Dr. Tom Biernacki, DPM, FACFAS

Quick answer: Aging is not inevitable deterioration but a biological process governed by nine hallmarks — genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication. Each hallmark is modifiable through targeted interventions, and longevity medicine has moved from the realm of … Read more

Quick answer: Asthma affects 25 million Americans, COPD kills 155,000 annually, and both are dramatically under-addressed by functional medicine approaches that can reduce exacerbations, improve FEV1/FVC trajectories, and in some cases achieve functional remission. The gut-lung axis, airway microbiome dysregulation, magnesium deficiency, omega-3 ratio imbalance, vitamin D insufficiency, and environmental triggers drive airway inflammation in … Read more

Quick answer: Chronic kidney disease (CKD) affects 37 million Americans (15% of adults) — and 90% are unaware of their condition. The functional medicine approach to kidney health extends beyond GFR and creatinine monitoring to identify and address the primary drivers of CKD progression: hypertension, diabetic nephropathy, hyperuricemia/gout, AKI-to-CKD transition, dietary acid load, gut dysbiosis-driven … Read more

Quick answer: Chronic pain affects 50.2 million American adults (CDC 2019) — more than cancer, diabetes, and heart disease combined. Yet the biomedical model’s focus on structural pathology and opioid management ignores the neurobiological reality: chronic pain is fundamentally a brain disease, driven by central sensitization, glial activation, neuroinflammation, and psychosocial amplification that persists and … Read more

Quick answer: “Adrenal fatigue” — dismissed by conventional endocrinology as a non-diagnosis — represents a real spectrum of HPA axis dysfunction that affects millions of people with chronic stress, sleep disruption, and modern lifestyle demands. While true Addison’s disease (primary adrenal insufficiency) is rare, functional HPA axis dysregulation producing subclinical cortisol rhythm disruption, blunted cortisol … Read more

Quick answer: Thyroid dysfunction is dramatically underdiagnosed — up to 60% of the 20 million Americans with thyroid disease are unaware of their condition (American Thyroid Association). The deeper problem: even diagnosed hypothyroid patients treated with levothyroxine often remain symptomatic because the standard TSH-only approach ignores free T3, reverse T3, thyroid antibodies, and the conversion … Read more

Quick answer: The immune system is not simply “weak” or “strong” — it is an extraordinarily complex regulatory network requiring precise calibration. Most immune dysfunction in functional medicine patients represents inappropriate activation (autoimmunity, allergies, chronic inflammation) or impaired surveillance (recurrent infections, impaired pathogen clearance) — both addressable through targeted nutritional, lifestyle, and microbiome interventions supported … Read more

Quick answer: Cardiovascular disease kills approximately 695,000 Americans annually — one death every 36 seconds — yet 90% of cases are attributable to modifiable risk factors identifiable years before a cardiac event. Functional cardiology extends beyond the standard lipid panel to evaluate advanced biomarkers — Lp(a), oxidized LDL, ApoB, high-sensitivity CRP, homocysteine, TMAO, Lp-PLA2, and … Read more

Quick answer: GERD affects 20% of Western populations, yet proton pump inhibitors — prescribed to over 15 million Americans — suppress symptoms while accelerating the nutritional deficiencies, gut dysbiosis, and motility dysfunction that drive the disease. Functional medicine identifies the actual root causes of reflux: insufficient lower esophageal sphincter tone, delayed gastric emptying, small intestinal … Read more

Quick answer: Sleep is not passive rest — it is the most anabolic, neurorestorative, immune-calibrating process in human biology. Matthew Walker’s declaration that “sleep is the single most effective thing we can do to reset our brain and body health each day” is supported by over 17,000 scientific papers. Functional sleep medicine identifies seven root … Read more