2026 Pauling Award Winner Reveals the Truth About Hormones & GLP-1s

Introduction and award announcement 0:00

What are some of the fondest memories you have of this sort of like international proliferation of functional medicine in the last 10 years? Well, what I would say is that just like you said, I've been lucky that I have been to London. I had been China four or five times. I could go through a long list. I even now have privileges at Reliance Hospital, Reliance Foundation Hospital in Mumbai, India, to practice functional medicine as a consultant. But the most exciting thing is being here at this international conference and all of the attendees that remember me from what I saw them in their home country.

And so that's exciting. It's excited to go to these other countries and get, you know, significant ovation, sometimes standing ovations, because they crave this care. And it's just so rewarding. Hello and welcome back to the Evolution of Medicine podcast. We are here at IFM's International Conference and we are with Dr. Joel Evans. In this podcast, we're going to get into a little bit about his journey and just a quick announcement before we start that today's a great day. because Dr. Joel Evans is this year's winner of the Linus Pauling Award, which if you haven't heard of it, is essentially like the lifetime achievement award for functional medicine.

It goes to one practitioner and doctor every year. And Joel, hey, congratulations. Thank you so much, James. You were on the original Evolution of Medicine Summit in 2014. So it's really amazing to see the journey that you've been on. Speaking of journeys, Share us a little bit about the journey to be here, to get the award. When did you find out you're winning it and how you made it here? So the award has been something that I have been very much aware of through most of my professional life as a functional medicine practitioner,

Winning the Linus Pauling Award 1:56

because as you said, it really is a lifetime achievement award. And the people that have selected really have really been my heroes. amongst my peer group, there's a lot of chatter. Who do you think is going to get it this year? We really discuss it. And when I got the call from Amy Mack about three and a half weeks ago, it was like, sit down. And as soon as she told me, I really was filled up with emotion. And I could feel that I was getting teary. For me like many other functional medicine practitioners, there's a fair amount of sacrifice.

that goes into pivoting and changing your professional career direction. And so this was the ultimate form of validation. So that was so exciting. I was happy that I available. We were away in Italy right beforehand. The challenge for me was, The acceptance speech. So how do you describe your professional life in five, six, seven minutes? Yeah. And so that was a great process and I would actually recommend it to people. If they're doing any sort of self-awareness kind of work, what would you do if you were forced to describe your personal and professional life and write it down as though you're going to give an acceptance speech for an award?

I think that's a nice exercise. That's what I came away with. That's amazing. Well, it's good to do that journey. And I'm glad you had the opportunity to to look back on this journey and you mentioned some of your heroes being previous award recipients.

Becoming a lifer in functional medicine 4:10

What would you say were some key moments where you realized like, I am a lifer. This is what I m doing. I mean, until this is done. Well, what I would say is that I was really lucky that Jeff Bland sort of tapped me on the shoulder and I learned about functional medicine and took to it and explained Some of my thoughts about a functional medicine approach to women's health as an OB-GYN, discussed them with Bethany Hayes, who was our leading GYN educator at the time. And Jeff brought me in to lecture for metagenetics on women health.

And then he brought me in as a member of the scientific advisory board of Medigetix. And that's when I realized I was a lifer in this community because I loved preparing the lectures. I love giving the lecture.s I Love the intellectual curiosity of being on the advisory Board of a supplement company that was leading edge and thinking about formulations and It just became, you know, once you do functional medicine, and you can't go back. And that was it. What would you say, like, I actually did an interview earlier today where the person said that they had seen a disproportionate number of OB-GYNs at this conference.

And I'm just wondering if you feel like there's something in the air or, you know, something that's happened. Have we reached a tipping point where this, your specialty is more aware of the need for a functional medicine approach to solve the women's health issues of today? Yeah, we certainly have reached the tipping And I think there's two reasons for that. I Think in general, if you look at the integrative holistic functional market, you know, historically, women, midlife women have been the leaders in bringing that kind of care to their families, to They've always been interested in this type of care.

But now with the demographic shifting of the numbers of women in menopause and perimenopausal, that is increasing their interest. And since they're the decision makers about health care, And then we're finally understanding some of the benefits of hormones for all these midlife issues in a sense that the prohibition about hormones that we got from the Women's Health Initiative, those prohibitions are falling away now.

Womenu2019s health reaches a tipping point 6:54

And so it's how can you use hormones in way that is a I would say wisdom based approach as opposed to a one size fits all. And that's what you get from functional medicine. You don't get that anywhere else. I speak to that because I'm creating, I've always been in charge of that hormone health module and I create the midlife women's segments. So I am totally on top of the different approaches to the issues of midlife women. It seems to me that in the last five years, there has been an explosion in this conversation, you know, online.

Maybe it's just that I'm getting to a certain age where I am targeted for that online content, but I see massive, mainly like female doctor celebrities sort of talking about everything from the menopause brain to, all of those aspects. Is that a real thing? Am I imagining it? Has there been explosion or am I just seeing more of it because I' m 45? Yeah, no, absolute explosion. Yeah. Absolute explosion, and that's good and bad. It's because there's a need for this information. The problem is the information is invented.

And so, you know, people can do and say anything. But in general, the rising tide lifts all boats, so there's more information, more interest. And our hope is that through the Find a Practitioner site, you know, at the IFM website, people will find practitioners so they can get this information in a responsible way. Yeah. What are some of the things that you feel are grown in popularity that are irresponsible, as an example? So I just want to take a minute to talk about the incredible mission partners that we have here at The Evolution of Medicine that have made this possible.

So first and foremost, I want thank Fullscript and Full script Journey. Full scripts has been an amazing partner for 10 years. We only pick partners, that can help us achieve our vision and help you achieve your practice vision. And Full Script have been incredible partner, for a decade. But their new offering journeys, this is why we called it The evolution of medicine journeys. is allowing practitioners to combine the relationships that they have with the newest technology to sell direct-to-consumer lab testing and use it as a funnel to bring into your practice and it's a game changer for the whole industry.

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Come on over here. I want to show you about the other mission partners. If you've been following us for a while, you know that these are organizations that we trust, that add a lot of value.

Risks of oversimplified hormone advice 10:11

Freedom Practice Coaching, I have been supported by them since the beginning. And so many of the issues that practitioners face in building a successful practice, scaling a success practice come down to having the right support with people who have done that. Go to goevomed.com. Big boost marketing. Uli and his team are the best in the business when it comes to really understanding how to market your functional medicine practice. Go to goevomed.com slash big boost and see how they can help you. And then what you're going to be hearing a lot about is the formation of clinical networks.

Ultimately, True Neura is our first effort at that, which is to build an integrated clinical network combining independent practices from across the country into a network that can reverse cognitive decline. And if you go to goevomed.com slash Trinura, you can get a demo. You can see what it means to be part of an integrative clinical networks. That's mentorship, that's software, and that makes it easier for you to get incredible outcomes in a disease state where there are no other options. So thanks to our mission partners.

Let's get back to the content. What's irresponsible is the, you know, the one size fits all and the lack of personalization for, different interventions and saying hormones can cure everything. So the biggest issue is that you look at the benefits of hormones and for example, There's a lot of information out there from influencers about hormones and mitochondria. Okay. And mitochondrial, as we know, are the part of the cell that's responsible for energy. Yeah. So the message on social media is your fatigue, your loss of energy, if you're a midlife woman is because you are estrogen deficient and you need HRT.

So people are coming to see practitioners saying I'm fatigued and I want hormones and they don't look at the other causes of fatigue. So it can be because there's no more estrogen. I mean, what people don' realize in the conventional world is that mitochondria actually have estrogen receptors. And so estrogen make the mitochondrial function more efficiently. So when you lose estrogen in menopause, the mitochondria are infected and they don't work as well. That's real. But that doesn't mean that that's the only cause of a menoppausal woman's fatigue.

So you have to look at other things that the Mitochondria do, other ways to assist mitochondrial health and make sure it's not just estrogen. And so that is the biggest problem. I have people come in, you know, insisting on hormones and I just do a basic check and their anemic. Yeah. So that's the problem is that influencers can look for a sexy sound bite. Yeah, which is different than how do you do a thorough evaluation of somebody? Yeah well that a great legacy to deliver the thorough valuation because sometimes there are so many like super elegant solutions, right, that are missed because of the lack of a workup.

I was interested in something that Jeff said today is that you couldn't even imagine at the beginning of functional medicine, how personalization will become a reasonable thing for everyone to enjoy. But now, you know, these things exist and this ability exists. What do you see as areas? What are you excited about in the sort of personalisation of women's health at The two hottest areas or three hottest in women's health are metabolic flexibility,

Personalized care: metabolic flexibility, mitochondria, and GLP-1s 14:07

mitochondrial health, and the wise use of GLP-1s. It's how do you find the sweet spot for how much of a GLP-1 does someone need? How much mitochondrial help does some one need, and what do we need to do to ensure metabolic flexibility? When I talk about metabolic flexible, it's that when someone's exercising, And they're starting off, they are going to be burning their blood sugar, burning sugar first in their body, then breaking down the glycogen in the liver. And then they have to go ahead and do fatty acid oxidation or fat oxidation to burn fat.

But when people have insulin issues or other cardio metabolic issues, they don't do that transition well. And sometimes they may have to, in order to get calories, may to burn muscle, for example. But you need to have the ability to go from burning the glycogen source and the liver to fat. If you can't burn fat, you don' have your metabolic flexibility. So you have to work on achieving that metabolic flexibility through normalizing blood sugar, through mitochondrial assessment, you know, all the things that we all know what to do.

And then the GLP-1 system. So the glps, the agonists are great for diabetics. We know that. And they definitely help people lose weight, but people don't always need the pharmacologic dose. And it could be that if people need to lose small amounts of weight but also, for example, you know, GLPs and mitochondria, there's a connection there. There are estrogen receptors in the intestinal cells that make GLP-1. So those are called the L cells. Those L-cells have estrogen receptor. If there's no estrogen around, there is going to be a natural decrease in GLPs secretion.

which is part of the weight gain you get with menopause. So the reflex is to, and again, this is influencer, is everybody should be on a GLP-1, but no, you have to look and see what their blood sugar dynamics are. And maybe you need to microdose, use a compounding pharmacy because the dose that they need is less than the lowest pharmaceutical. That's really, top shelf care is you could look at mitochondrial health, look a metabolic flexibility and look in the GLP-1 system and end up helping in those three domains and that's top-shelf care.

Yeah. Well, that's what we're aiming for. And I think that the world is coming around to that and we have to put out the signal of it. I acknowledge that this signal has been put our over the years. Part of the reason for the award today is just that, this has being an area that has so much need and I that functional medicine is flying the flag for top shelf care. So I'd love to just ask you, because I know you've had the opportunity to travel a lot with the functional medicine bandwagon to teach all over the world.

What are some of the fondest memories you have of this sort of like international proliferation of functional Medicine in the last 10 years? Well, what I would say is that, just like you said, I've been lucky that I have been to London. I had been China four or five times. Um, um, really been, been Ireland. You know, go through a long list. Even now have privileges at Reliance Hospital, Reliant Foundation Hospital in Mumbai, India to practice functional medicine as a consultant. But the most exciting thing is being here at this international conference and all of the attendees that remember me from when I saw them in their home country.

And so that's exciting. It's excited to go to these other countries and get significant ovation, sometimes standing ovations, because they crave this care.

International growth of functional medicine 18:48

And it's just so rewarding. That's amazing. Well, I'm sure that will continue because one of the things I've noticed here is just the level of international delegation, the places that I have seen, all different places I gone. I'd love to just get into a little bit. One of things that we're seeing obviously is a huge trend is people wanting access to their data, that kind of data that is available. that is available typically used to only be available through coming to see a doctor like yourself.

You know, if you want to get these kind of other information, but now it's a lot more available to the consumer. What are some of the information that you gather, let's say about women's health, that wouldn't be in a sort of a standard panel that, you think, is extremely helpful in you personalizing care for, say, a menopause female? So what I would say is that the latest thing in lab evaluation would be an FSH level. Okay. Now, conventional wisdom has it that. FSH, which is follicle stimulating hormone, Which comes from the pituitary and stimulates the egg, the follicles to make estrogen.

And when the eggs are not making estrogen, that's menopause. So the feedback loop with the brain was no estrogen, menopause, high FSH, because the body is trying to make the ovary produce estrogen. So it's pressing on the gas pedal as hard as it can, sending out a total, I mean, a very high amount of FSh to the ovarie. Metapause, there aren't those eggs left, so there's no estrogen to make. So you end up with low estrogen level, high FSH level and no one measures an F SH level in metapaus because you know it's going to be high.

Yeah. However, The top shelf way to manage somebody menopause is you give them the estrogen. And one of the ways to check if your estrogen level is right for a particular woman is to see what her FSH level. Because if her FSH level starts to go down, that means that there's enough estrogen in her system. Yeah. And you've hit the right dose. You've had the sweet spot. If you're giving a dose and the FSH level is still really high, that's a sign that maybe you need to give a little bit more estrogen.

Using lab data to personalize menopause care 21:38

So that the cutting edge thing now with laboratory. Yeah, I love that. I mean, clinics that have been trained by IFM and been through your training and being to the hormone modules could form a nationwide network where the standard of care is at the top shelf and that ultimately the outcomes could be shown through those to be superior to outcomes of, let's say, the bog standard hormone clinic where everyone gets hormones because that's what they do, right? And that, you know, that that could facilitate a harmonization of the standard of care towards you, what you call it.

That's how standard care has changed is with data. So I know that there are a lot of smart minds out there figuring out how to collect that data Well, look, this has been amazing from my end to be on the other side of this. I mentioned at the beginning, so when we did the first Evolution of Medicine Summit, it's been great over my career to meet so many practitioners who that was their first moment. They hadn't heard of functional medicine. The summit gives them a free thing to sign up for. They listen to people like yourself.

I mean, looking back on that summit, there's obviously like the Hymen, the Blans, and the Evans of the world, but there are also people, like Robin Berzen, who went on to create Parsley Health. It's now in network across all 50 states. Jeff Glad who ends up being now Chief Medical Officer of Fullscript. So many people that I met there at the very beginning who have had an outsized impact on this journey towards where we're heading. And it's really a fun experience to be here now and to see it starting to...

Yeah, I think it is great. Well, it was cool to say that we'll see where we are in another five or ten years.

Closing reflections on the evolution of medicine 23:38

Absolutely. Dr. Evans, thanks so much for being part of the evolution. We've been here at IFMAIC with Dr. Joel Evans. He's the winner of this year's Linus Pauling Award. We'll have all the details here in the show notes. Thanks so much for tuning in and we'll see you next time. So we are here asking practitioners about their practitioner journeys and the reason why is because Journeys is a new product from Fullscript. Journeys allows you to set up your own lab offerings as the top of the funnel.

Give the patients what they want. They want to know about themselves and it's the easiest way to bring them into your practice. We have all types of practices from across the country that are building their own unique lab panels for their unique practices, selling them to their community and acting as a great funnel into their practice is a massive innovation. I think this will accelerate the evolution of medicine. You can go to goevomed.com slash journeys to find out more, set up your own journeys in half an hour and transform the health of your community.

Go get it. So that was the podcast. What an epic session. Thank you so much for tuning in to the Evolution of Medicine podcast, we'll be back again next week. And thanks so