# The Private Practice - Functional Medicine & Longevity Blog by Dr. Tom Biernacki, DPM

> Evidence-based functional medicine and longevity content written by Dr. Tom Biernacki, DPM, FACFAS - a board-certified surgeon at Balance Foot & Ankle. Topics include mold illness (CIRS), methylation, hormesis, mitochondrial health, POTS syndrome, magnesium therapy, Zone 2 training, sauna and cold therapy, functional genomics, chronic inflammation, gut health, and advanced lab interpretation. All content is clinically grounded and written for patients seeking root-cause solutions. Site: https://theprivatepractice.co

---


## Pages

- [Health Hub: Complete Evidence-Based Protocol Library](https://theprivatepractice.co/health-hub/)
- [Cut Out The Middleman](https://theprivatepractice.co/cut-out-the-middleman/)
- [Home](https://theprivatepractice.co/)
- [About](https://theprivatepractice.co/about-dr-tom-biernacki/)
- [Explore](https://theprivatepractice.co/explore-health-topics/)
- [My Protocol](https://theprivatepractice.co/protocol/)
- [Courses](https://theprivatepractice.co/health-courses/)
- [Work With Me](https://theprivatepractice.co/health-consultation/)

---


## Posts

- [Functional Genomics: APOE4, CYP450, and Precision Medicine Explained](https://theprivatepractice.co/functional-genomics-nutrigenomics-guide/)
- [Lyme Disease & PTLDS: Co-Infections, Babesia, Bartonella, and Neuroinflammation](https://theprivatepractice.co/lyme-disease-tick-borne-illness-treatment/)
- [Nobiletin and Diabetic Peripheral Neuropathy: CLOCK/BMAL1 Circadian Amplification, HDAC1/PPAR-α Schwann Cell Fatty Acid Oxidation Rescue, and PFKFB3/2,6-BPF Endoneurial Glycolytic Rebalancing](https://theprivatepractice.co/nobiletin-diabetic-peripheral-neuropathy/)
- [POTS Syndrome: Why Your Doctor Keeps Missing It and What Actually Helps](https://theprivatepractice.co/pots-syndrome-symptoms-treatment/)
- [Mold Illness (CIRS): Symptoms, Testing, and the Shoemaker Protocol Explained](https://theprivatepractice.co/mold-illness-cirs-shoemaker-protocol/)
- [Chrysin and Diabetic Peripheral Neuropathy: STOML3/PIEZO2 Allodynia Suppression, eIF2B5 Integrated Stress Response Reversal, and cGAS/STING/TBK1 Endoneurial Innate Immune Silencing](https://theprivatepractice.co/chrysin-diabetic-peripheral-neuropathy/)
- [Magnesium for Migraines: What a Surgeon Takes (and Why It Works)](https://theprivatepractice.co/magnesium-migraine-prevention/)
- [Baicalein and Diabetic Peripheral Neuropathy: RAGE/DIAPH1/Cofilin Axon Growth Cone Rescue, CXCR2/Src/STAT3→Shh/c-Jun Schwann Cell Repair Reactivation, and LOXL2 Endoneurial Fibrosis Reversal](https://theprivatepractice.co/baicalein-diabetic-peripheral-neuropathy/)
- [Fasting Mimicking Diet (FMD): Longo Protocol, Science, and Longevity Benefits](https://theprivatepractice.co/fasting-mimicking-diet-protocol/)
- [Magnesium, Mitochondrial Biogenesis and Longevity: The Del Gobbo 2013 Meta-Analysis and Nerve Health](https://theprivatepractice.co/magnesium-mitochondrial-biogenesis-and-longevity-the-del-gob/)
- [Vagus Nerve and HRV: The Science of Vagal Tone, Inflammation, and Healing](https://theprivatepractice.co/vagus-nerve-hrv-vagal-tone/)
- [IV Nutrient Therapy: Myers Cocktail, High-Dose Vitamin C, and IV NAD+ Evidence Guide](https://theprivatepractice.co/iv-nutrient-therapy-myers-cocktail/)
- [Berberine, AMPK Activation and Longevity: The Yin 2008 Metformin Trial and Diabetic Neuropathy](https://theprivatepractice.co/berberine-ampk-longevity-yin-2008-neuropathy/)
- [Environmental Toxins and Microplastics: Testing, Health Risks, and Detoxification](https://theprivatepractice.co/environmental-toxins-microplastics-detox/)
- [VO2max and Longevity: The Science of Cardiorespiratory Fitness as Medicine](https://theprivatepractice.co/vo2max-longevity-cardiorespiratory-fitness/)
- [NAD+, NMN and Longevity: The Yoshino 2021 Science Trial, Sirtuin Activation, and Nerve Protection](https://theprivatepractice.co/nad-nmn-longevity-yoshino-2021-neuropathy/)
- [Muscle as an Endocrine Organ: Myokines, Sarcopenia, and Longevity](https://theprivatepractice.co/muscle-myokines-sarcopenia-longevity/)
- [Lyme Disease and Tick-Borne Co-Infections: Functional Medicine Diagnosis and Treatment](https://theprivatepractice.co/lyme-disease-tick-borne-co-infections/)
- [Alpha-Lipoic Acid and Longevity: The SYDNEY 2 Trial, PDH/TCA Restoration, and Diabetic Neuropathy](https://theprivatepractice.co/alpha-lipoic-acid-longevity-sydney-2-neuropathy/)
- [The Glymphatic System: How Your Brain Detoxifies During Sleep](https://theprivatepractice.co/glymphatic-system-brain-detox-sleep/)
- [Ozone Therapy: Evidence-Based Guide to Medical O₃ Treatments, Mechanisms, and Protocols](https://theprivatepractice.co/ozone-therapy-medical-o3-treatments/)
- [Coenzyme Q10 and Longevity: Q-SYMBIO Mortality Reduction and Peripheral Neuropathy Protection](https://theprivatepractice.co/coq10-ubiquinol-longevity-q-symbio-pmp22/)
- [PEMF Therapy: Pulsed Electromagnetic Field Science, Evidence & Protocols](https://theprivatepractice.co/pemf-therapy-pulsed-electromagnetic-field/)
- [Telomere Health & Telomerase Activation: Science-Based Guide to Protecting Your Chromosomal Clock](https://theprivatepractice.co/telomere-health-telomerase-activation/)
- [Resveratrol, SIRT1, and Longevity: LKB1/AMPK Mitophagy and Diabetic Peripheral Neuropathy](https://theprivatepractice.co/resveratrol-sirt1-longevity-lkb1-ampk-neuropathy/)
- [Precision Medicine & Pharmacogenomics: How Your Genes Determine Drug and Nutrient Response](https://theprivatepractice.co/precision-medicine-pharmacogenomics-gene-response/)
- [Peptide Therapy Guide: BPC-157, TB-500, GHK-Cu, and Growth Hormone Secretagogues for Repair and Longevity](https://theprivatepractice.co/peptide-therapy-bpc157-tb500-ghk-cu-growth-hormone/)
- [Vitamin D, VDR, and Longevity: How D2d's Diabetes Risk Reduction Impacts Nerve Health](https://theprivatepractice.co/vitamin-d-vdr-longevity-ngf-neuropathy/)
- [Bioidentical Hormone Replacement Therapy (BHRT): Complete Evidence-Based Guide](https://theprivatepractice.co/bioidentical-hormone-replacement-therapy-bhrt/)
- [Quercetin, Senolytics, and Longevity: Senescence Framework and Diabetic Peripheral Neuropathy](https://theprivatepractice.co/quercetin-senolytics-longevity-dpn-sasp/)
- [Gut Microbiome & Dysbiosis: Evidence-Based Guide to Testing, Diet, and Treatment](https://theprivatepractice.co/gut-microbiome-dysbiosis-testing-diet-treatment/)
- [Intermittent Fasting & Time-Restricted Eating: Circadian Biology, Autophagy, and Clinical Evidence](https://theprivatepractice.co/intermittent-fasting-time-restricted-eating-circadian/)
- [Zinc & Longevity: The Metallothionein Switch That Protects Nerves After 50](https://theprivatepractice.co/zinc-longevity-metallothionein-diabetic-neuropathy/)
- [Mitochondrial Dysfunction & Medicine: CoQ10, NAD+, and Restoring Cellular Energy](https://theprivatepractice.co/mitochondrial-dysfunction-coq10-nad-energy/)
- [Cold Therapy & Ice Bath Science: Evidence-Based Guide to Cold Water Immersion and Cryotherapy](https://theprivatepractice.co/cold-therapy-ice-bath-science-cryotherapy/)
- [Infrared Sauna Therapy: The Science Behind Heat, Longevity, and Detoxification](https://theprivatepractice.co/infrared-sauna-therapy-heat-stress-longevity-detox/)
- [Ketogenic Diet for Metabolic and Neurological Conditions: Evidence-Based Protocols](https://theprivatepractice.co/ketogenic-diet-metabolic-neurological-epilepsy/)
- [Mast Cell Activation Syndrome (MCAS): Diagnosis, Triggers, and Functional Medicine Treatment](https://theprivatepractice.co/mast-cell-activation-mcas-diagnosis-treatment/)
- [Benfotiamine & Longevity: The Fat-Soluble Thiamine That Blocks Four Nerve-Destruction Pathways at Once](https://theprivatepractice.co/benfotiamine-longevity-thiamine-diabetic-neuropathy/)
- [CIRS (Chronic Inflammatory Response Syndrome): Mold Illness, Biotoxins, and the Shoemaker Protocol](https://theprivatepractice.co/cirs-mold-illness-shoemaker-protocol/)
- [Curcumin & Longevity: How Bioavailable Curcumin Reverses Brain Aging and Protects Peripheral Nerves](https://theprivatepractice.co/curcumin-longevity-bcm95-diabetic-neuropathy/)
- [Heavy Metal Testing and Chelation Therapy: Lead, Mercury, Arsenic, and Cadmium](https://theprivatepractice.co/heavy-metal-testing-chelation-lead-mercury/)
- [Exosome and Regenerative Cell Therapy: Science, Clinical Evidence, and Applications](https://theprivatepractice.co/exosome-therapy-regenerative-stem-cell/)
- [Ashwagandha & Longevity: How KSM-66 Withanolides Reduce Cortisol, Protect Nerves, and Slow Biological Aging](https://theprivatepractice.co/ashwagandha-longevity-ksm66-diabetic-neuropathy/)
- [HPA Axis Dysregulation: Cortisol Patterns, Stress Biology, and Functional Medicine Protocols](https://theprivatepractice.co/hpa-axis-dysregulation-cortisol-adrenal-stress/)
- [Lion's Mane Mushroom: How Hericenones and Erinacines Regenerate Nerves and Reverse Brain Aging](https://theprivatepractice.co/lions-mane-hericenone-nerve-regeneration/)
- [Longevity Supplement Stack: Evidence-Based Protocols for Rapamycin, NMN, Senolytics, and Urolithin A](https://theprivatepractice.co/longevity-supplement-stack-rapamycin-nmn-senolytics/)
- [Functional Thyroid Medicine: Hashimoto's, DIO2 Polymorphism, Reverse T3, and Beyond TSH](https://theprivatepractice.co/functional-thyroid-hashimotos-dio2-reverse-t3/)
- [Melatonin & Longevity: The Circadian Master Hormone That Protects Nerves, Mitochondria, and Cardiovascular Health](https://theprivatepractice.co/melatonin-longevity-circadian-diabetic-neuropathy/)
- [Advanced Cardiovascular Risk Assessment: ApoB, LP(a), CAC Scoring, and Functional Cardiology](https://theprivatepractice.co/advanced-cardiovascular-risk-apob-lpa-cac/)
- [Sleep Optimization: Glymphatic Clearance, Circadian Biology, and Functional Medicine Protocols](https://theprivatepractice.co/sleep-optimization-glymphatic-circadian-insomnia/)
- [Boswellia & Longevity: How AKBA Silences Nerve Inflammation, Preserves Endoneurial Collagen, and Fights Diabetic Peripheral Neuropathy](https://theprivatepractice.co/boswellia-akba-longevity-diabetic-neuropathy/)
- [Insulin Resistance and Metabolic Syndrome: Root Cause Assessment and Reversal Protocols](https://theprivatepractice.co/insulin-resistance-homa-ir-reversal-functional-medicine/)
- [Fisetin & Longevity: The Flavonoid Senolytic That Clears Zombie Schwann Cells, Restores Nerve Lymphatics, and Fights Diabetic Peripheral Neuropathy](https://theprivatepractice.co/fisetin-longevity-senolytic-diabetic-neuropathy/)
- [Exercise Science for Longevity: VO2 Max, Zone 2 Training, and Resistance Training as Medicine](https://theprivatepractice.co/exercise-science-vo2max-zone-2-resistance-training/)
- [Phosphatidylserine & Longevity: The Membrane Phospholipid That Rebuilds Neural Synapses, Buffers Mitochondrial Calcium, and Protects Diabetic Peripheral Nerves](https://theprivatepractice.co/phosphatidylserine-longevity-diabetic-neuropathy/)
- [Testosterone Optimization and Men's Hormonal Health: HPG Axis, Testing, and Evidence-Based Treatment](https://theprivatepractice.co/testosterone-mens-hormonal-health-hpg-axis-trt/)
- [Acetyl-L-Carnitine & Longevity: The Mitochondrial Fuel That Regenerates Nerves, Clears Schwann Lipid Droplets, and Fights Diabetic Peripheral Neuropathy](https://theprivatepractice.co/acetyl-l-carnitine-longevity-diabetic-neuropathy/)
- [PCOS: Polycystic Ovary Syndrome Diagnosis, Inositol Treatment, and Hormonal Balance](https://theprivatepractice.co/pcos-myo-inositol-treatment-hormonal-health/)
- [Autoimmunity and Leaky Gut: Intestinal Permeability, Zonulin, and the 5R Gut Restoration Protocol](https://theprivatepractice.co/autoimmunity-leaky-gut-zonulin-5r-protocol/)
- [Palmitoylethanolamide (PEA): Endocannabinoid, Mast Cells, and Neuroprotection](https://theprivatepractice.co/palmitoylethanolamide-pea-nerve-inflammation/)
- [Neuroinflammation and Chronic Pain: Microglia, Central Sensitization, and Anti-Inflammatory Treatment](https://theprivatepractice.co/neuroinflammation-chronic-pain-microglia/)
- [BDNF and Neuroplasticity: How to Grow Your Brain with Exercise, Diet, and Targeted Supplements](https://theprivatepractice.co/bdnf-neuroplasticity-exercise-lions-mane/)
- [Organic Acids Testing: Mitochondrial Function, Neurotransmitter Metabolism, and Dysbiosis Markers](https://theprivatepractice.co/organic-acids-testing-mitochondrial-neurotransmitters/)
- [Sulforaphane and Longevity: The Broccoli Molecule That Activates Nrf2, Restores Nerve Vessel BH4, and Protects Diabetic Peripheral Neuropathy via Three Distinct Pathways](https://theprivatepractice.co/sulforaphane-longevity-nrf2-diabetic-neuropathy/)
- [Nutrigenomics and Genetic Testing: MTHFR, COMT, APOE ε4, and Precision Functional Medicine](https://theprivatepractice.co/nutrigenomics-mthfr-comt-apoe-precision-medicine/)
- [Environmental Toxins and Detoxification: PFAS, BPA, Phthalates, and Evidence-Based Detox Protocols](https://theprivatepractice.co/environmental-toxins-pfas-bpa-phthalates-detox/)
- [Urolithin A and Longevity: The Gut Postbiotic That Activates Mitophagy, Protects Schwann Cell Mitochondria, and Prevents Quinolinic Acid Neurotoxicity in Diabetic Peripheral Neuropathy](https://theprivatepractice.co/urolithin-a-longevity-mitophagy-diabetic-neuropathy/)
- [SIBO: Small Intestinal Bacterial Overgrowth Testing, Treatment, and Root Cause Resolution](https://theprivatepractice.co/sibo-breath-test-rifaximin-root-cause/)
- [Peptide Therapy: GH Secretagogues, BPC-157, Thymosin, and GLP-1 Agonists](https://theprivatepractice.co/peptide-therapy-bpc157-cjc-glp1-semaglutide/)
- [Heart Rate Variability (HRV) and Vagal Tone: Measuring and Improving Autonomic Resilience](https://theprivatepractice.co/heart-rate-variability-hrv-vagal-tone-autonomic/)
- [Comprehensive Functional Medicine Lab Testing: Biomarkers, Optimal Ranges, and What Standard Panels Miss](https://theprivatepractice.co/functional-medicine-lab-testing-biomarkers/)
- [Bone Health & Osteoporosis Prevention: Vitamin K2, Bisphosphonates, and Functional Medicine](https://theprivatepractice.co/bone-health-osteoporosis-vitamin-k2-bisphosphonates/)
- [IV Nutrition Therapy: NAD+, Myers Cocktail, High-Dose Vitamin C, and Glutathione](https://theprivatepractice.co/iv-therapy-nad-glutathione-functional-medicine/)
- [Mitochondrial Medicine: CoQ10, Electron Transport Chain, PGC-1α, and Bioenergetic Restoration](https://theprivatepractice.co/mitochondrial-medicine-coq10-etc-bioenergetics/)
- [Circadian Biology: Light Therapy, Time-Restricted Eating, and Chronotype Optimization](https://theprivatepractice.co/circadian-biology-light-therapy-chronotype/)
- [Functional Cardiology: ApoB, Lp(a), Coronary Calcium Score, and Advanced Cardiovascular Risk](https://theprivatepractice.co/advanced-cardiovascular-risk-assessment/)
- [Longevity Medicine: 12 Hallmarks of Aging, Senolytics, Rapamycin, and Biological Age Reversal](https://theprivatepractice.co/longevity-hallmarks-biological-age-reversal/)
- [Gut Microbiome Diversity: Akkermansia, SCFAs, 30 Plants/Week, and Dysbiosis Treatment](https://theprivatepractice.co/gut-microbiome-diversity-akkermansia-scfa-plants/)
- [Sleep Medicine: CBT-I, Sleep Architecture, Glymphatic System, and Sleep Apnea](https://theprivatepractice.co/sleep-medicine-cbt-i-sleep-architecture-glymphatic-system-an/)
- [Thyroid Optimization: Hashimoto's, Selenium, Reverse T3, and Comprehensive Thyroid Panel](https://theprivatepractice.co/thyroid-hashimotos-selenium-reverse-t3-panel/)
- [HPA Axis & Cortisol Optimization: Adrenal Health, Burnout, Ashwagandha, and Adaptogens](https://theprivatepractice.co/hpa-axis-cortisol-burnout-adaptogens/)
- [Perimenopause & Women's Hormones: Bioidentical Estradiol, Progesterone, and the Timing Hypothesis](https://theprivatepractice.co/perimenopause-bioidentical-estradiol-progesterone/)
- [Peptide Therapy: BPC-157, Sermorelin, CJC-1295/Ipamorelin, and GLP-1 Agonists](https://theprivatepractice.co/peptide-therapy-bpc157-cjc-ipamorelin-glp1/)
- [PCOS and Endometriosis: Functional Medicine's Root-Cause Approach to Women's Hormonal Health](https://theprivatepractice.co/pcos-endometriosis-insulin-resistance-androgens/)
- [Functional Medicine for Chronic Pain and Fibromyalgia: Central Sensitization and Neuroinflammation](https://theprivatepractice.co/functional-medicine-fibromyalgia-neuroinflammation/)
- [Ozone Therapy: Major Autohemotherapy, Prolozone, and the Nrf2 Antioxidant Pathway](https://theprivatepractice.co/ozone-therapy-major-autohemotherapy-prolozone-and-the-nrf2-a/)
- [Mast Cell Activation Syndrome (MCAS): Upstream Triggers, Quercetin, and Dysautonomia](https://theprivatepractice.co/mast-cell-mcas-histamine-quercetin-dysautonomia/)
- [IV Micronutrient Therapy: Myers Cocktail, High-Dose Vitamin C, NAD+, and Glutathione](https://theprivatepractice.co/iv-therapy-myers-cocktail-vitamin-c-nad/)
- [Longevity Medicine: Epigenetic Clocks, Senolytics, mTOR Inhibition, and the Nine Hallmarks of Aging](https://theprivatepractice.co/longevity-epigenetic-clocks-senolytics-rapamycin/)
- [Thyroid Optimization: Hashimoto's, T4-to-T3 Conversion, Reverse T3, and Comprehensive Assessment](https://theprivatepractice.co/thyroid-optimization-hashimotos-t3-reverse-t3/)
- [Functional Cardiology: ApoB, Lp(a), Coronary Calcium Score, and Cardiovascular Risk Beyond LDL](https://theprivatepractice.co/functional-cardiology-apob-lpa-calcium-score/)
- [Functional Medicine for Weight Loss: Leptin Resistance, Adipokines, and GLP-1](https://theprivatepractice.co/functional-medicine-weight-loss-leptin-glp1/)
- [Functional Sleep Medicine: Glymphatic System, Circadian Biology, and Root-Cause Insomnia Treatment](https://theprivatepractice.co/functional-sleep-glymphatic-circadian-sleep-apnea/)
- [HPA Axis Dysfunction and Adrenal Health: Cortisol Rhythm, DHEA, and Adaptogens](https://theprivatepractice.co/hpa-axis-dysfunction-cortisol-rhythm-adaptogens/)
- [Women's Hormone Replacement Therapy: Bioidentical Estradiol, Progesterone, and the Timing Hypothesis](https://theprivatepractice.co/womens-hrt-bioidentical-estradiol-progesterone/)
- [Chronic Lyme Disease & Post-Infectious Syndromes: Coinfections, Biofilm, and Immune Dysregulation](https://theprivatepractice.co/chronic-lyme-post-infectious-coinfections-biofilm/)
- [Heavy Metal Detoxification & Chelation: Evidence-Based Guide to EDTA, DMSA, and the TACT Trial](https://theprivatepractice.co/heavy-metal-detoxification-and-chelation-evidence-based-guid/)
- [Mitochondrial Medicine: PGC-1α, NAD+, CoQ10, and the Root Cause of Chronic Disease](https://theprivatepractice.co/mitochondrial-medicine-pgc1a-nad-coq10/)
- [Gut Microbiome Restoration: FMT, Akkermansia, Psychobiotics, and Dysbiosis Treatment](https://theprivatepractice.co/gut-microbiome-restoration-fmt-akkermansia/)
- [Long COVID & Post-Viral Syndrome: Microclots, EBV, Dysautonomia, and Recovery](https://theprivatepractice.co/long-covid-post-viral-microclots-ebv-dysautonomia/)

---

> Disclaimer: All content on The Private Practice is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare provider before making any health decisions. Dr. Tom Biernacki practices at Balance Foot & Ankle, Bloomfield Hills and Howell, Michigan. Contact: https://theprivatepractice.co


---