Dr. Tom Biernacki, DPM, FACFAS

Quick answer: Anemia affects 1.62 billion people globally — yet the standard workup (CBC + ferritin) misidentifies the cause in a significant proportion of cases, leading to iron supplementation in patients with inflammation-driven anemia that won’t respond to iron, or missing functional iron deficiency in patients with “normal” ferritin levels. Functional medicine hematology identifies the … Read more

Quick answer: Food sensitivity testing — particularly IgG-based panels — generates more controversy among physicians than almost any other functional medicine tool, yet IgG4 food antibodies in the clinical context of a systematic elimination-reintroduction protocol have helped thousands of patients identify dietary drivers of IBS, migraines, eczema, fatigue, and joint pain that standard allergy testing … Read more

Quick answer: The human gut microbiome contains approximately 38 trillion microbial cells encoding over 3 million unique genes — 150 times more genetic information than the human genome — yet standard gastroenterology evaluation measures none of it. Comprehensive microbiome testing now provides clinically actionable information about gut dysbiosis patterns, pathogen overgrowths, intestinal permeability, digestive enzyme … Read more

Quick answer: Depression affects 280 million people worldwide according to the WHO, yet the conventional model — monoamine deficiency corrected by antidepressants — explains fewer than 50% of cases and fails to account for the 30-40% of patients who don’t respond to first-line SSRI therapy. Functional psychiatry identifies the upstream biological drivers of mood disorders: … Read more

Quick answer: The liver processes over 500 distinct functions and filters approximately 1.4 liters of blood per minute — yet most “detox” protocols on the market bypass the actual biochemistry entirely. Functional medicine liver detoxification focuses on the two-phase enzymatic system that converts fat-soluble toxins into water-soluble metabolites for elimination, supported by specific nutrients, dietary … Read more

Quick answer: Mast cell activation syndrome (MCAS) affects an estimated 17% of the population according to Molderings et al. (2011), yet remains underdiagnosed for an average of 9 years — because symptoms affect every organ system simultaneously and standard allergy tests are often negative. Functional medicine identifies the root triggers driving mast cell hyperreactivity and … Read more

Quick answer: Metabolic syndrome — the cluster of central obesity, elevated triglycerides, low HDL, hypertension, and impaired fasting glucose — affects 34.7% of American adults (Aguilar 2015 JAMA) and predicts a 5× increased risk of type 2 diabetes and 3× increased cardiovascular disease risk. But the real insight from functional medicine is that metabolic syndrome … Read more

Quick answer: Fibromyalgia affects approximately 4 million Americans and represents one of the most challenging conditions in conventional medicine — yet functional medicine identifies its root causes with increasing precision. The neurobiological reality: fibromyalgia is a central sensitization syndrome with measurable alterations in brain fMRI connectivity, elevated substance P in cerebrospinal fluid (Russell 1994), reduced … Read more

Quick answer: Executive health and corporate wellness represent the highest-yield preventive medicine investment available — a comprehensive annual evaluation identifying metabolic, cardiovascular, cognitive, hormonal, and psychological risk factors averages $3,000-5,000 but can prevent a single acute MI hospitalization averaging $38,000, or a disability event costing hundreds of thousands in lost productivity. Functional medicine executive health … Read more

Quick answer: Women’s health spans a continuum from menarche to post-menopause, with functional medicine addressing the root causes of conditions that disproportionately affect women: PCOS, endometriosis, PMS/PMDD, peri/postmenopausal transitions, thyroid autoimmunity (7-10:1 female predominance), autoimmune disease, and the often-inadequately addressed cardiovascular risk that becomes the leading cause of death in post-menopausal women. Sex-based biology demands … Read more