Dr. Tom Biernacki, DPM, FACFAS

Quick answer: Standard annual physicals test a narrow panel of 15–20 biomarkers designed to detect overt disease — already too late for optimal intervention. Functional medicine’s comprehensive lab evaluation includes 60–100+ biomarkers assessing metabolic health, inflammation, hormones, micronutrients, cardiovascular risk, and organ function at the sub-clinical level — identifying dysfunction years before disease becomes diagnosable … Read more

Quick answer: Heart Rate Variability (HRV) — the millisecond-to-millisecond variation in the interval between heartbeats (R-R intervals) — is the single most validated non-invasive biomarker of autonomic nervous system balance and physiological resilience. Higher HRV indicates robust parasympathetic (vagal) tone and adaptive capacity; low HRV is an independent predictor of all-cause mortality, cardiovascular events, depression, … Read more

Quick answer: Therapeutic peptides — short amino acid chains (typically 2–50 amino acids) with specific biological signaling activity — represent one of the fastest-growing areas of functional and regenerative medicine. Unlike small-molecule drugs that broadly inhibit or activate receptors, peptides work through physiological signaling pathways with high receptor specificity and typically favorable safety profiles. Key … Read more

Quick answer: Small Intestinal Bacterial Overgrowth (SIBO) — defined as >10³ bacteria/mL in jejunal aspirate or abnormal lactulose/glucose hydrogen/methane breath test — is found in 30–85% of patients with IBS, up to 78% of fibromyalgia patients, and in significant proportions of those with hypothyroidism, Parkinson’s disease, and rosacea. It is both under-diagnosed and over-treated — … Read more

Medically reviewed by Thomas Biernacki, DPM — Board-Eligible Podiatric Surgeon, Balance Foot & Ankle PLLC | Howell & Bloomfield Hills, MI Quick Answer Urolithin A — a postbiotic compound produced when gut bacteria metabolize ellagitannins from pomegranate, walnuts, and berries — is the first dietary metabolite clinically proven to activate mitophagy, the selective removal of … Read more

Quick answer: The U.S. Centers for Disease Control’s National Exposure Report documents measurable levels of 300+ synthetic chemicals in average Americans’ blood and urine — including phthalates, BPA, PFAS (“forever chemicals”), pesticides (glyphosate, chlorpyrifos), heavy metals, and polychlorinated biphenyls (PCBs). Total body burden of these xenobiotics correlates with insulin resistance, thyroid dysfunction, hormone disruption, neurological … Read more

Quick answer: Nutrigenomics — the study of how genetic variants alter individual responses to nutrients, foods, and environmental exposures — has identified hundreds of clinically actionable SNPs (Single Nucleotide Polymorphisms) affecting methylation (MTHFR), detoxification (GSTP1, CYP1B1), neurotransmitter metabolism (COMT, MAO-A), inflammation (TNF-α, IL-6 promoter), and cardiovascular risk (APOE ε4, Factor V Leiden). Genetic testing combined … Read more

Medically reviewed by Thomas Biernacki, DPM — Board-Eligible Podiatric Surgeon, Balance Foot & Ankle PLLC | Howell & Bloomfield Hills, MI Quick Answer Sulforaphane — the isothiocyanate released when you chew broccoli sprouts — activates Nrf2 by covalently modifying Keap1-Cys151, simultaneously inducing more than 200 cytoprotective genes for 48–72 hours from a single dose. In … Read more

Quick answer: Organic acids testing (OAT) — analysis of 70+ metabolic intermediates in urine — provides a biochemical snapshot of mitochondrial function, Krebs cycle efficiency, neurotransmitter metabolism, B-vitamin status, oxidative stress markers, dysbiosis markers, and fatty acid oxidation. It is one of functional medicine’s most comprehensive single-specimen metabolic assessments, capable of identifying cellular energy deficits … Read more

Quick answer: Brain-Derived Neurotrophic Factor (BDNF) — the most critical neurotrophin for synaptic plasticity, neurogenesis, and cognitive function — declines 15–25% with chronic stress, depression, sedentary behavior, and Western diet. Conversely, specific lifestyle and nutritional interventions can increase hippocampal BDNF 20–200%, representing one of the most powerful levers available to protect against cognitive decline, depression, … Read more