ENCORE: Chronic Pain: The Psychophysiological Perspective with Dr. David Clarke, Part 1

Dr. David Clarke, president of the Psychophysiologic Disorders Association, details the link between stress and chronic pain and the scope of brain-generated symptoms. Clarke says many patients have symptoms not explained by disease or injury, estimating about 20% of U.S. adults (about 50 million) live with chronic pain, with costs estimated at $650 billion, and notes clinicians are often not trained to evaluate psychosocial stressors. He describes clues that pain is brain-generated (e.g., multiple long-lasting or shifting symptoms, lack of objective nerve damage) and a broad symptom spectrum from migraines and IBS to pelvic pain and rashes. Clarke discusses adverse childhood experiences, triggers, personality traits, and repressed emotions, cites randomized trials showing “pain relief psychology” can reduce pain and change MRI findings, and shares resources including a clinician directory, self-assessment quiz, and the Curable app. 

Dr. Hoffman continues his conversation with Dr. David Clarke, president of the Psychophysiologic Disorders Association.

How Continuous Glucose Monitors Can Optimize Metabolic Health—and Where GLP-1 Drugs Fit: Emergency physician-turned-preventive/metabolic medicine specialist Dr. Paul Kolodzik of Metabolic MD reveals how continuous glucose monitors (CGMs) are a tool not only for diabetics but also for non-diabetics and pre-diabetics to personalize diet, sleep, and exercise by seeing real-time glucose patterns instead of relying on fingersticks or A1c averages. Kolodzik describes CGM use in his clinic (two-week diagnostic wear, then therapeutic guidance), highlights insulin resistance, fasting insulin testing, glucose variability, and the role of low-carb eating, intermittent fasting, and strength training to improve metabolic syndrome, triglycerides, and fatty liver. They discuss CGM sourcing/cost, device mechanics and accuracy, possible future noninvasive wearables, and GLP-1/GIP weight-loss drugs, emphasizing supervised, limited-dose use with protein and lifestyle changes to avoid muscle loss and weight regain. A free PDF of Kolodzik’s book is offered HERE.  

Dr. Hoffman continues his conversation with Dr. Paul Kolodzik of Metabolic MD.

Are eggs good or bad for the brain? Low levels of a key nutrient can foster anxiety; Dealing with muscle cramps that develop hours after exercise; Garlic mouthwash outperforms chemical antibacterials; 76% of the world’s population aren’t getting enough omega-3s; Surgery may hasten progression to Alzheimer’s, but a vitamin may help; After marijuana legalization, some states want a do-over.

The pros and cons of natural vs synthetic vitamins; Telehealth site for ADD meds lands founder in prison; Why eradicating H. pylori may set the stage for Alzheimer’s; Why integrative physicians often don’t accept insurance; Far-infrared phototherapy may offer “electroceutical” treatment for dementia; Hobbies may forestall all-cause mortality—by 29%! 

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.