Ashwagandha & Liver Injury: What Clinicians Need to Know with Dr Eric Viegas

What if the real problem with hormones isn’t what’s broken… but what’s being missed? In this conversation, Dr. Cheryl Burdette invites us to rethink everything we’ve been taught about hormonal health. Instead of chasing isolated lab values or treating systems in silos, she introduces a more useful question: what if hormones only make sense when you look at how they talk to each other? We explore the concept of the hormonal matrix—a lens that connects thyroid, adrenal, and reproductive hormones into one dynamic, interdependent network. Because in the body, nothing operates alone. Signals overlap. Pathways intersect. And small imbalances can ripple across systems in ways we don’t always measure. This systems-based perspective isn’t just philosophical—it’s increasingly supported by emerging research on the cross-talk between the HPTA axis, the gut, and broader metabolic and immune signaling. When you zoom out, patterns start to appear. And when you see the pattern, your clinical decisions can change. This episode is about shifting from fragments to frameworks—and why that shift may open up entirely new possibilities for understanding and supporting hormonal health.

Are your patients putting Salmonella in their morning smoothie? That’s essentially what happened recently when people added what they believed was a safe, antioxidant-packed greens powder to their daily routine. The ingredient? Moringa. Moringa leaf powder is often marketed as a nutrient-dense botanical containing vitamins, minerals, antioxidants, and plant compounds that may support general wellness. For many people, it feels like an easy health habit: add a scoop to a smoothie and start the day feeling proactive about nutrition. But recently, moringa powder was linked to Salmonella infections that resulted in hospitalizations. In this episode, we chat through what clinicians needs to know to keep their clients safe.

A recent analysis of 22 St. John’s Wort supplements purchased online found that only one actually matched its label for the key compound hypericin. Several products contained little to none of the active ingredient, and some appeared to use synthetic dyes to mimic the color of hypericin, potentially misleading simple testing methods (Now, 2025). Why does this matter? Because when a supplement doesn’t contain the ingredient it claims, patients may not receive the support they expect. That can lead to wasted money, confusing clinical outcomes, and lost trust in integrative care. In this episode of the Root Cause Medicine Podcast, we’re joined by Dr. Eric Viegas, Medical Product Manager at Fullscript, to unpack what this report means for clinicians and patients. We discuss how ingredient discrepancies can happen—from plant sourcing and manufacturing to risks in online marketplaces—and how practitioners can help protect patients from misleading products. We also explore what clinicians should look for when choosing supplements, including validated testing methods, Certificates of Analysis, and quality standards that help ensure products contain what the label promises.

In this episode of the Root Cause Medicine Podcast, we explore a growing clinical reality: patients now have immediate access to advanced bloodwork but not necessarily interpretation with a clinician. In this conversation, we introduce Fullscript Journeys, the provider-led answer to direct-to-consumer lab platforms. With lab testing, AI-supported interpretations and wellness plans, and seamless follow-ups, Journeys empowers providers to deliver a modern patient experience — without compromising clinical guidance.

On this episode of Root Cause Medicine, we’re honored to share the story of Dr. Emlah Tubuo, PharmD, MS, an integrative pharmacist who came to the U.S. in 2003 with $300 in her wallet and built what many of us wish existed in every community: a pharmacy designed around whole person care. Dr. Emlah explains how growing up around infectious disease in Cameroon shaped her prevention-first mindset, and how arriving in the U.S. revealed a different challenge: chronic disease that silently progresses for years before symptoms demand urgent intervention.

Creatine is one of the most extensively researched nutrients in sports, metabolic, and brain health, yet parents and practitioners alike have questions about its use in children and adolescents. In this episode, Dr. Kate Kresge speaks with Jeff Gladd, MD, Chief Medical Officer at Fullscript, to clarify how creatine functions in normal physiology, what the research shows about pediatric safety, and how clinicians can guide families with confidence. Together, they explore growth-related energy needs and practical clinical considerations—offering an evidence-informed framework for responsible conversations about creatine use in youth.

In this Root Cause Medicine podcast episode, we explore emerging concerns around ashwagandha-associated drug-induced liver injury (DILI). While ashwagandha remains one of the most widely used adaptogens in integrative medicine, recent international case reports have highlighted rare but clinically meaningful hepatic adverse events. This episode equips clinicians with a mechanistic understanding of potential risk factors, extraction methods that may increase vulnerability, and practical strategies for patient screening, education, and monitoring—without dismissing the therapeutic value of this foundational herb.

Nearly one in three adults will experience a voice disorder at some point in their lifetime, often without realizing it may be connected to their overall health (Stachler et al., 2018). In this episode, we sit down with integrative otolaryngologist Dr. Linda Dahl to unpack how subtle changes in vocal tone, stamina, and clarity can serve as early clues to what’s happening systemically - from inflammation and hormonal shifts to nervous system stress, reflux, and microbiome changes - and what to do next depending on what you hear. From simple in-office listening strategies and targeted questions to appropriate referrals, lab considerations, and integrative support options, this episode helps clinicians effectively resolve common voice issues using a whole person approach.

In part two of our SIBO series, we’re joined again by Dr. Allison Siebecker to focus on what often determines whether patients stabilize or relapse: nutritional management and supportive care during and after SIBO treatment. We explore how to use prokinetics to support migrating motor complex function, when digestive aids like bile acids and enzymes may be appropriate, and how to apply SIBO dietary frameworks as personalized, flexible tools—not rigid rules. We also cover practical approaches to suspected yeast/dysbiosis overlap, how to support gut barrier integrity without worsening fermentation, and the key myths that can derail outcomes. This episode helps clinicians move from “eradication mode” to sustainable, integrative SIBO care.

The research around SIBO is evolving, and 2026 has brought more subtypes, testing and treatment options than ever before. Our guest this week, Dr. Allison Siebecker, is an expert in conventional and natural approaches to SIBO, helped to open one of the first integrative SIBO centers in the nation, and frequently teaches physicians about how to effectively treat even the toughest cases of SIBO, ISO, IMO and more. Today, we explore how hydrogen, methane (IMO), and hydrogen sulfide–associated (ISO) pattern-typing can help us choose treatment options that help to decrease SIBO symptoms effectively. We discuss how impaired motility - particularly dysfunction of the migrating motor complex - can impact symptom persistence and relapse in addition to microbial type and load, and why we should address it in treatment plans. Dr. Siebecker also reviews the newest advances in SIBO testing, breath test interpretation, and how long to test depending on what you’re looking to discover. If SIBO has felt like a guessing game in your practice, or if you’re just looking to stay on the leading edge, this episode offers a clearer, physiology-driven framework grounded in education that will help your clients get and stay well.