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MTHFR: Treating Genes or Patients?

In the discussion about nutrition, genetics and genomics, invariably the topic of methylation and genes related to methylation will find their way into the discussion. Chief among the genes mentioned in such conversations is MTHFR, the gene encoding...

Thomas G. Guilliams, PhD |

Wellness
Wellness

Folate Supplements: Differences and Benefits

The Food and Nutrition Board (FNB) developed dietary folate equivalents (DFEs) to reflect the higher bioavailability of supplemental folic acid compared to that of food folate. The intake recommendations for folate are provided in the recommended dietary allowance (RDA) as micrograms (mcg) of DFEs.

Thomas G. Guilliams, PhD |

Immune Health
Immune Health

Fundamental Principles for Building Immune Strength

When confronted with the need to build immune system strength, we instinctively gravitate toward pills, injections and powders. For functional medicine clinicians, this pharmaceutical imprinting is very often translated into non-pharmacological immunomodulating agents (e.g., herbs, mushrooms etc.). But this approach is still often reactionary, and overlooks the fundamental physiological relationship between the immune system and the biological functions with which it interfaces.

Thomas G. Guilliams, PhD |

Musculoskeletal Health
Musculoskeletal Health

Strontium: Still a Viable Therapy for Bone Health

Strontium (Sr) is an alkali earth metal, with characteristics very similar to that of calcium; though having an atomic weight nearly double that of calcium. First discovered in the 18th century, this trace element is found in ground water, ocean water and in various foods such as leafy green vegetables and some seafood. The ability for Sr to naturally accumulate in the bones of animals after being fed small doses was first published in 1870. However, it wasn't until the 1950s that human studies were first published.

Thomas G. Guilliams, PhD |

Wellness
Wellness

Berberine and the Gut Microbiota: A Bidirectional Relationship

There are many phytonutrients that have a bidirectional relationship with the gut microbiome. That is, the nutrient affects the types and/or metabolic activities of the gut microbiota, and the activities of the gut microbiota affect the bioactivity of the phytonutrient, typically through metabolism to more bioavailable and/or more bioactive compounds. The popular phytonutrient compound, berberine, is a classic example of this bidirectional relationship.

Thomas G. Guilliams, PhD |

Gastrointestinal Health
Gastrointestinal Health

The Complex Relationship Between IBS and SIBO

The symptoms of SIBO (e.g., bloating, abdominal distension/ pain/discomfort, diarrhea, fatigue, weakness, etc.) overlap considerably with those of irritable bowel syndrome (IBS), and many clinicians consider these conditions to be commonly associated. However, epidemiological research shows that the relationship between the two conditions is not well understood, is controversial, and varies considerably depending upon the diagnostic criteria used to define SIBO (and IBS). In fact, the large variance in the frequency of SIBO in IBS subjects mirrors that found in healthy controls.

Thomas G. Guilliams, PhD |

Immune Health
Immune Health

The Innate Immune System is More Adaptive Than You Think

A few weeks back I spoke at the Microbiome 2.0 Symposium, part of the Personalized Lifestyle Medicine Institute's Mastering the Implementation of Personalized Lifestyle Medicine series. This was one of the first live events that I have attended since March of 2020! I was tasked with teaching on a variety of topics, but my first lecture focused on the gut-immune interface. As part of this lecture, I included a few slides designed to remind the clinician audience how the immune system interprets self from non-self, or more specifically, harmful vs. non-harmful encounters.

Thomas G. Guilliams, PhD |

Gastrointestinal Health
Gastrointestinal Health

Benefits of Spore-Forming Probiotics

In the past two decades, there have been few areas of research that have expanded as greatly as that which explores the importance of the human microbiome(s), especially the nuanced relationship between the bacteria in the GI tract and their human host. It is not uncommon to see papers published, weekly, showing the potential connection between metabolic activity within the gut microbiome and some important human pathophysiology.

Thomas G. Guilliams, PhD |

Gastrointestinal Health
Gastrointestinal Health

The Emergence of Autoinflammatory Syndromes

Most clinicians are familiar with autoimmune disease mechanisms. Typically, these define situations where effectors within the adaptive immune system (i.e., immunoglobulins or T-cell receptors) bind inappropriately to...

Thomas G. Guilliams, PhD |

Stress and HPA Axis Health
Stress and HPA Axis Health

The HPA Axis: A System Beyond the Stress Response

For many years, I have been researching, writing, and teaching about the HPA axis, primarily in the context of the stress response and chronic disease. Along with others, I have been emphasizing that the primary focus of clinicians should not be the adrenal glands, but upon the brain and the stress signals that trigger the hypothalamus in the first place (perceived mental and emotional stress, circadian disruptors, inflammatory signals and glycemic dysregulation).

Thomas G. Guilliams, PhD |

Cardiometabolic Health
Cardiometabolic Health

Microbiome Availability & How Botanicals Interact with the Gut

There has been a lot of buzz around "bioavailability" lately, especially as it concerns dietary supplement ingredients like fish oil, CoQ10, and phytonutrients like curcumin and resveratrol. However, much of what is marketed as having increased bioavailability rarely translates into meaningful therapeutic improvements, especially when it comes to phytonutrients.? This is primarily because phytonutrient research has mostly followed the same path used for developing drugs, which focuses on single compounds discovered through in vitro activity screening methods.

Thomas G. Guilliams, PhD |

Stress and HPA Axis Health
Stress and HPA Axis Health

The Term "Adrenal Fatigue" Should be Abandoned

Sometimes, when we endeavor to understand and describe complicated medical topics, there is a temptation to find a simple explanation to cut through that complexity. Sometimes these simple explanations can help bridge the knowledge gap for a while, but as our knowledge grows, those explanations lose some of their original usefulness (i.e., "good" and "bad" cholesterol). In many cases, those oversimplified explanations actually become a hindrance to helping clinicians and patients understand the important mechanisms and solutions related to their chronic conditions.

Thomas G. Guilliams, PhD |

Stress and HPA Axis Health
Stress and HPA Axis Health

The Role of Stress and Nutrient Availability in Circadian Metabolism

In the last several years, I dove into the research exploring the intersection between circadian rhythm and the HPA axis. As most of you probably know, normal cortisol production follows a predictable circadian output, which rises sharply upon awakening (the cortisol awakening response, or CAR) and then drops quickly over the next few hours, gradually declining and reaching its nadir late at night. What many may not know is that glucocorticoid receptors (i.e., cortisol receptors), found in almost every tissue, are vital in helping to maintain peripheral circadian rhythm, which can greatly influence cellular metabolic function.

Thomas G. Guilliams, PhD |

Cardiometabolic Health
Cardiometabolic Health

Ketogenic Diets for Cardiometabolic Outcomes: What is the Evidence?

While the ketogenic diet (KetoDiet) may have had its roots as a treatment modality for epilepsy as far back as the 1920s, variations of this diet are now mostly popular for their metabolic outcomes (e.g., weight loss, improved glycemic control, etc.) or for cognitive support/neurological conditions (e.g., Alzheimer's disease, malignant glioma, migraine headache, and other neurologic disorders).

Thomas G. Guilliams, PhD |

Stress and HPA Axis Health
Stress and HPA Axis Health

Neurotransmitters, Mood and the Perception of Stress, Part 3

The hypothalamus is directly innervated by neuronal systems that produce neurotransmitters, such as serotonin (5-HT), dopamine and norepinephrine (NE), that are involved in mood regulation and play various other roles in cognitive health. During the acute stress crisis, the mesolimbic dopaminergic reward system is stimulated to help maintain morale. However, during chronic stress or depression, the reward system is down-regulated by stress mediators, resulting in anhedonia.

Thomas G. Guilliams, PhD |

Stress and HPA Axis Health
Stress and HPA Axis Health

Neurotransmitters, Mood and the Perception of Stress, Part 2

When we talk about "stress," or allostatic load, in terms of the perception of an event, we must realize that these "events" must first be translated into neurochemical signals before they trigger the HPA axis. Therefore, the sensitivity and outcome of translating these events (whether they are ongoing events, memories of past events, or stressful anticipation of unrealized events), is highly dependent upon signaling from other neurotransmitters. In fact, the signaling neurotransmitters that manage mood and affect often overlap with measures of HPA axis activation, and cannot be easily distinguished in some subjects.

Thomas G. Guilliams, PhD |

Stress and HPA Axis Health
Stress and HPA Axis Health

Neurotransmitters, Mood and the Perception of Stress, Part 1

When we talk about "stress," or allostatic load, in terms of the perception of an event, we must realize that these "events" must first be translated into neurochemical signals before they trigger the HPA axis. Therefore, the sensitivity and outcome of translating these events (whether they are ongoing events, memories of past events, or stressful anticipation of unrealized events), is highly dependent upon signaling from other neurotransmitters. In fact, the signaling neurotransmitters that manage mood and affect often overlap with measures of HPA axis activation, and cannot be easily distinguished in some subjects.

Thomas G. Guilliams, PhD |

Gastrointestinal Health
Gastrointestinal Health

Managing the Exposome

Two related fields of study, both owing to the emerging science of genetics and genomics, are beginning to help us discover the role toxins play in human health and disease. The first is toxicogenetics, which describes how the genetic differences between certain individuals allow for varying susceptibility to different toxins. Since there are hundreds of different enzymes involved in our detoxification pathways, many individuals carry gene variants (polymorphisms) that allow for more efficient conversion and removal of toxins than others. Those individuals with slower detoxification pathways for a given toxin will show signs of toxicity at much lower doses than those with normal detoxification capacity. These differences often complicate "cause-and-effect" studies in large populations that carry over into the clinic. That is, just because a large epidemiological trial does not find a statistically significant relationship between exposure to a particular toxin and a particular health outcome (the average of all genetic variants), does not mean that such a relationship does not exist in the genetically-susceptible patient. Read more

Thomas G. Guilliams, PhD |

Stress and HPA Axis Health
Stress and HPA Axis Health

Re-assessing the Notion of "Pregnenolone Steal"

When clinicians measure salivary cortisol and DHEA (DHEA-S) to assess stress and HPA axis function, it is common to find DHEA levels below the reference range in a number of individuals. A common explanation for the depletion of DHEA and other hormones (e.g., progesterone, testosterone) due to chronic stress is the phenomenon known as "pregnenolone steal." This notion basically states that since all steroid hormones use pregnenolone (derived from cholesterol) as a precursor, the elevated secretion of cortisol caused by acute or chronic stress will inevitably result in less available pregnenolone to serve as a precursor for the production of DHEA and other down-stream hormones. Read more

Thomas G. Guilliams, PhD |

Gastrointestinal Health
Gastrointestinal Health

Dysbiosis or Adaptation: How Stable is the Gut Microbiome?

One of the greatest paradigm shifts in medicine over the past few decades has been the unfolding discoveries revealing the metabolic influence of the human microbiome, especially that which resides within the gastrointestinal tract. Indeed, it is difficult to find a medical discipline that is not actively investigating the potential role played by the gut microbiome in human health and disease. Read more

Thomas G. Guilliams, PhD |

Immune Health
Immune Health

Age-Associated Changes Impacting Immune Function

Newborns have an immature immune system and are vulnerable to infectious agents. The immune system begins to mature with appropriate interaction with antigens and is enhanced by the changing microflora of the gut throughout adolescence and adulthood. Of course, aging affects all the systems of the body, and the immune system is no exception. The changes in immune system function that result from aging have been well characterized and are known as immunosenescence. Read more

Thomas G. Guilliams, PhD |

Gastrointestinal Health
Gastrointestinal Health

Canary in the Coal Mine: AMD and the Lifestyle Synergy Model

Since doing my initial research for The Original Prescription, in which I discuss the benefits of lifestyle synergy, I keep running into more and more data confirming the overall health benefit of multiple "signals" coming from a variety of lifestyle decisions. Read more

Thomas G. Guilliams, PhD |

Stress and HPA Axis Health
Stress and HPA Axis Health

Is it Adrenal Fatigue? Reassessing the Nomenclature of HPA Axis Dysfunction

Sometimes, when we endeavor to understand and describe complicated medical topics, there is a temptation to find a simple explanation to cut through the complexity.

Thomas G. Guilliams, PhD |

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