Full Transcript 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? 0:06 Well, what I would say is that just like you said, I've been lucky that I have been to London. 0:12 I had been China four or five times. 0:19 I could go through a long list. 0:22 I even now have privileges at Reliance Hospital, Reliance Foundation Hospital in Mumbai, India, to practice functional medicine as a consultant. 0:31 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. 0:45 And so that's exciting. 0:46 It's excited to go to these other countries and get, you know, significant ovation, sometimes standing ovations, because they crave this care. 0:56 And it's just so rewarding. 0:57 Hello and welcome back to the Evolution of Medicine podcast. 1:00 We are here at IFM's International Conference and we are with Dr. 1:05 Joel Evans. 1:08 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. 1:15 because Dr. 1:15 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. 1:24 It goes to one practitioner and doctor every year. 1:27 And Joel, hey, congratulations. 1:29 Thank you so much, James. 1:32 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. 1:42 Speaking of journeys, Share us a little bit about the journey to be here, to get the award. 1:48 When did you find out you're winning it and how you made it here? 1:52 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 2:03 because as you said, it really is a lifetime achievement award. 2:08 And the people that have selected really have really been my heroes. 2:15 amongst my peer group, there's a lot of chatter. 2:18 Who do you think is going to get it this year? 2:19 We really discuss it. 2:23 And when I got the call from Amy Mack about three and a half weeks ago, it was like, sit down. 2:35 And as soon as she told me, I really was filled up with emotion. 2:40 And I could feel that I was getting teary. 2:45 For me like many other functional medicine practitioners, there's a fair amount of sacrifice. 2:52 that goes into pivoting and changing your professional career direction. 2:59 And so this was the ultimate form of validation. 3:04 So that was so exciting. 3:07 I was happy that I available. 3:11 We were away in Italy right beforehand. 3:13 The challenge for me was, The acceptance speech. 3:22 So how do you describe your professional life in five, six, seven minutes? 3:31 Yeah. 3:31 And so that was a great process and I would actually recommend it to people. 3:39 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 3:54 it down as though you're going to give an acceptance speech for an award? 3:56 I think that's a nice exercise. 3:58 That's what I came away with. 4:00 That's amazing. 4:01 Well, it's good to do that journey. 4:02 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 4:12 What would you say were some key moments where you realized like, I am a lifer. 4:15 This is what I m doing. 4:17 I mean, until this is done. 4:20 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 4:37 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, 4:49 who was our leading GYN educator at the time. 4:52 And Jeff brought me in to lecture for metagenetics on women health. 5:01 And then he brought me in as a member of the scientific advisory board of Medigetix. 5:07 And that's when I realized I was a lifer in this community because I loved preparing the lectures. 5:16 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 5:27 about formulations and It just became, you know, once you do functional medicine, and you can't go back. 5:34 And that was it. 5:36 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. 5:44 And I'm just wondering if you feel like there's something in the air or, you know, something that's happened. 5:49 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 6:00 of today? 6:00 Yeah, we certainly have reached the tipping And I think there's two reasons for that. 6:07 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 6:19 that kind of care to their families, to They've always been interested in this type of care. 6:29 But now with the demographic shifting of the numbers of women in menopause and perimenopausal, that is increasing their interest. 6:41 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 6:52 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 7:04 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. 7:18 And that's what you get from functional medicine. 7:21 You don't get that anywhere else. 7:23 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. 7:35 So I am totally on top of the different approaches to the issues of midlife women. 7:43 It seems to me that in the last five years, there has been an explosion in this conversation, you know, online. 7:49 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 7:58 sort of talking about everything from the menopause brain to, all of those aspects. 8:05 Is that a real thing? 8:06 Am I imagining it? 8:07 Has there been explosion or am I just seeing more of it because I' m 45? Yeah, no, absolute explosion. 8:14 Yeah. 8:14 Absolute explosion, and that's good and bad. 8:17 It's because there's a need for this information. 8:22 The problem is the information is invented. 8:25 And so, you know, people can do and say anything. 8:29 But in general, the rising tide lifts all boats, so there's more information, more interest. 8:36 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 8:45 in a responsible way. 8:46 Yeah. 8:47 What are some of the things that you feel are grown in popularity that are irresponsible, as an example? 8:53 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. 9:01 So first and foremost, I want thank Fullscript and Full script Journey. 9:05 Full scripts has been an amazing partner for 10 years. 9:07 We only pick partners, that can help us achieve our vision and help you achieve your practice vision. 9:13 And Full Script have been incredible partner, for a decade. 9:16 But their new offering journeys, this is why we called it The evolution of medicine journeys. 9:20 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 9:30 funnel to bring into your practice and it's a game changer for the whole industry. 9:33 So go to goevomed.com slash journeys and you can get started on building the journeys for your practices an optimal way into practice. 9:40 We're going to have some conversations about it. 9:43 This is a Game Changer. 9:44 Next, Jenova. 9:45 Janova have been fans of the Evolution of Medicine for a long time. 9:49 We're big fans with them and they now have a lot more specialty testing. 9:53 They have lot of more tools and it's a key part of understanding the body ecologically. 9:59 So go to goyomed.com slash Jonova to find out more. 10:02 Come on over here. 10:03 I want to show you about the other mission partners. 10:06 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. 10:17 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 10:26 people who have done that. 10:28 Go to goevomed.com. 10:32 Big boost marketing. 10:33 Uli and his team are the best in the business when it comes to really understanding how to market your functional medicine practice. 10:39 Go to goevomed.com slash big boost and see how they can help you. 10:44 And then what you're going to be hearing a lot about is the formation of clinical networks. 10:50 Ultimately, True Neura is our first effort at that, which is to build an integrated clinical network combining independent practices from across the country 10:59 into a network that can reverse cognitive decline. 11:02 And if you go to goevomed.com slash Trinura, you can get a demo. 11:07 You can see what it means to be part of an integrative clinical networks. 11:10 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. 11:19 So thanks to our mission partners. 11:20 Let's get back to the content. 11:26 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. 11:42 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 12:00 and mitochondria. 12:01 Okay. 12:02 And mitochondrial, as we know, are the part of the cell that's responsible for energy. 12:09 Yeah. 12:11 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. 12:22 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. 12:35 So it can be because there's no more estrogen. 12:39 I mean, what people don' realize in the conventional world is that mitochondria actually have estrogen receptors. 12:45 And so estrogen make the mitochondrial function more efficiently. 12:49 So when you lose estrogen in menopause, the mitochondria are infected and they don't work as well. 12:55 That's real. 12:56 But that doesn't mean that that's the only cause of a menoppausal woman's fatigue. 13:01 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. 13:08 And so that is the biggest problem. 13:12 I have people come in, you know, insisting on hormones and I just do a basic check and their anemic. 13:18 Yeah. 13:19 So that's the problem is that influencers can look for a sexy sound bite. 13:26 Yeah, which is different than how do you do a thorough evaluation of somebody? 13:31 Yeah well that a great legacy to deliver the thorough valuation because sometimes there are so many like super elegant solutions, 13:39 right, that are missed because of the lack of a workup. 13:43 I was interested in something that Jeff said today is that you couldn't even imagine at the beginning of functional medicine, 13:48 how personalization will become a reasonable thing for everyone to enjoy. 13:52 But now, you know, these things exist and this ability exists. 13:56 What do you see as areas? 13:59 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 14:15 mitochondrial health, and the wise use of GLP-1s. 14:23 It's how do you find the sweet spot for how much of a GLP-1 does someone need? 14:31 How much mitochondrial help does some one need, and what do we need to do to ensure metabolic flexibility? 14:40 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, 14:50 burning sugar first in their body, then breaking down the glycogen in the liver. 14:56 And then they have to go ahead and do fatty acid oxidation or fat oxidation to burn fat. 15:04 But when people have insulin issues or other cardio metabolic issues, they don't do that transition well. 15:15 And sometimes they may have to, in order to get calories, may to burn muscle, for example. 15:20 But you need to have the ability to go from burning the glycogen source and the liver to fat. 15:27 If you can't burn fat, you don' have your metabolic flexibility. 15:30 So you have to work on achieving that metabolic flexibility through normalizing blood sugar, through mitochondrial assessment, 15:39 you know, all the things that we all know what to do. 15:42 And then the GLP-1 system. 15:45 So the glps, the agonists are great for diabetics. 15:53 We know that. 15:55 And they definitely help people lose weight, but people don't always need the pharmacologic dose. 16:04 And it could be that if people need to lose small amounts of weight but also, for example, you know, GLPs and mitochondria, 16:12 there's a connection there. 16:15 There are estrogen receptors in the intestinal cells that make GLP-1. 16:24 So those are called the L cells. 16:26 Those L-cells have estrogen receptor. 16:29 If there's no estrogen around, there is going to be a natural decrease in GLPs secretion. 16:36 which is part of the weight gain you get with menopause. 16:40 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. 16:51 And maybe you need to microdose, use a compounding pharmacy because the dose that they need is less than the lowest pharmaceutical. 17:01 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 17:15 those three domains and that's top-shelf care. 17:18 Yeah. 17:18 Well, that's what we're aiming for. 17:20 And I think that the world is coming around to that and we have to put out the signal of it. 17:25 I acknowledge that this signal has been put our over the years. 17:29 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 17:39 top shelf care. 17:40 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. 17:49 What are some of the fondest memories you have of this sort of like international proliferation of functional Medicine in the last 10 years? 17:56 Well, what I would say is that, just like you said, I've been lucky that I have been to London. 18:03 I had been China four or five times. 18:07 Um, um, really been, been Ireland. 18:12 You know, go through a long list. 18:15 Even now have privileges at Reliance Hospital, Reliant Foundation Hospital in Mumbai, India to practice functional medicine as a consultant. 18:26 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. 18:41 And so that's exciting. 18:43 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 18:54 And it's just so rewarding. 18:55 That's amazing. 18:56 Well, I'm sure that will continue because one of the things I've noticed here is just the level of international delegation, 19:03 the places that I have seen, all different places I gone. 19:06 I'd love to just get into a little bit. 19:10 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. 19:19 that is available typically used to only be available through coming to see a doctor like yourself. 19:24 You know, if you want to get these kind of other information, but now it's a lot more available to the consumer. 19:29 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, 19:38 you think, is extremely helpful in you personalizing care for, say, a menopause female? 19:47 So what I would say is that the latest thing in lab evaluation would be an FSH level. 20:00 Okay. 20:00 Now, conventional wisdom has it that. 20:05 FSH, which is follicle stimulating hormone, Which comes from the pituitary and stimulates the egg, the follicles to make estrogen. 20:19 And when the eggs are not making estrogen, that's menopause. 20:27 So the feedback loop with the brain was no estrogen, menopause, high FSH, because the body is trying to make the ovary produce estrogen. 20:40 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. 20:49 Metapause, there aren't those eggs left, so there's no estrogen to make. 20:54 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. 21:04 Yeah. 21:06 However, The top shelf way to manage somebody menopause is you give them the estrogen. 21:15 And one of the ways to check if your estrogen level is right for a particular woman is to see what her FSH level. 21:24 Because if her FSH level starts to go down, that means that there's enough estrogen in her system. 21:34 Yeah. 21:34 And you've hit the right dose. 21:36 You've had the sweet spot. 21:37 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 21:44 So that the cutting edge thing now with laboratory. 21:47 Yeah, I love that. 21:48 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 22:03 standard of care is at the top shelf and that ultimately the outcomes could be shown through those to be superior to outcomes of, 22:13 let's say, the bog standard hormone clinic where everyone gets hormones because that's what they do, right? 22:18 And that, you know, that that could facilitate a harmonization of the standard of care towards you, what you call it. 22:26 That's how standard care has changed is with data. 22:29 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 22:43 other side of this. 22:43 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 22:53 was their first moment. 22:55 They hadn't heard of functional medicine. 22:58 The summit gives them a free thing to sign up for. 23:01 They listen to people like yourself. 23:03 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, 23:08 like Robin Berzen, who went on to create Parsley Health. 23:12 It's now in network across all 50 states. 23:16 Jeff Glad who ends up being now Chief Medical Officer of Fullscript. 23:20 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. 23:27 And it's really a fun experience to be here now and to see it starting to... 23:33 Yeah, I think it is great. 23:34 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 23:40 Absolutely. 23:41 Dr. 23:41 Evans, thanks so much for being part of the evolution. 23:45 We've been here at IFMAIC with Dr. 23:47 Joel Evans. 23:48 He's the winner of this year's Linus Pauling Award. 23:51 We'll have all the details here in the show notes. 23:52 Thanks so much for tuning in and we'll see you next time. 23:55 So we are here asking practitioners about their practitioner journeys and the reason why is because Journeys is a new product from Fullscript. 24:03 Journeys allows you to set up your own lab offerings as the top of the funnel. 24:09 Give the patients what they want. 24:10 They want to know about themselves and it's the easiest way to bring them into your practice. 24:15 We have all types of practices from across the country that are building their own unique lab panels for their unique practices, 24:22 selling them to their community and acting as a great funnel into their practice is a massive innovation. 24:27 I think this will accelerate the evolution of medicine. 24:30 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. 24:39 Go get it. 24:40 So that was the podcast. 24:42 What an epic session. 24:43 Thank you so much for tuning in to the Evolution of Medicine podcast, we'll be back again next week. 24:49 And thanks so
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