and the anabolic resistance of ageing, explains why the isolated branched chain yields less than complete protein, and delimits the real space for glutamine.

included in the course

Creatine, carnitine and bioenergetic support

Places creatine monohydrate as the best characterised ergogenic agent and describes its safety record, presents the creatine kinase system and the pleiotropic effects outside muscle, shows why oral carnitine raises muscle content only under a sustained insulin stimulus, sets out the microbial conversion to trimethylamine N oxide as the safety counterweight, and delimits coenzyme Q10 to the evidence that actually exists.

included in the course

Omega 3, CLA, whey protein and caffeine

Reads four heavily marketed supplements against their own trials: the marine fatty acid at nutritional dose and the primary endpoint that did not move, the pharmacological dose in a treated population and the comparator caveat, the measured effect of conjugated linoleic acid against the promise on the package, daily protein total against the timing window, and the ergogenic range of caffeine with its variation between people.

included in the course

Obesity and metabolic syndrome

Treats obesity and metabolic syndrome as a clinical nutrition problem: the harmonised definition and what it resolved, body mass index as a population instrument and its behaviour against all cause mortality, the hormonal adaptation persisting a year after weight loss that reframes regain as physiology, intensive lifestyle intervention and the cardiovascular endpoint that did not move, and total diet replacement in primary care with durable remission of type 2 diabetes.

included in the course

Insulin resistance and diabetes

Describes intramyocellular and hepatic lipid accumulation as the origin of the insulin signalling defect, presents metabolic inflammation and cellular stress as a second convergent axis, sets out the multiple organ contributions that make single agent reasoning insufficient, shows the trial in which lifestyle outperformed pharmacotherapy in prevention, and establishes the consensus that the eating pattern, and not the macronutrient fraction, is the unit of prescription.

included in the course

Dyslipidaemias and cardiovascular risk

Establishes low density lipoprotein as a causal and cumulative exposure, presents the guideline risk stratification and the dual target logic, sets fat substitution rather than fat reduction as the operative concept, presents the eating pattern trial that reduced hard outcomes, and situates lipoprotein (a) as a largely genetic residual that diet does not move.

included in the course

Bone health and osteoporosis

Places peak bone mass as the determinant built before the third decade, organises the three entry points to diagnosis and to fracture risk assessment, sizes the small and non progressive effect of calcium on bone density, separates correction of vitamin D deficiency from added dose in someone already replete, and delimits the role of nutrition in postmenopausal osteoporosis.

included in the course

Eating disorders and eating behaviour

Describes the diagnostic spectrum and why the nutrition consultation is often the first clinical contact, presents the aetiology, assessment and treatment architecture of anorexia nervosa, details prevention of refeeding syndrome, examines what long follow up shows about recovery, and translates the rise documented in the pandemic period into screening and referral practice.

included in the course

Vegetarianism, veganism and restrictive diets

Sets out what the professional position states about the adequacy of a well planned plant based diet and what planning requires in practice, reads the cohort evidence on mortality alongside its confounding structure, establishes cobalamin as mandatory supplementation, treats iron and zinc bioavailability as a problem of matrix and preparation, and translates the fracture finding of the largest prospective comparison into management.

included in the course

Maternal and infant nutrition and the first thousand days

Situates the double burden of undernutrition and overweight in the same population and the same household, fixes periconceptional folic acid from the trial that demonstrated prevention of neural tube defect recurrence, presents the developmental origins model with its cautions, grades the breastfeeding evidence between early and late outcomes, and treats the introduction of allergenic foods after the reversal of the earlier advice.

included in the course

Children and adolescents

Sets the difference between a growth standard and a growth reference and the reading by trajectory, presents the guideline treating paediatric obesity as a chronic disease requiring immediate treatment, delimits the risk window of iron deficiency and its neurobehavioural cost, describes the coincidence of peak demand and food autonomy in adolescence, and establishes universal eating disorder screening in the nutrition consultation.

included in the course

Active older adults, sarcopenia and longevity

Presents the current operational definition of sarcopenia and the move from mass to strength as the primary criterion, justifies why the population reference intake of protein is insufficient for the older adult, quantifies anabolic resistance and the threshold per meal, demonstrates resistance exercise as an indispensable intervention, and organises malnutrition screening around the reversible causes.

included in the course

Motor disability and rehabilitation

Explains why standard anthropometry and predictive energy equations lose validity in motor disability, sets the international terminology that makes texture prescription reproducible between services, presents the energy and protein delivery that sustains tissue integrity in pressure injury, summarises the clinical nutrition guideline in neurology, and describes the division of responsibility that makes the plan executable.

included in the course

Nutrition applied to training methodology

Periodises carbohydrate availability against the training block instead of fixing a constant daily target, presents the joint position on nutrition and athletic performance and what decides the position inside each range, separates dose from distribution in protein prescription, delimits the interval in which immediate recovery actually matters, and translates the training plan into a written eating plan.

included in the course

Overtraining and low energy availability

Defines energy availability as the exposure variable and presents the threshold below which endocrine consequences appear, follows the expansion of the female athlete triad into relative energy deficiency in sport across both sexes, shows why bone records the deficit with delay, places the overtraining syndrome as a diagnosis by exclusion, and organises screening and the return to training decision.

included in the course

Nutritional prevention of muscle and joint injury

Presents collagen synthesis and the connective matrix as a target that depends on substrate coinciding with load, places vitamin D status within muscle function and stress fracture, describes immobilisation as the period in which the protein requirement rises while expenditure falls, sets out the tension between suppressing inflammation and permitting adaptation, and delimits the evidence for the supplements most marketed for the joint.

included in the course

Nutritional demands in endurance modalities

Sets the exogenous carbohydrate oxidation ceiling and the combination of sources that raises it, describes the gastrointestinal syndrome of effort and gut training, replaces the fixed hydration schedule with thirst and measured loss together with its hyponatraemic consequence, explains the hepcidin response that closes the iron absorption window, and presents carbohydrate periodisation across the season with its limits.

included in the course

Nutritional demands in strength and power

Establishes where the protein dose and response curve flattens and why the practical recommendation sits higher, separates the behaviour of strength and hypertrophy in an energy deficit, delimits the scenario in which creatine has the strongest evidence, situates the buffering agents in the effort range where the proton limits, and subjects body composition assessment to the measurement error of the method.

included in the course

Precision modalities and weight control

Documents the prevalence and magnitude of rapid weight loss in modalities with weight categories, gathers the physiological and cognitive cost the practice imposes at the moment of competition, describes the proposed regulatory measures and the gaps that persist, presents the elevated prevalence of eating disorders in aesthetic and weight sensitive modalities, and establishes sustainable competitive weight from energy availability.

included in the course

Therapeutic meal plans and prescription

Establishes the nutrition care process as the structure that makes prescription auditable, exposes the individual error of predictive energy expenditure equations and the situations that indicate measurement, shows that adherence to follow up explains more outcome than the prescribed composition, describes the portion and exchange architecture that keeps a plan adaptable, and sets measurable targets at the moment of prescription.

included in the course

Therapeutic diets: ketogenic, low FODMAP and elimination

Places the ketogenic diet as established therapy in refractory epilepsy and bounds the real size of its metabolic effect outside it, describes the three phase structure of the low FODMAP diet and the microbiological cost of remaining in restriction, sets the primacy of the oral challenge over elimination alone, and defines the exit criterion that separates a therapeutic diet from an indefinite restriction.

included in the course

Applied functional gastronomy

Translates the nutrition prescription into cooking: measures the effect of culinary technique on retention and bioavailability, presents the food matrix as a determinant of metabolic response beyond composition, describes the chemistry of high heat and the mitigations that exist, sets out the controlled trial that isolated the degree of industrial processing as a determinant of consumption, and shows the adherence gain that comes from teaching preparation.

included in the course

Adherence, behaviour and motivational interviewing

Treats adherence as the variable that decides the effect of any prescription, shows why patient report overestimates execution, isolates the clinician behaviours that carry the effect of motivational interviewing, presents the taxonomy of behaviour change techniques and the combination with a replicated effect in dietary intervention, and describes the consultation structure that produces an executable plan.

included in the course

Documentation, follow up and outcome audit

Organizes the follow up layer of a nutrition practice: standardised terminology and structured records as the condition for any analysis, definition of the outcome set before the intervention with patient reported measures alongside biochemical ones, the follow up interval as a clinical decision, audit as a loop that closes only with a new measure, and the reporting standards that make a practice auditable and a case series publishable.

included in the course

Endocrine Signaling Architecture

How glands, hormones, receptors, transport proteins, second messengers, and feedback loops coordinate physiology.

included in the course

Hypothalamus and Pituitary Integration

The master coordination layer: releasing hormones, trophic hormones, posterior pituitary peptides, pulsatility, and feedback.

included in the course

Thyroid Hormone Physiology

Iodide handling, T4 and T3 synthesis, deiodinases, receptor action, thermogenesis, growth, and cardiovascular effects.

included in the course

Adrenal Cortex and Stress Biology

Zona specific steroidogenesis, cortisol rhythm, aldosterone control, adrenal androgens, and the HPA stress response.

included in the course

Pancreatic Islets and Fuel Homeostasis

Insulin, glucagon, somatostatin, incretin signals, fasting fed transitions, and metabolic flexibility.

included in the course

Gonadal Axis and Reproductive Endocrinology

GnRH pulsatility, LH and FSH, steroidogenesis, ovarian cycle, testicular function, and sex steroid feedback.

included in the course

Growth Hormone and IGF Biology

GH pulsatility, hepatic IGF-1, sleep, nutrition, insulin interaction, growth plates, lipolysis, and anabolic signaling.

included in the course

Calcium, Phosphate, PTH, and Vitamin D

Parathyroid calcium sensing, renal phosphate handling, vitamin D activation, bone remodeling, and mineral balance.

included in the course

Circadian and Neuroendocrine Timing

Suprachiasmatic timing, melatonin, cortisol rhythm, sleep hormone interactions, feeding windows, and light exposure.

included in the course

Integrated Endocrine Reasoning

How endocrine axes interact across thyroid, adrenal, gonadal, pancreatic, bone, growth, and circadian systems.

included in the course

Safety Foundations and Chart Reading

Turns the introductory material into a safety map: word of caution, goals sources and limits, important warning, how to read the charts, optimal levels, reference ranges and deficient values.

included in the course

Detection of Hormone Deficiencies and Laboratory Strategy

Covers diagnose hormone deficiencies, short or extensive check, laboratory tests sufficient, blood urine saliva, 24-hour urine, toxicology tests, borderline deficiencies, optimal hormone level and cancer detection.

included in the course

Principles of Hormone Therapy, Safety and Efficiency

Covers replacement or corrective therapy, suppress the activity, physiological doses, bio-identical hormones, type and brand, safest and most efficient route, simultaneously correct, regular follow-ups and improve diet environment and lifestyle.

included in the course

Follow-up, Adjustment and Monitoring of Hormone Therapies

Covers follow-up with hormone therapies, patient return, lab testing, when to do the laboratory tests, adjust the dose and dose is too high.

included in the course

MSH, Melanocortins, Pigment and Inflammation

Applied module on MSH. Source terms preserved in the map: MSH, melanocyte-stimulating hormone, melanocortin.

included in the course

Calcitonin, Bone and Paget Disease

Applied module on Calcitonin. Source terms preserved in the map: calcitonin, intranasal calcitonin, Paget.

included in the course

DHEA, Androstenedione and Adrenal Androgens

Applied module on DHEA and androstenedione. Source terms preserved in the map: DHEA, androstenedione, adrenal suppression, prostate cancer, breast cancer.

included in the course

Pregnenolone, Steroidogenesis and Neurosteroids

Applied module on Pregnenolone. Source terms preserved in the map: pregnenolone.

included in the course

Testosterone in Women, Hirsutism and Safety

Applied module on Testosterone in women. Source terms preserved in the map: testosterone in women, female testosterone, hirsutism.

included in the course

Progesterone in Men and Gonadal Modulation

Applied module on Progesterone in men. Source terms preserved in the map: progesterone in men.

included in the course

Male Problems: Prostate, Estradiol and Peyronie

Applied module on particular men disease sections. Source terms preserved in the map: prostate, excessive estradiol, benign prostate hypertrophy, prostate cancer patients, Peyronie.

included in the course

Female Problems: Endometrium, Breast, Ovary and Hair

Applied module on particular women disease sections. Source terms preserved in the map: excessive body hair, male pattern hair loss, endometriosis, uterine cancer, benign breast cysts, menorrhagia, uterine fibroids, ovarian cysts.

included in the course

Atlas of Overviews, References, Bibliography and Index

Applied module on quick overviews, references, bibliography and index. Source terms preserved in the map: mental and emotional complaints, physical complaints, physical signs, disease susceptibility, initial hormone assessment, follow-up of hormone therapies, best hormone medications and doses, hormone diet, Hormone References, Bibliography, recommended resources, Articles and resources, seminars, laboratories, compounding pharmacies, Index, 6-sulfatoxy-melatonin, GH treatment, endogenous secretion, muscle strength, functional capacities, diabetes controversy, cardiovascular system, GH and cancer, life span, VP, antidiuretic hormone, free T3, free T4, T4-T3, thyroid treatment and the heart, bone density, parathormone, insulin-like growth factor, Alzheimer, serum cortisol, fludrocortisone, hypoglycemia, female HRT, bio-identical progesterone, testosterone in men, testicular suppression.

included in the course

Unit systems and the U-100 syringe

Why milligram, microgram, international unit, millilitre and syringe unit do not belong to the same quantity space, and how conflating them produces factor 10 and factor 100 errors.

included in the course

Reconstitution mathematics: from vial to unit

Derivation of the four identities that govern the whole platform, with dimensional checking and bidirectional solving between dose and units.

included in the course

Concentration design and diluent selection

Concentration is an engineering decision, not a value inherited from the vendor. Criteria for choosing the reconstitution volume and how to record that choice in an auditable form.

included in the course

Dose bands, titration and schedules

Modelling dose bands as intervals with a declared basis, and the difference between a source stated band and a label anchored band.

included in the course

Blends and multi component vials

In a blend the component ratio is fixed at manufacture. Engineering, titration and mass reconciliation consequences.

included in the course

Activity units and non mass based products

IU does not convert to milligram without a product specific factor. Modelling HCG, HGH and other products whose quantity is defined by biological activity.

included in the course

Deliverability, rounding and syringe error

The calculated dose and the delivered dose are not the same quantity. Explicit modelling of the deliverability envelope and of redilution remediation.

included in the course

Program stacks: composition and sequencing

Multi product programs as an intelligence object, never as a protocol. Phase modelling, catalog references and referential integrity.

included in the course

Dose, reconstitution and syringe-unit atlas

Ninety peptide records with vial, dose, concentration, syringe units, route, frequency and review status.

included in the course

Unit systems and the U-100 syringe

Why milligram, microgram, international unit, millilitre and syringe unit do not belong to the same quantity space, and how conflating them produces factor 10 and factor 100 errors.

included in the course

Reconstitution mathematics: from vial to unit

Derivation of the four identities that govern the whole platform, with dimensional checking and bidirectional solving between dose and units.

included in the course

Concentration design and diluent selection

Concentration is an engineering decision, not a value inherited from the vendor. Criteria for choosing the reconstitution volume and how to record that choice in an auditable form.

included in the course

Dose bands, titration and schedules

Modelling dose bands as intervals with a declared basis, and the difference between a source stated band and a label anchored band.

included in the course

Blends and multi component vials

In a blend the component ratio is fixed at manufacture. Engineering, titration and mass reconciliation consequences.

included in the course

Activity units and non mass based products

IU does not convert to milligram without a product specific factor. Modelling HCG, HGH and other products whose quantity is defined by biological activity.

included in the course

Deliverability, rounding and syringe error

The calculated dose and the delivered dose are not the same quantity. Explicit modelling of the deliverability envelope and of redilution remediation.

included in the course

Program stacks: composition and sequencing

Multi product programs as an intelligence object, never as a protocol. Phase modelling, catalog references and referential integrity.

included in the course

Dose, reconstitution and syringe-unit atlas

Ninety peptide records with vial, dose, concentration, syringe units, route, frequency and review status.

included in the course

Semaglutide: approved doses and the evidence behind them

Every approved semaglutide presentation, subcutaneous and oral, with the dose exactly as the label or the pivotal trial states it, the identifier that supports it and the declared level of evidence.

included in the course

Tirzepatide: dual GIP and GLP 1 agonism

The approved tirzepatide ladder across both products, the maintenance ceilings by indication, and the fixed dose against maximum tolerated dose distinction that separates the SURPASS programme from SURMOUNT.

included in the course

Retatrutide and GIP, GLP 1 and glucagon triagonism

Every published retatrutide dose, from phase 1b to phase 2, with starting dose and maintenance dose kept apart, and an exact record of what the phase 3 programme states and what it does not yet state.

included in the course

Survodutide and the glucagon axis

The published survodutide doses in obesity and in steatohepatitis, the long escalation design the programme demands, and a literal reading of the adjusted dose wording used by phase 3.

included in the course

Cagrilintide and the amylin pathway

The published doses of cagrilintide alone and of the CagriSema coformulation, with the dose of each component kept separate, and what phase 3 already measures about adding amylin to incretin.

included in the course

Oral incretin mimetics and the bioavailability barrier

The four approved oral ladders, the ritual oral semaglutide demands, the interactions orforglipron brings, and the documented discrepancy between the trial dose and the label dose.

included in the course

Setmelanotide and the MC4R pathway

The only approved MC4R agonist, the five populations in which it is indicated, the dose matrix by indication and age, and the exact evidence that supports each number.

included in the course

Tesamorelin and the growth hormone axis

The only registered GHRH analogue, the dose that changed when the formulation changed, and where sermorelin, CJC 1295 and ipamorelin sit once one asks what supports each number.

included in the course

Teriparatide and abaloparatide in bone

Two fixed doses, no titration, and three divergences that matter: the duration wording between labels, the European 18 month limit and the fact that only one of the two holds a Brazilian registration.

included in the course

Unapproved peptides: regulatory framing and what the evidence supports

For every catalogue agent without a marketing registration: the regulatory status by agency, the level of human evidence that exists, the exact provenance of the circulating dose and, where none exists, the statement that none exists.

included in the course

Introduction to Biochemistry and Metabolism

Professional Clinical Biochemistry program: Introduction to Biochemistry and Metabolism. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Introduction to Metabolic Chemistry

Professional Clinical Biochemistry program: Introduction to Metabolic Chemistry. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

DNA and RNA

Professional Clinical Biochemistry program: DNA and RNA. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Transcription Factors

Professional Clinical Biochemistry program: Transcription Factors. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

DNA and Epigenetics

Professional Clinical Biochemistry program: DNA and Epigenetics. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Cells and Organelles

Professional Clinical Biochemistry program: Cells and Organelles. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Membrane, Signaling and Transport

Professional Clinical Biochemistry program: Membrane, Signaling and Transport. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Introduction to Macromolecules

Professional Clinical Biochemistry program: Introduction to Macromolecules. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Water

Professional Clinical Biochemistry program: Water. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

AMPK, AKT, mTOR, HIF, PPAR and PGC-1 alpha

Professional Clinical Biochemistry program: AMPK, AKT, mTOR, HIF, PPAR and PGC-1 alpha. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Endoplasmic Reticulum and Mitochondria

Professional Clinical Biochemistry program: Endoplasmic Reticulum and Mitochondria. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Bioenergetics

Professional Clinical Biochemistry program: Bioenergetics. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Energy Metabolism

Professional Clinical Biochemistry program: Energy Metabolism. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

ATP: Generation and Metabolic Pathways

Professional Clinical Biochemistry program: ATP: Generation and Metabolic Pathways. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

ATP: Catabolism and Consequences

Professional Clinical Biochemistry program: ATP: Catabolism and Consequences. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

ATP and Fatigue

Professional Clinical Biochemistry program: ATP and Fatigue. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Energy Metabolism: Mitochondria

Professional Clinical Biochemistry program: Energy Metabolism: Mitochondria. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Anaerobic Glycolysis: Pathways and Repercussions

Professional Clinical Biochemistry program: Anaerobic Glycolysis: Pathways and Repercussions. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Glycolysis and Oxidative Metabolism

Professional Clinical Biochemistry program: Glycolysis and Oxidative Metabolism. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Urea Cycle

Professional Clinical Biochemistry program: Urea Cycle. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Amino Acids and Proteins

Professional Clinical Biochemistry program: Amino Acids and Proteins. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Lipids

Professional Clinical Biochemistry program: Lipids. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Carbohydrates

Professional Clinical Biochemistry program: Carbohydrates. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Energy Metabolism: Lipids

Professional Clinical Biochemistry program: Energy Metabolism: Lipids. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Energy Metabolism: Proteins

Professional Clinical Biochemistry program: Energy Metabolism: Proteins. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Metabolism: Vitamins, Minerals and Trace Elements

Professional Clinical Biochemistry program: Metabolism: Vitamins, Minerals and Trace Elements. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Enzymes

Professional Clinical Biochemistry program: Enzymes. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Biosignaling

Professional Clinical Biochemistry program: Biosignaling. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Chemical Signaling and Feedback

Professional Clinical Biochemistry program: Chemical Signaling and Feedback. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Receptors, Cellular Response, Agonism and Antagonism

Professional Clinical Biochemistry program: Receptors, Cellular Response, Agonism and Antagonism. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Metabolism, Health and Disease

Professional Clinical Biochemistry program: Metabolism, Health and Disease. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Nuclear Receptors

Professional Clinical Biochemistry program: Nuclear Receptors. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Hormones and Metabolic Regulation

Professional Clinical Biochemistry program: Hormones and Metabolic Regulation. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Anabolism and Pathologies

Professional Clinical Biochemistry program: Anabolism and Pathologies. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Glucotoxicity

Professional Clinical Biochemistry program: Glucotoxicity. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Lipotoxicity

Professional Clinical Biochemistry program: Lipotoxicity. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

Metabolomic Testing and Frontiers

Professional Clinical Biochemistry program: Metabolomic Testing and Frontiers. Integrates mechanisms, laboratory reasoning, nutrients, pathologies, treatments, doses and protocols into usable clinical reasoning.

What evidence based medicine is

Defines evidence based medicine by its original formulation, separates what the definition asserts from what is attributed to it, presents the three components of the decision, shows through the phenomenon of medical reversal why method matters and examines the criticisms directed at the movement and the correction each one proposes.

included in the course

The structured clinical question

Treats the clinical question as the unit of work of evidence based practice, separates background from foreground doubts, decomposes the question into population, intervention, comparator, outcome and time horizon, shows how each component translates into the search and teaches how to write the question as the protocol of a target trial.

included in the course

Evidence hierarchies and their limits

Explains what an evidence hierarchy is for and what each design actually controls, shows that certainty is a property of the body of evidence rather than of the design label, reviews the empirical comparison between trials and observational studies, presents the criticism of the hierarchical format and delimits the narrow class of the dramatic effect.

included in the course

Surrogate outcomes and outcomes that matter

Defines the surrogate outcome and the incentive that makes it attractive, presents the formal conditions for a marker to validly replace an outcome, reviews the counterexample of arrhythmia suppression after infarction, separates patient level from trial level correlation and presents core outcome sets as an organised answer.

included in the course

Probability, uncertainty and Bayesian reasoning

Treats probability as degree of belief and shows how presentation format determines the reading of risk, separates the question the p value answers from the one the clinician asks, presents the professional consensus on the limits of threshold inference, explains why the pre study probability governs the meaning of a positive finding and illustrates the Bayesian rereading of a neutral trial.

included in the course

Cross sectional studies

Delimits what a cross sectional cut measures and what stays beyond its reach, separates prevalence from incidence through the duration of the condition, shows why the odds ratio misleads when the outcome is frequent, exposes reverse causation and selective survival, and lists the reporting items that make the estimate interpretable.

included in the course

Case control studies

Explains why sampling on the outcome inverts the reasoning and what that inversion delivers, states the source population principle and the reciprocal eligibility test, works through the sources of controls and the distortion of each, separates symmetric from differential recall error and presents the arrangements nested in a cohort.

included in the course

Cohort studies

Establishes what following people through time makes measurable, separates the prospective from the historical cohort by when the data were made, demonstrates immortal time and the other errors in counting the denominator, exposes confounding by indication through the hormone therapy reanalysis and presents target trial emulation.

included in the course

Architecture of the randomised controlled trial

Works through the four structural pieces of the randomised trial, generation of the sequence by chance, allocation concealment protecting the instant of enrolment, blinding understood as a set of functions rather than a label, the empirical magnitude of displacement when those safeguards are missing, and the reporting that allows them to be verified.

included in the course

Alternative and adaptive designs

Separates foreseen adaptation from improvised alteration and enumerates the statistical price of each, states the validity conditions of the crossover trial, exposes the temporal confounding and intracluster correlation of the stepped wedge, describes the master protocol and its variants, and delimits the use of the N of 1 trial.

included in the course

Pragmatic and explanatory trials

Recovers the original distinction between the explanatory and the pragmatic attitude, turns the opposition into a continuum with named dimensions, presents the nine dimensions that position a trial at the planning stage, sets out the reporting items on comparator and context, and delimits what the pragmatic design delivers and charges.

included in the course

Absolute risk and relative risk

Separates the absolute scale from the relative scale, shows why mathematically equivalent formats produce different decisions, exposes the omission of absolute risk from abstracts, derives absolute benefit from baseline risk and translates the average trial effect for the individual patient.

included in the course

The odds ratio and when it misleads

Distinguishes odds from risk through the arithmetic of the denominator, delimits the designs in which the odds ratio is obligatory, quantifies the exaggeration it produces when the outcome is frequent, explains the non collapsibility that shifts the measure under adjustment and reconstructs the case in which an odds ratio was read as a risk.

included in the course

Survival analysis and the hazard ratio

Explains why time to event demands its own method, shows how censoring preserves partial information, teaches the reading of a Kaplan Meier curve through the numbers at risk, delimits the proportional hazards assumption, exposes selection among survivors and presents restricted mean survival.

included in the course

Number needed to treat and to harm

Derives the number needed to treat from the inverse of the absolute difference, fixes the four elements without which the figure is uninterpretable, shows why the interval runs through infinity when the effect is uncertain, requires one value per horizon for time to event endpoints and presents the balance against the harm number.

included in the course

Confidence intervals and reading precision

Replaces the binary decision of a test with the range of compatible values, separates a negative study from an inconclusive one through the width of the range, rebuilds precision from the p value, enumerates the most resistant false interpretations and proposes reading by compatibility.

included in the course

The p value: what it states and what it does not

Fixes the strict definition of the p value and what it conditions upon, enumerates the false interpretations that resist training, appraises the proposal to lower the conventional threshold, exposes the multiplicity that manufactures significance and describes what the published literature actually reports.

included in the course

Selection bias

Defines selection bias as the distortion produced by the procedure that decides who enters and who remains in the study, walks through the Berkson hospital paradox and loss to follow up, gathers the classic mechanisms under conditioning on a common effect and lists what the report must show for the reader to judge the direction and size of the error.

included in the course

Measurement bias and misclassification

Separates measurement error from misclassification, shows why attenuation toward the null holds for the expected value and not for an isolated study, quantifies the exaggeration produced by assessors without blinding, distinguishes agreement from accuracy and presents the levels of quantitative bias analysis that replace a generic mention in the discussion.

included in the course

Confounding and effect modification

Defines confounding as a failure of exchangeability rather than an observed imbalance, sets out the three requirements for a confounder and the error of adjusting for a mediator, separates effect modification into four types with distinct implications, shows why the additive and the multiplicative scales must appear together and presents the E value as a measure of robustness to unmeasured confounding.

included in the course

Time related biases and immortal time

Defines immortal time as the interval in which the outcome could not occur, walks through a published example in which the same cohort returns protection or nothing depending on how time is allocated, compares the methods that correct the problem, exposes prevalent user bias and presents the new user design with an active comparator.

included in the course

Reverse causation, mediation and colliders

Organises causal reading around the three elementary structures of the diagram, shows how subclinical disease inverts the apparent direction of an association, sets out the conditions mediation analysis requires, demonstrates the association created by conditioning on a collider and discusses the reach of the problem in large volunteer cohorts.

included in the course

Internal validity, external validity and transportability

Orders the two validities and shows why the internal one is a condition of the external one, presents the procedure for appraising applicability, explains why representativeness is not a criterion of causal validity, sets out the positivity requirement and formalises the transport of a result to a population that was not studied.

included in the course

Randomisation and allocation concealment

Separates restricted generation of the sequence from the concealment that protects it, walks the concrete routes by which allocation is deciphered during recruitment, confronts what published papers report about concealment, and demonstrates that stratifying in the draw creates a debt only the adjusted analysis can repay.

included in the course

Blinding and its failure

Walks the concrete methods of blinding and the breaking point of each, shows where protection relocates when placebo is impossible, quantifies observer bias through the design comparing two judgments inside one trial, exposes the ambiguity of the blinding test and reconciles the aggregate evidence that appears to contradict it.

included in the course

Intention to treat and alternative analyses

Rebuilds the intention to treat principle as a verifiable rule, separates exclusions made after the draw by the moment at which the reason was established, dismantles the modified label, orders the conduct in the face of absent outcomes and distinguishes the per protocol effect as an autonomous question demanding its own adjustment.

included in the course

Sample size, power and precision

Exposes the four quantities governing the sample size calculation and the inversion that turns it into justification, tracks where the planned size is lost before analysis, shows why power calculated after the result adds nothing, and explains the gradient that makes effects observed in smaller trials larger.

included in the course

Interim analysis, stopping rules and the truncated trial

Quantifies the type one error consumed by repeated analyses, contrasts the constant threshold boundary with the boundary that is strict early, presents the alpha spending function and the information fraction, and demonstrates why a trial stopped early for benefit delivers an estimate biased upward by construction.

included in the course

Non inferiority, equivalence and the margin

Rebuilds the inversion of the null hypothesis and the five possible readings of one interval, derives the margin from the historical effect of the comparator, exposes assay sensitivity and constancy as untestable assumptions, and shows why intention to treat stops being the conservative analysis here.

included in the course

Systematic review: protocol, search and selection

Places the registered protocol as the commitment that separates synthesis from selection, details the reporting that makes a search reproducible, shows where the electronic strategy usually fails, reconstructs duplicate screening and the flow that documents selection, and applies the critical appraisal that judges the review and not only the studies it gathered.

included in the course

Meta analysis: fixed and random effects models

Separates the question a fixed effect model answers from the one random effects answer, examines inverse variance weighting and the choice of summary measure, reconstructs the classical estimator of the between study variance, exposes the coverage failure corrected by the Hartung Knapp adjustment, and distinguishes the confidence interval from the prediction interval.

included in the course

Heterogeneity and the decision to pool

Separates clinical and methodological diversity from statistical heterogeneity, distinguishes the homogeneity test from the measure of inconsistency, shows why that measure depends on the precision of the studies included, examines estimators of the between study variance with their uncertainty, and turns all of it into the decision to pool or not to pool.

included in the course

Publication bias and funnel asymmetry

Reconstructs the geometry of the funnel plot and the asymmetry test, shows why that test is uninformative with few studies, separates small study effects from selective suppression with the help of significance bands, exposes trimming and filling as a sensitivity analysis, and sends the detected asymmetry to the certainty judgment.

included in the course

Network meta analysis and indirect comparisons

Formalises the indirect comparison anchored on a common comparator, generalises the procedure to networks that combine direct with indirect evidence, submits the network to the transitivity assumption, distinguishes local from global strategies for appraising inconsistency, and lists the reporting items that allow a network synthesis to be judged.

included in the course

Certainty of evidence and strength of recommendation

Defines certainty of evidence as confidence that the true effect lies on one side of a declared threshold, works the imprecision domain beyond the p value, sets out the three conditions that rate up observational evidence, applies the certainty appraisal to network estimates, and separates certainty from strength of recommendation in the framework leading to decision.

included in the course

Sensitivity, specificity and diagnostic study design

Fixes sensitivity and specificity as proportions conditioned on the true state, shows how the spectrum of those examined governs the accuracy observed, orders the design biases that inflate it, applies the structured appraisal of risk of bias and applicability, and lists the reporting items without which the estimate does not transport.

included in the course

Predictive values and dependence on prevalence

Defines the predictive value as the inversion of conditioning that matters to the clinician, rebuilds the classic demonstration that prevalence is forgotten, redoes the sum in natural frequencies, shows that sensitivity and specificity also shift with the setting, and gathers the practices that interrupt the interpretation error.

included in the course

Likelihood ratios and post test probability

Builds the likelihood ratio as the factor that multiplies the odds of disease, walks through the compulsory conversion between probability and odds, presents the approximations that spare the calculator, delimits what the diagnostic odds ratio summarises and erases, and places the testing and treatment thresholds that decide whether ordering the test is worthwhile.

included in the course

The ROC curve, thresholds and the cost of error

Builds the curve as the path through every cut point, interprets the area under the curve as the probability of correct ranking, shows that the optimal cut depends on the criterion and not on the curve, quantifies the optimism of a cut chosen in the data itself, and introduces net benefit as a way of declaring the cost of error.

included in the course

Prediction models: discrimination and calibration

Distinguishes the multivariable model from the isolated test, separates overall performance, discrimination, calibration and clinical usefulness, shows why the concordance statistic moves so little when a strong predictor is added, places calibration as a compulsory check, and ties overfitting to the sample size needed for development.

included in the course

External validation and performance that does not transport

Separates reproducibility from transportability, gathers the evidence that external validation is rare and performance falls, shows how to tell a drop caused by case mix from a drop caused by differing associations, sizes the sample a validation demands, and uses the review of pandemic models as a demonstrative case.

included in the course

Prospective registration and outcome switching

Places public registration before enrolment as the condition that made outcome switching verifiable, presents the empirical comparison between approved protocols and published papers, measures the magnitude and direction of selective omission, reconstructs the outcome by outcome check conducted in real time, and separates the act of registering from the act of depositing results.

included in the course

Spin: the null result presented as positive

Defines spin as a presentation that overstates benefit without altering a single datum, locates the points of the paper where it settles, organises the finite repertoire of distortion and the test that exposes each device, shows its prevalence outside the randomized trial, presents the experiment that measured its effect on clinicians and traces the propagation into the news.

included in the course

Conflict of interest and funding

Documents the association between industry sponsorship and a favourable conclusion within the same clinical question, shows that methodological quality stays preserved and moves suspicion to the design decisions, maps the financial ties that do not fund the study, bounds what disclosure does and does not do, and examines the text format in which affiliation expresses itself most.

included in the course

Reproducibility and replication

Separates the three senses the word reproducibility has accumulated and the remedy each failure calls for, presents the consortium that replicated one hundred published studies and how it shielded itself from objections, reconstructs preclinical irreproducibility and the bench practices that produce it, exposes the project that ran aground on absent method description, and gathers the structural measures with evidence of effect.

included in the course

Retraction, correction and persistent citation

Separates correction, expression of concern and retraction as editorial acts of distinct consequence, reclassifies the causes of retraction from formal investigation reports, distinguishes a rise in incidence from a rise in detection within the ascending curve, documents the citing of already withdrawn papers, and traces the persistence of the invalidated finding through the derived layers of the literature.

included in the course

Open science: data, code and peer review

Turns the call for openness into tiered editorial standards the reader can read, presents the data sharing statement now required of every trial, distinguishes depositing a file from making data reusable, places code and environment on the spectrum that separates the paper from full reproduction, and submits peer review itself to the empirical examination it demands of others.

included in the course

Critical appraisal of a clinical trial

Treats the trial report as the only instrument available to the reader, moves the risk of bias judgement from the trial to the result, opens the composite outcome into its components, demands of harm the same rigour required of benefit, and measures how many events hold the conclusion up before any change of management.

included in the course

Critical appraisal of a systematic review

Orders the appraisal of a systematic review by the match of the question before the examination of method, locates bias at the stage of the process that produced it, dispels the illusion of accumulation among overlapping reviews, separates a pooled result from a conclusive one, and treats the final search date as the shelf life of the synthesis.

included in the course

Clinical guidelines: how they are made and how they fail

Reconstructs the process that separates a trustworthy guideline from a collective opinion in print, applies the international instrument that measures rigour of development, sets real guidelines against the standards they ought to meet, shows what happens when recommendations written one disease at a time meet the patient who has several, and treats the silent expiry of the document.

included in the course

Risk communication and shared decision making

Starts from the gap between what the patient expects and what the estimate shows, treats the choice of numerical format as part of the recommendation, separates what improves understanding from what only appears to, organises the consultation into three successive movements, and places decision support tools as preparation for the conversation rather than a substitute for it.

included in the course

Subgroup analysis and the promise of individualisation

Applies the criteria that separate a credible subgroup effect from an artefact of chance, replaces the comparison of two p values with the formal test of interaction, shows what published claims actually contain, checks how much of them withstands external corroboration, and moves individualisation from the stratum to the risk predicted at the outset.

included in the course

From question to protocol

Locates research waste in the four stages where it occurs, shows why a systematic assessment of existing evidence precedes any new study, presents the minimum items of a clinical trial protocol and the threat each one neutralises, and delimits what a pilot study delivers and what it never delivers.

included in the course

Research ethics and informed consent

Presents the requirements that make clinical research ethical and why scientific validity precedes consent, situates randomisation in genuine disagreement among experts, describes the two instances of ethics review in Brazil and the norms governing it, and shows why a long consent document protects the institution and fails the person signing it.

included in the course

Data management and the pre specified analysis plan

Follows the chain of custody carrying a datum from the source document to the locked database, separates what belongs in the protocol from what belongs in the analysis plan, presents the five attributes of an estimand and the strategies for intercurrent events, addresses the prevention of missing data and measures the distance between the prior plan and the published paper.

included in the course

Transparent reporting and the reporting guidelines

Separates the study conducted from the study reported, maps which reporting checklist corresponds to which design, works through the items most often omitted from trial and observational reports, and shows why the abstract, read by almost everyone, is the least checked part of the paper.

included in the course

Funding

Turns a clinical idea into a fundable proposal without trading relevance for administrative convenience.

included in the course

Research data management

Treats data as future evidence: defined, versioned, protected, reusable and auditable.

included in the course

Research collaborations

Organizes roles, authorship, governance and scientific delivery before collaboration becomes dispute.

included in the course

Research design

Connects question, population, comparator, measurement, foreseeable bias and analysis before collection.

included in the course

Sex and gender equity in research: SAGER guidelines

Shows when sex, gender or both must enter the question, methods, analysis and report.

included in the course

Fundamentals of manuscript preparation

Converts protocol, analysis and results into a narrative that permits scientific judgment.

included in the course

Writing skills

Trains sentence, paragraph, argument, transition and conclusion so the method guides the reader.

included in the course

Technical writing skills

Teaches terminology, units, tables, figures and statistical description without decorating the result.

included in the course

Fundamentals of publishing

Explains what the journal must decide: scope, validity, transparency, novelty and usefulness.

included in the course

Finding the right journal

Turns journal selection into fit between question, audience, method, format and editorial risk.

included in the course

Ethics

Integrates authorship, conflict, redundancy, consent, transparency and correction after publication.

included in the course

Open science

Teaches data, code, protocol, preprint and open review as reproducibility choices.

included in the course

Publishing in the chemical sciences

Adapts scientific reporting to compounds, analytical methods, purity, reproducibility and safety.

included in the course

How to publish in premium journals

Shows how to align a strong question, clean method, transparent reporting and a focused cover letter.

included in the course

Research metrics

Teaches use of citations, impact factor, altmetrics and indicators without replacing scientific judgment.

included in the course

Fundamentals of peer review

Defines what peer review can improve and what it cannot rescue.

included in the course

Becoming a peer reviewer

Teaches reviewer competence: scope, conflict, methods, language and timeliness.

included in the course

Going through peer review

Turns reviews into a response plan, manuscript revision and documented decision trail.

included in the course

Certified peer reviewer course

Organizes demonstrable peer review competence: criteria, examples, limits and portfolio.

included in the course

Social impact

Shows how to translate results into social consequence without overstating causality or applicability.

included in the course

Ensuring visibility

Makes work findable, citable and understandable without confusing visibility with evidence.

included in the course

Confidence in communicating research

Trains message, audience, inferential limit and response to criticism for responsible public communication.

included in the course