Dr. Tom Biernacki, DPM, FACFAS 
Quick answer: Iron deficiency anemia affects over 1.2 billion people globally and is the world’s most common nutritional deficiency — yet serum ferritin below 30 ng/mL (functional iron deficiency without frank anemia) is present in 20–40% of premenopausal women and causes fatigue, hair loss, impaired cognition, and exercise intolerance that resolves completely with repletion. Functional … Read more
Quick answer: A Mediterranean dietary pattern is associated with 13% lower overall cancer risk in a meta-analysis of 83 studies (Schwingshackl 2017, International Journal of Cancer), while obesity — now the second leading preventable cause of cancer after tobacco — drives 13 cancer types including colorectal, breast, endometrial, and pancreatic cancers via insulin/IGF-1 signaling, chronic … Read more
Quick answer: Non-alcoholic fatty liver disease (NAFLD/MASLD) affects 38% of U.S. adults and is now the most common cause of chronic liver disease globally — yet 80% of cases are reversible through dietary, exercise, and metabolic interventions. Functional hepatology targets the insulin resistance, gut microbiome dysbiosis, and oxidative stress root causes driving hepatic steatosis, NASH, … Read more
Quick answer: Dietary protein restriction to 0.6–0.8 g/kg/day slows CKD progression by 30–40% versus unrestricted protein intake across multiple RCTs — the Modification of Diet in Renal Disease (MDRD) study confirmed this effect — while the gut-kidney axis (uremic toxin generation from gut bacterial fermentation of protein) represents a reversible driver of CKD progression independent … Read more
Medically Reviewed by Thomas Biernacki, DPM — Board-Eligible Podiatric Surgeon, Balance Foot & Ankle PLLC Howell, MI · Bloomfield Hills, MI · 3,000+ lower-extremity surgeries Quick Answer Benfotiamine — the lipophilic thiamine precursor that achieves 3.6× higher blood thiamine levels than water-soluble thiamine at equivalent doses — corrects diabetic peripheral neuropathy through three distinct mechanisms … Read more
Quick answer: Vitamin D deficiency increases asthma exacerbation risk by 50% in deficient patients — Martineau et al. (2017, Lancet) meta-analyzed 955 patients across 7 RCTs to confirm this finding. Functional pulmonology targets the gut-lung axis, oxidative stress, airway microbiome dysbiosis, and nutrient deficiencies driving asthma, COPD, and chronic airway inflammation as reversible upstream root … Read more
Medically Reviewed by Thomas Biernacki, DPM — Board-Eligible Podiatric Surgeon, Balance Foot & Ankle PLLC Howell, MI · Bloomfield Hills, MI · 3,000+ lower-extremity surgeries Quick Answer Acetyl-L-carnitine (ALCAR) reverses diabetic peripheral neuropathy through three distinct mechanisms: it donates acetyl groups to histone acetyltransferase p300/CBP, restoring H3K9ac and H4K16ac at the NGF promoter in DRG … Read more
Quick answer: The Age-Related Eye Disease Study 2 (AREDS2, 2013, JAMA) demonstrated that lutein 10 mg + zeaxanthin 2 mg reduced advanced age-related macular degeneration progression by 18% versus placebo — and reduced progression by 26% in participants with low dietary lutein/zeaxanthin intake. Functional ophthalmology targets the oxidative stress, vascular dysfunction, and nutrient deficiencies driving … Read more
Related Compounds Acetyl-L-Carnitine: Neuropathy Protocols CoQ10/Ubiquinol & Diabetic Neuropathy Alpha-Lipoic Acid: Neuropathy Protocols Berberine (Advanced) & Diabetic Neuropathy
Medically Reviewed by Thomas Biernacki, DPM — Board-Eligible Podiatric Surgeon, Balance Foot & Ankle PLLC Howell, MI · Bloomfield Hills, MI · 3,000+ lower-extremity surgeries Quick Answer Alpha-lipoic acid (ALA) reverses diabetic peripheral neuropathy through three mechanisms that most supplements miss entirely: it regenerates the mitochondrial antioxidant relay (DHLA→TrxR2→Trx2→Prx3) that scavenges mtH₂O₂ specifically inside DRG … Read more