Dr. Tom Biernacki, DPM, FACFAS

Quick answer: “Adrenal fatigue” is not a medically accepted diagnosis — but HPA axis dysregulation is a real, measurable neurobiological phenomenon affecting millions with symptoms of chronic fatigue, low morning energy, salt cravings, poor stress resilience, and disrupted cortisol rhythms. Measured by 4-point salivary cortisol testing, HPA dysregulation is distinct from both normal cortisol and … Read more

Quick answer: Sleep is not passive rest — it is an active biological process during which the brain clears toxic waste (amyloid-β, tau) via the glymphatic system, consolidates memory, restores immune function, and resets hormonal axes. Short sleep (<7 hours) is associated with 2× cardiovascular mortality, 2.9× higher susceptibility to upper respiratory infection, 33% increased … Read more

Quick answer: Depression and anxiety are not simply serotonin deficiency disorders — they are complex neurobiological conditions driven by neuroinflammation, gut dysbiosis, mitochondrial dysfunction, nutritional deficiencies, and hormonal imbalances that SSRIs do not address. The “cytokine hypothesis of depression” explains why 35% of depressed patients have elevated inflammatory markers and why anti-inflammatory interventions produce antidepressant … Read more

Quick answer: Chronic kidney disease (CKD) affects 37 million Americans (15% of adults) and is strongly reversible in early stages through functional medicine addressing the three root causes driving 90% of CKD: diabetes and insulin resistance (43% of CKD), hypertension (26%), and glomerulonephritis driven by gut dysbiosis and immune activation. The ketogenic diet demonstrates 30–40% … Read more

Quick answer: Musculoskeletal conditions — tendon degeneration, osteoporosis, cartilage loss, and soft tissue injury — have identified nutritional, hormonal, and inflammatory root causes that are largely ignored by conventional orthopedics. Collagen peptide supplementation demonstrates significant tendon repair in RCTs; vitamin K2 directs calcium into bone rather than arteries; sex hormone optimization is essential for bone … Read more

Quick answer: Cardiovascular disease kills 695,000 Americans annually — yet the dominant “LDL hypothesis” of heart disease misses the 50% of heart attack patients with normal LDL. Functional cardiology identifies the true drivers: small-dense LDL particles, Lp(a), apolipoprotein B, oxidized LDL, trimethylamine N-oxide (TMAO) from gut dysbiosis, insulin resistance, homocysteine, and systemic inflammation as measured … Read more

Quick answer: COPD is considered irreversible by conventional medicine — yet 30–40% of COPD diagnoses are misdiagnosed (Soriano 2010, Chest), inflammation-driven airway remodeling is partially reversible, and the gut-lung axis links gut dysbiosis to systemic COPD inflammation through mechanisms that are modifiable. Asthma’s root causes — gut dysbiosis, vitamin D deficiency, omega-3 deficiency, and early … Read more

Quick answer: Integrative oncology reduces cancer treatment side effects, improves treatment completion rates, and has emerging evidence for extending survival through metabolic, immune, and microbiome interventions. The ketogenic diet reduces tumor glucose availability (Warburg effect), berberine inhibits mTOR pathway, and mistletoe lectin (Iscador) demonstrated a 40% survival improvement in a meta-analysis of 10 trials — … Read more

Quick answer: Fibromyalgia, complex regional pain syndrome, and chronic widespread pain are not “psychological” — they represent neurobiological central sensitization, a measurable state in which the central nervous system amplifies pain signals through glial cell activation, NMDA receptor sensitization, and HPA axis dysregulation. Functional medicine addresses the gut dysbiosis, small fiber neuropathy, mitochondrial dysfunction, and … Read more

Quick answer: Rheumatoid arthritis, lupus, and other autoimmune rheumatic diseases are driven by four modifiable root causes: intestinal permeability (leaky gut), gut dysbiosis, molecular mimicry between microbial antigens and joint/organ tissue, and environmental triggers including smoking, silica, and dietary antigens. The Prevnar immunization for pneumococcal polysaccharides shares epitopes with citrullinated proteins in RA — illustrating … Read more