36 Great Ideas from Mastering the Implementation of Personalized Lifestyle Medicine

On May 13-14, 2022, Personalized Lifestyle Medicine Institute, in collaboration with Lifestyle Matrix Resource Center, hosted healthcare practitioners at Mastering the Implementation of Personalized Lifestyle Medicine: Advances in Clinical Functional Immunity. The sold-out, live conference provided expert insights on immune health, clinical applications and resources for practitioners. The speakers also engaged with attendees in lively panel discussions on topics ranging from autoimmunity and inflammation to Lyme disease and biotoxins. The field of immunology is rapidly evolving during the COVID-19 era, and cutting-edge research on the immune system’s interplay with genetics, lifestyle and environment is invaluable to clinicians and the future of functional medicine.

Here are key takeaways from the event, organized by speaker:

Day 1—May 13, 2022

Jeffrey Bland, PhD

• Although the focal point throughout the conference was the many challenges our immune systems face in the 21st century, Dr. Jeffrey Bland shared a note of optimism: “The human spirit and biology are very resilient… And wellness is in all of us.”
• He also provided an enlightening paradigm through which to understand the complexity of the immune system: the holobiont self. Dr. Bland defines the holobiont as a set of convergent systems, such as the immune and nervous system, microbiome, and external environment.
• Our landscape influences our genes and immune system, so “kinship is as powerful an immunological measure as vitamin D,” according to Dr. Bland. Clinicians must be aware of all the factors involved in immune challenges, including social isolation. One way to address this growing problem is to host collaborative group visits that both inform and engage your patients.

Thomas Guilliams, PhD

• Regarding nutrient deficiencies, Dr. Tom Guilliams posed the question, “what stands between function and dysfunction?” The answer in part is resiliency, which also relies on adequate metabolic reserves. Many body states inhibit resilience, including obesity, aging and chronic stress.
• While “rewilding” the immune system through exposure to a variety of organisms may benefit children and younger adults, Dr. Guilliams advises avoiding allergens and antigens for older adults since the immune system becomes less adaptive.
• Functional immune insufficiency can be supported by nutritional supplements, such as antioxidants like lipoic acid and N-acetyl cysteine, which both improve glutathione status. Omega-3 fatty acids, including DHA and EPA, along with resveratrol also support inflammatory balance.
• Dr. Guilliams recommended reading his books from The Standard Road Map Series, Supplementing Dietary Nutrients and  Supporting Immune Function, for expanded charts, recommendations and studies mentioned during his presentation.

Aristo Vojdani, PhD

• Dr. Aristo Vojdani shared more recent research indicating environmental factors play a larger role (~70%) in autoimmune condition susceptibility than genetics or family history (~30%), depending on the condition studied.¹
• SARS-CoV-2 causes neo-antigen formation similar to chemical toxins and heavy metals. Patients with long COVID produce autoantibodies and exhibit symptoms of autoimmune disease.
• Dr. Vojdani also cited his chief complaint with food allergen tests performed today: many use raw ingredients to test for allergens in foods typically consumed cooked. The difference in protein structures between raw and cooked foods may make some allergen tests less valid than they seem. Check out his book Food Associated Autoimmunity for more insights.

Elroy Vojdani, MD

• Dr. Elroy Vojdani posed the question, “Why are the five ‘As’ all rising?” This includes ASD, ADD/ADHD, allergies, Alzheimer’s and autoimmune conditions. He suggested that increased exposure to barrier damaging agents, particularly those affecting the gastrointestinal tract, may be to blame.
• Antinuclear antibody (ANA) prevalence in the United States is increasing as well. Some of the greatest increases within the population have been seen in teens and young adults.² ANA is an early, non-specific marker of autoimmunity.
• During initial patient evaluations, Dr. Vojdani explained that clinicians can administer baseline panels, like CBC, chem, CRP, A1C, thyroid, and vitamin D tests, for indicators of autoimmunity or inflammation.
• What is the goal when addressing these autoimmune symptoms and conditions? According to Dr. Vojdani, functional medicine doctors can aim to resolve inflammation early with testing, root-cause identification and lifestyle modification. Learn more about this topic from his contributions to the Immune Foundations Program.

Carrie Jones, ND

• Dr. Carrie Jones titled her talk, “Hormones: First to React, Last to Recover.” Symptoms of hormone dysfunction may be caused by latent immune challenges, but clinicians will often identify a hormone issue before the lagging immune symptoms.
• Stress impacts the way the body produces hormones, and hormones, like estrogen and progesterone, massively impact the immune system.
• A key takeaway for clinicians is to be wary of cortisol feedback loops and natural variation in daily cortisol rhythms. High cortisol from chronic stressors can eventually revert to low cortisol, according to Dr. Jones, so addressing potential causes of the imbalance is integral to breaking the cycle.
• Overall, Dr. Jones urged clinicians to take a step back before prescribing direct hormone intervention medications. She encouraged first examining immune challenges, stress levels and environment for potential root causes.

Day 2—May 14, 2022

Jill Carnahan, MD

• Dr. Carnahan detailed her journey from aspiring doctor to a patient beleaguered by an aggressive form of breast cancer in her mid-twenties. She described other autoimmune conditions that arose not long after, and her quest to determine the root cause of these health challenges.
• She eventually narrowed her search to her upbringing on a farm in central Illinois, where pesticides like atrazine and other chemicals were regularly used.³
• Dr. Carnahan explained that genetics are not destiny—they point the gun, but it is environmental exposures that pull the trigger of chronic illness. Approximately 85% of all chronic illnesses are lifestyle- and diet-related.
• A key takeaway for clinicians is that toxic load combined with infectious burden can cause immune dysfunction and inflammation.
• Dr. Carnahan’s motto is “test, don’t guess”—and she advised clinicians to investigate the types of tests they are running on patients to ensure accuracy and effectiveness.
• Though she has since restored her health, her own patient journey inspired her work as a functional medicine practitioner. At her Colorado practice, Flat Iron Functional Medicine, she regularly studies and tests for environmental toxicity in her patients. Dr. Carnahan is also a well-known educator and thought leader within the functional medicine industry, and shares her story of healing to raise awareness about the prevalence of environmental toxicity and related health issues.

Sunjya Schweig, MD

• Tickborne infections are an expanding global epidemic, and treatment must be swift and comprehensive.
• Antibiotic-tolerant “persister cells” are one reason for treatment failure. Specific botanicals have been shown in vitro to have significant activity against persister cells.⁴
• Dr. Schweig recommended MyLymeData, a website dedicated to the research and treatment of Lyme disease, as a resource for clinicians treating patients with complex Lyme issues.

Jacob Leone, ND

• Dr. Leone described his research on botanicals used for the treatment of Lyme disease—specific botanicals have been selected based on anecdotal reports, preliminary in vitro data and bioavailability profiles.
• Persister cells can be formed by most bacteria, and by definition, they are a subpopulation of a bacteria that is antibiotic-tolerant. In clinical practice, many of these patients are poly-microbially infected with different bacteria, and are often prescribed a regimen of different antibiotics. Although antibiotics can improve symptomology over time, if persister cells remain, they can continue to cause symptoms or relapse.
• How can clinicians effectively address persister cells in their patients? Dr. Leone detailed his research on persister cell response to antibiotic and natural treatment, noting the effectiveness of natural antimicrobials in destroying persister cells.⁴ He specifically mentioned the effectiveness of Cryptolepis sanguinolenta; this was the only herb that sterilized persister cells, inhibiting their regrowth.

Aristo Vojdani, MD

• Patients’ immune systems are as diverse as height, intelligence and other human features. Genomes, lifestyles and exposomes affect immunotypes. Immunotypes can be determined by flow cytometry, or the study of cells as they move in fluid suspension (this allows for multiple measurements to be made per cell).
• Dr. Vojdani defined immunophenotyping as “quantification by flow cytometry of an individual’s lymphocyte subsets into an identifiable pattern.”
• Using his own test results as examples, Dr. Vojdani demonstrated the significant impact a viral infection like SARS-CoV-2 can have on the immune system, even months after recovery. He noted the importance of a functional medicine approach for treating COVID long-haulers.

Elroy Vojdani, MD

• Immunosenescence, at its core, is cell aging; the patient’s immune system has aged much faster than they have biologically aged.
• Dr. Vojdani described the role of Th17 in autoimmunity—traditionally, Th17 was said to be involved in extracellular pathogenesis, but is now known to be a marker of autoimmunity.⁵
• Dr. Vojdani explained that immunological injury and autoimmunity are best handled in the early stages, and encouraged clinicians to consider several key immune therapeutics in practice, including supplements that address gut-immune barrier dysfunction.

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