Dr. Tom Biernacki, DPM, FACFAS 
Quick answer: Nutrigenomics — the study of how genetic variants interact with dietary components — reveals why the same food can be medicine for one person and metabolic poison for another. Over 50 clinically actionable SNPs in genes governing folate metabolism (MTHFR), vitamin D activation (VDR, CYP2R1), caffeine clearance (CYP1A2), saturated fat response (APOE, FTO), … Read more
Quick answer: Approximately 1 in 6 couples worldwide face infertility, yet functional medicine identifies reversible root causes — from sperm DNA fragmentation to mitochondrial dysfunction, thyroid subclinical imbalance, and microbiome disruption — that standard fertility workups routinely miss. Evidence-based interventions can improve both egg quality and sperm parameters within 90 days. The Fertility Crisis: Why … Read more
Quick answer: Prediabetes — defined as fasting glucose 100–125 mg/dL or HbA1c 5.7–6.4% — affects 96 million Americans (38% of the adult population), with 70% progressing to type 2 diabetes within 10 years if untreated, yet the CDC’s National Diabetes Prevention Program demonstrates that intensive lifestyle intervention (7% weight loss + 150 minutes/week moderate exercise) … Read more
Quick answer: Functional rheumatology addresses autoimmune conditions — rheumatoid arthritis, lupus, ankylosing spondylitis, Sjögren’s syndrome, and others — not as isolated aberrations of the immune system requiring permanent immunosuppression, but as multifactorial expressions of gut dysbiosis, molecular mimicry, intestinal permeability, environmental triggers, hormonal imbalances, and chronic low-grade infection, with growing evidence that identifying and eliminating … Read more
Quick answer: Sports medicine and performance optimization in functional medicine extends far beyond treating injuries — it encompasses the optimization of VO2 max, lactate threshold, sleep architecture, HPA axis stress response, gut microbiome composition (which directly influences athletic performance), and the individualized nutrition, supplementation, and recovery protocols that separate elite athletic performance from average, with … Read more
Quick answer: Cancer is not primarily a genetic disease of random mutation — it is increasingly understood as a metabolic and epigenetic disease driven by mitochondrial dysfunction, inflammation, immune evasion, and the tumor microenvironment, with the striking statistic that only 5–10% of cancers are attributed to inherited genetic mutations while 90–95% arise from environmental exposures, … Read more
Quick answer: Environmental medicine addresses the growing burden of chronic illness driven by ubiquitous exposures to endocrine-disrupting chemicals (EDCs), heavy metals, mycotoxins (mold toxins), air pollutants, and persistent organic pollutants (POPs) — with the Endocrine Society estimating that EDC-related health costs in the EU alone reach €163 billion annually, and epidemiological evidence linking these exposures … Read more
Quick answer: Functional neurology addresses the same neurodegenerative and neuropsychiatric conditions as conventional medicine — Alzheimer’s disease, Parkinson’s, depression, anxiety, ADHD, and traumatic brain injury — but from the perspective of modifiable upstream drivers: neuroinflammation, impaired glymphatic clearance, mitochondrial dysfunction in neurons, gut-brain axis dysbiosis, and vascular insufficiency, with the FINGER trial (2015, Lancet, n=1,260) … Read more
Quick answer: Functional dermatology recognizes that skin conditions — from androgenic alopecia to psoriasis, acne, and premature aging — are not isolated skin diseases but visible manifestations of internal physiological dysfunction: insulin resistance, gut dysbiosis, sex hormone imbalance, chronic inflammation, nutrient deficiencies, and mitochondrial stress all express themselves through the skin, and addressing these upstream … Read more
Quick answer: Small Intestinal Bacterial Overgrowth (SIBO) — the presence of excessive bacteria in the normally near-sterile small intestine — affects an estimated 6–15% of healthy adults and up to 78% of patients with irritable bowel syndrome (IBS), producing bloating, abdominal pain, diarrhea, constipation, malnutrition, and systemic inflammation, yet remains dramatically underdiagnosed because its symptoms … Read more