ENCORE: Q&A with Leyla, Part 1: Gut Bacteria and Cholesterol

Nutritionist Leyla Muedin discusses nutrition and menopause, defining menopause as 12 months without a period and noting it can occur naturally or due to surgery/medical procedures. She links declining estrogen to increased cardiometabolic risk, endothelial dysfunction, vascular aging, musculoskeletal pain, and higher risks with early menopause (including cardiovascular disease, chronic kidney disease, and dementia), and notes many estrogen-modulated conditions are associated with gut dysbiosis. She emphasizes lifestyle—especially nutrition—as key, highlighting anti-inflammatory, minimally processed eating and warning against ultra-processed foods, refined carbs, and excess omega-6. She cites research that high adherence to a Mediterranean diet improves markers like heart rate, lipids, triglycerides, CRP, and overall cardiometabolic risk, and mentions omega-3s lowering triglycerides while modestly raising HDL and LDL. She reviews diet approaches for hot flashes, suggests reducing caffeine, alcohol, sugar, and carbs, notes some women require (bioidentical) HRT, and describes clients improving symptoms with dietary change.

Half of US adults are interested in GLP-1 agonists for weight lossIs spelt matzoh better than traditional wheat matzoh for Passover?Is a dry red wine preferable to sweet wine or grape juice?Is Einkorn flour a better alternative to modern wheat?Which liver support supplements are best for alcoholic issues?

I was diagnosed with Exocrine Pancreatic Insufficiency. Which digestive enzymes are best to take?I still have pain and tingling after a shingles outbreak. What can I take for it?So many protein shakes contain carrageenan, but isn't it a carcinogen?My 5-year-old grandson has pancolitis.  Do you have any recommendations?What do you think of an organic acids test for chronic fatigue?How can I find the cause of my atopic dermatitis?  

Oral Health, Inflammation, and Periodontal Disease: Dr. William Levine, a board-certified periodontist and chief scientist at Peri Active Oral Rinse, offers a deep-dive on periodontal disease as an infectious inflammatory condition with autoimmune-like tissue destruction. It affects over 50% of U.S. adults over 35 and rises with age. He details bidirectional links between gum disease and systemic conditions, including cardiovascular disease, stroke, diabetes, and some dementias, and notes signs such as bleeding, pain, swelling, loose or shifting teeth, and gum recession. Levine explains plaque, dysbiosis, and biofilms, emphasizing mechanical plaque removal to preserve a healthy oral microbiome. Standard care includes scaling and root planing, possible surgery, and lasers; antiseptic rinses like chlorhexidine can be harsh and limited against biofilms. Levine describes a plant-bioactive rinse (gotu kola, echinacea, elderberry) designed to reduce harmful bacteria, penetrate gums, lower inflammation, and promote repair; xylitol may help via saliva stimulation. He also addresses smoking, dry mouth, fluoride toothpaste, interdental cleaning, and osteoporotic drugs’ dental risks.

Dr. Hoffman continues his conversation with Dr. William Levine, a board-certified periodontist and chief scientist at Peri Active Oral Rinse.

Herbal Medicine, Quality Control, and Adulteration Prevention: Mark Blumenthal, founder and executive director of the American Botanical Council (ABC), recounts his entry into herbalism via vegetarianism in 1968, off-grid living, and starting a wholesale herb business in 1974 before shifting to nonprofit education, research, advocacy, and quality control. The discussion covers the evolution from teas and tinctures to standardized extracts, the complexity and synergy of multiple constituents, and how standardization supports quality control and therapeutic consistency. Blumenthal explains ABC’s Botanical Adulterants Prevention Program and its free, peer-reviewed resources addressing global fraud, plus GMP requirements and laboratory methods for identity, contamination, and potency testing. He discusses herbs including ashwagandha, turmeric/curcumin and adulteration risks, maca, nigella, and milk thistle, and outlines ABC resources, HerbClip, and membership options at herbalgram.org.

Dr. Hoffman continues his conversation with Mark Blumenthal, founder and executive director of the American Botanical Council (ABC).

New weight loss drugs may portend end of “Fat Acceptance” movement; Celebs and Southerners embrace GLP-1s; Trump clears path for more access to diet drugs; Mid- and late-life exercise slash dementia risk; “Ethicists” urge more tick-borne meat allergy to save planet—as alpha-gal syndrome claims first fatality; What’s wrong with the melatonin study that claims it leads to heart failure? How to detox 9-11 first-responders? Can weekend warriors obtain same benefits as regular exercisers? 

Can natural herbs aid recovery from anorexia? What an analysis of Hitler’s DNA tells us about how genes shaped his personality; Can surgical anesthesia accelerate memory loss?  Bananas could be interfering with your smoothie’s health benefits; Not just sun, but pesticides and herbicides increase risk for melanoma; Chemical residues on produce impair male fertility; Proliferation of fast-paced social media videos are dumbing us down; Doctors aren’t less resilient, the demands of medicine are just fostering unprecedented levels of physician burnout.

Registered dietitian nutritionist Leyla Muedin discusses a New England Journal of Medicine paper (July 2024, cited via Holistic Primary Care) warning about drug-induced magnesium depletion, especially from diuretics, proton pump inhibitors (e.g., Nexium, Prilosec), and certain antibiotics. She notes magnesium is often not routinely measured despite links between deficiency and cardiovascular, metabolic, and neurological problems, including arrhythmias (AFib, long QT, torsades), endothelial dysfunction, and longer ICU stays. Prevalence estimates range from 7–11% (up to 20%) in hospitalized patients and 2–4% among outpatients, with higher rates among long-term PPI and diuretic users. She reviews symptoms and causes, explains limits of serum magnesium testing, highlights associations with diabetes, alcohol use, low potassium and calcium, and outlines evaluation options and oral repletion approaches, favoring better-absorbed forms like magnesium glycinate over oxide due to diarrhea risk.