Evidence-based health, wellness, and longevity content from Dr. Tom Biernacki.
Hypothyroidism affects 20 million Americans, but TSH-only testing misses most functional hypothyroidism. A surgeon explains the full panel — free T3, reverse T3, TPO antibodies — and the nutritional drivers.
Medically Reviewed by Dr. Tom Biernacki, DPM, FACFAS | Functional Medicine & Longevity Medicine | Updated May 2025 Quick Answer Heart rate variability (HRV) is the millisecond variation between consecutive heartbeats, controlled by your autonomic nervous system. Higher HRV indicates better cardiovascular resilience and stress adaptability — and it predicts all-cause mortality better than most … Read more
Male testosterone has declined 1% per year since the 1980s. A surgeon explains the four reversible causes — cortisol, vitamin D deficiency, zinc, visceral fat — and the evidence-based protocol to fix them before considering TRT.
✅ Medically reviewed by Dr. Tom Biernacki, DPM, FACFAS Board-certified podiatric surgeon · 3,000+ procedures · The Private PracticeLast reviewed: May 18, 2026 Quick answer: A continuous glucose monitor (CGM) shows your blood sugar in real time, every few minutes, for 10–14 days. For people without diabetes, it reveals hidden glucose spikes from specific foods, … Read more
B12 deficiency affects 20% of adults over 60 — and the standard serum test misses half of cases. A surgeon explains MMA testing, who is at high risk, and why neurological damage becomes permanent after 6-12 months.
40% of US adults aged 18-44 are insulin-resistant — and fasting glucose misses the diagnosis. A surgeon explains the real tests, the cellular mechanism, and the 8-week reversal protocol.
✅ Medically reviewed by Dr. Tom Biernacki, DPM, FACFAS Board-certified podiatric surgeon · 3,000+ procedures · The Private PracticeLast reviewed: May 18, 2026 Quick answer: Berberine is a plant alkaloid with robust evidence for improving blood glucose, insulin sensitivity, lipids, and gut microbiome composition. Multiple meta-analyses show it produces glucose-lowering effects comparable to metformin. It … Read more
✅ Medically reviewed by Dr. Tom Biernacki, DPM, FACFAS Board-certified podiatric surgeon · 3,000+ procedures · The Private PracticeLast reviewed: May 18, 2026 Quick answer: Testosterone declines 1–2% per year after age 30 in men, and low testosterone is associated with increased cardiovascular risk, metabolic disease, cognitive decline, and all-cause mortality. Before considering TRT, optimizing … Read more
✅ Medically reviewed by Dr. Tom Biernacki, DPM, FACFAS Board-certified podiatric surgeon · 3,000+ procedures · The Private PracticeLast reviewed: May 18, 2026 Quick answer: NAD+ (nicotinamide adenine dinucleotide) is a coenzyme essential to cellular energy production, DNA repair, and longevity signaling. It declines ~50% between ages 20 and 50. NMN and NR are precursors … Read more
✅ Medically reviewed by Dr. Tom Biernacki, DPM, FACFAS Board-certified podiatric surgeon · 3,000+ procedures · The Private PracticeLast reviewed: May 18, 2026 Quick answer: Thyroid optimization goes well beyond TSH. A fully optimized thyroid workup includes Free T3, Free T4, Reverse T3, and thyroid antibodies. Millions of people have “normal” TSH but suboptimal Free … Read more