Microbiome Basics: How Pre-, Pro-, and Postbiotics Support Health, Part 2

Concurrent Training for Healthy Aging and the Overlooked B12 Risk of Metformin: Nutritionist Leyla Muedin discusses how concurrent training—combining cardio and strength work—supports healthy aging by building endurance, preserving muscle, and maintaining independence and “healthspan.” She explains that aerobic exercise improves cardiorespiratory efficiency while resistance training preserves lean tissue and functional strength, and offers practical scheduling tips: place strength sessions on two non-consecutive days, add moderate cardio around them, separate hard sessions, prioritize recovery with rest days, sleep, and adequate protein, and avoid pairing heavy lifting with hard endurance work if explosive power is important. She then summarizes evidence that clinicians often fail to check vitamin B12 levels in diabetic patients on long-term metformin, despite guidelines; metformin can impair B12 absorption, leading to deficiency, anemia, and potentially reversible neuropathy, with higher risk in the elderly, high-dose users, vegans, and PPI users. She urges proactive B12 monitoring and supplementation, such as a multivitamin with at least 100 mcg B12.

Autonomous Artificial Intelligence (AI) and the future of medicineAre there any alternative ways to lower my blood pressure other than taking prescription medication?

As soon as I take my blood pressure meds, I get tired and lack energy for the rest of the day.  What gives?I'm 77 and have Sjögren's syndrome.  Can I take carnitine?  How much should I take?Are there cardiac side effects to berberine?  Both my husband and I take it for blood sugar.What types of protein are most helpful for osteoporosis and weight gain?The coronary artery inflammation controversy

Innate–Adaptive Balance and BWH 85 Beta-Glucan with Functional Medicine Physician Dr. Rob Rountree: He brings a nuanced view of immunity that rejects the simple “immune boosting” dimmer-switch model and emphasizes immune regulation and readiness. He reviews innate immunity as sentinel cells using pattern recognition receptors (e.g., macrophages) and explains how innate and adaptive systems interface, with innate signaling training adaptive responses; chronic inflammatory disease is framed as rooted in innate dysregulation. He reveals how immune responses can both protect and harm (candida, cytokine storm concerns during COVID) and why test-tube “stimulation” doesn’t equal human effects. The focus is a purified brewer’s yeast (Saccharomyces cerevisiae) beta-1,3/1,6-glucan (BWH 85, 85% purity), its triple-helix structure, receptors (Dectin-1, CR3), dosing (100–500 mg), evidence for improving vaccine response in elders, and potential relevance for autoimmunity, athletes, and cancer surveillance alongside lifestyle and key nutrients like vitamins A, C, D and zinc.

Dr. Hoffman continues his conversation with functional medicine practitioner Robert Rountree, MD, medical director of Boulder Wellcare, in Boulder, Colorado, and long-time educator at the Institute for Functional Medicine.

Dr. Ross Pelton, Director of Science & Education for Essential Formulas Incorporated, maker of Dr. Ohhira’s premium probiotic products, reveals how the gut microbiome affects metabolism, appetite, weight regulation, and overall health. He emphasizes the importance of microbiome diversity, supported by eating a wide variety of plant foods rich in fiber and polyphenols, and discusses how fermented foods and postbiotic metabolites help maintain a healthy gut environment. Pelton explains Dr. Ohhira’s multi-year fermentation process and the idea that postbiotics may be key health regulators. He reviews studies suggesting benefits from Dr. Ohhira’s probiotics for athletic performance markers, reduced fatigue, and improved bowel regularity, and notes research showing antibiotic-related losses in gut diversity can persist for years. He also mentions a higher-dose “Reset Challenge,” a postbiotic paste concentrate, and an ME-3 product aimed at increasing glutathione.

Dr. Hoffman continues his conversation with Dr. Ross Pelton, Director of Science & Education for Essential Formulas Incorporated, maker of Dr. Ohhira’s premium probiotic products.

Paying attention to injuries may speed healing—could pain meds blunt the healing response? Fact check: “Everyone over 70 should take a statin”? Billy Joel’s “brain surgery”; How to live past 100—get condemned to “death row”; Are vegans hotter than meat eaters? Promising lp(a) drug fails crucial test; Pain under the left rib cage—what are the possibilities? 

Wobbly arms and shaky legs—could it be FND? Women who start hormones in the 50s have 23% lower dementia risk; How to prep for cataract surgery; Plant-based meat alternatives may deliver harmful mycotoxins; Keto diets outperform low-fat and Mediterranean diets for liver health, blood sugar; NY Times highlights magnesium for sleep; Even a single bout of antibiotics produces long-term harm to microbiome.

Nutritionist Leyla Muedin answers a listener question about taking many supplements with oolong tea, explaining that tea tannins can interfere with vitamin and mineral absorption; because oolong is partially oxidized, its tannin level falls between green and black tea, so she recommends taking supplements with water and separating them from tea or coffee by at least an hour (ideally 1.5–2 hours). She then reviews research in Nature Communications from USC on how gut signals via the vagus nerve may influence which food experiences become memories: in rats, nutrient-rich foods increased acetylcholine signaling to the hippocampus, supporting memory for food location, while sweetness without calories did not. Over time, high-fat/high-sugar diets weakened this gut–hippocampus communication and memory performance, with implications for obesity, diabetes/prediabetes, and cognitive decline, and possible future vagus-nerve-based approaches.