Total Load Theory (Featuring: Patricia S. Lemer)

This week on the podcast, we welcome Patti Lemer who last year gave me the opportunity to do something I've never done before, write the foreword to her new book. Patti is an OG in the autism space and a true pioneer in understanding the environmental drivers impacting children's health. The book is Total Load Theory. Many people know Patti from her earlier work, Outsmarting Autism, which drew from decades of hands-on experience working with kids on the spectrum. Long before environmental illness entered mainstream conversation, Patti was already mapping the terrain, looking at toxic burden, immune stress, and the cumulative impact of modern life on developing nervous systems. As the cultural conversation shifted and the term "Outsmarting Autism" began to feel limiting, Patti revisited the work with fresh eyes. The result is Total Load Theory – a reframing grounded in functional medicine's understanding of total allostatic load: the combined environmental, biochemical, infectious, emotional, and physiological burdens our children are carrying.

To start the year, I would love it if you could find 10 minutes today to read what I believe is the most important blog I've written. It contextualizes the importance of both my first book, The Evolution of Medicine and my second, The Community Cure, to now what I believe is the most important moment and mission of our time… I also reviewed the incredible recent Lyme Disease Roundtable that probably should have been 30 years ago, but it is exciting to see something come into light that has been hidden to health seekers and clinicians alike. It sets up our community for leadership on this topic for the next decade.

This week on the Evolution of Medicine podcast, we're exploring what may be the most natural, and most underutilized, home for precision brain health: senior living. Earlier this year, I was introduced to Doug Motter, President of Homestead Village in Pennsylvania. For the past 27 years, Doug has been guiding a 600-resident senior living community with a clear north star: health, dignity, and longevity. He joins me on the podcast alongside Hal Cranmer, CEO of A Paradise for Parents, a five-location senior living organization in Arizona. While their communities are different, Doug and Hal share one powerful thing in common: They are innovating at the intersection of senior living and precision brain health. In this conversation, we explore how both leaders were influenced by the work of Dr. Dale Bredesen, and how they've each taken meaningful steps to bring proactive, root-cause brain health approaches into senior living environments—places traditionally designed for management of decline, not reversal. This topic is close to my heart. It's personal, not just as someone building in this space, but as someone thinking about where our parents, and eventually we ourselves, might want to live in our later years. What makes this conversation so exciting is that it clearly shows why senior living may be the ideal setting for precision brain health: You have people who need this level of care You have built-in community and connection And you have the opportunity to deliver group-based, proactive brain health at scale On the podcast, we also announce an exciting new partnership between Homestead Village and TruNeura, where we'll be deploying a group-focused precision brain health program, in collaboration with Turnpaugh Health & Wellness, a six-location, 20-provider functional medicine clinic serving Central Pennsylvania. This episode is a glimpse into what's possible when senior living shifts from custodial care to cognitive optimization, community, and purpose. Listen in if you're: In senior living and curious about the future of brain health A functional or integrative clinic interested in partnering with senior communities Or simply thinking about what "aging well" could really look like If you're interested in exploring a partnership with a senior living center or bringing precision brain health into this setting get in touch with us and book a concierge call to learn more. This is the future. And it's already beginning.

This week on the podcast we feature Dr. Kirstie Lawton, Founder of Food for the Brain Foundation and a virtual brain health clinic in the UK focused on ALS (Lou Gehrig's Disease) which in the UK is called "Motor Neurone Disease" (MND) This is a hot topic in the UK as there has been a flurry of cases and concern about MND in the professional rugby players community. In this podcast you will learn: Is there hope for MND / ALS and what role for nutrition? Lessons from delivering a completely virtual brain clinic How science and survival of MND / ALS is evolving Listen wherever you listen to your podcast or watch the full interview on our YouTube channel.

This week on Season 2, Episode 7 of the Evolution of Medicine, we take a deeper and more personal dive into immune resilience and the COVID vaccines, a topic that, five years later, continues to shape our work, our patients, and our health system. In the News: A UK Decision That Should Concern Everyone A recent report from the UK announced that public health authorities will not be releasing records that could clarify whether the COVID vaccines were associated with the rise in excess deaths. Their stated reason: It might create privacy issues and emotional distress for grieving families. As someone who lost my mother three months after her COVID vaccination in the UK in June 2021, I want to be extremely clear: There is nothing more important to bereaved families than the truth. Understanding what happened is not traumatic, it is healing, clarifying, and necessary for public trust. I share a brief personal reflection in the episode, not to stoke controversy, but to highlight the human cost of opacity and why functional medicine practitioners must continue to be leaders in evidence-based immune resilience. Clinical Deep Dive: The Most Important COVID Talk You've Never Seen In the clinical corner, we pivot to what I believe was a critical education session made early in the pandemic: Dr. Ari Vodjii's April 16, 2020 lecture on immune resilience. It outlined, early and brilliantly, the patterns of immune dysregulation that would go on to shape the entire COVID era. And yet… we didn't listen. In the episode, we break down one pivotal slide that every practitioner needs to know cold—a framework that explains: how host resilience determines patient outcomes how metabolic fragility and chronic inflammation amplify viral severity This alone is worth the listen.

This week on the Evolution of Medicine podcast, we dive into a topic that weaves together many of the threads we've been exploring over the last few weeks. We've talked about AI and its rapid rise. We've talked about cognitive decline and the extraordinary possibility of reversing it. And we've talked about what it will take to get there on an individual practice level. But this week's episode brings those themes together in a way I didn't expect. A friend recently sent me what looked like a legitimate video commercial, featuring credible, household-name figures like Dr. Sanjay Gupta and Anderson Cooper. At first glance, it looked polished, believable, even authoritative. But as you'll see in the episode, not everything is as it appears. In fact, almost nothing is. And that's the point. We are moving into a world where AI blurs the boundaries between truth, reality, and persuasion. Where advertising looks like journalism. Where journalism looks like entertainment. And where the only thing we can count on is that we need better tools, better communities, and better critical thinking to navigate what comes next. This episode unpacks what that means for medicine, for cognitive decline, for health creation – and for the evolution of our entire ecosystem. I think you'll find it interesting… hopefully funny… and definitely insightful.  

This week on the Evolution of Medicine podcast, we dive into one of the most exciting developments in healthcare – the Primary Care Renaissance. Starting January 1st, new legislation makes it easier than ever for both patients and employers to participate in Direct Primary Care (DPC). This shift could finally deliver on many of the promises we've been talking about for years – cutting out the middleman, reducing costs, lowering friction, and restoring the sacred doctor-patient relationship. We explore what this means for the future of medicine, and share insights from a powerful article written by a physician on the pride of ownership – and how reclaiming that sense of purpose and autonomy could be the spark that transforms primary care for good. In our Worst Pharma Ad of the Week segment, we break down another unforgettable SkyRizi commercial – and what it reveals about the state of modern healthcare marketing. Finally, we revisit a timeless conversation from our archives – a segment of James's 2017 interview with Prof. Raphael Mechoulam, the "Godfather of Medical Cannabis," whose pioneering work laid the foundation for today's cannabinoid revolution. It's a jam-packed episode that connects the dots between economics, empowerment, and evolution in medicine. Tune in, share it with your DPC colleagues, and let's continue building the future together.

Last week, I shared the differences in entries between Wikipedia and Grokipedia and why that shift represents a turning point for functional medicine. This week on The Evolution of Medicine Podcast, we take a deeper dive into Grokipedia: what it is, how it's changing the landscape for practitioners, and why it might finally put to rest the old "pseudoscience" critiques. We also lighten things up with my favorite pharmaceutical commercial of all time – a hilarious rip-off that prescribes nature instead of pills. And in the Clinical Corner, we explore a fascinating new tool I found online: the Functional Medicine Capability Maturity Matrix. It's a quick self-assessment that helps you see exactly where your practice is on the journey from early adoption to full system mastery.  

This week on the Evolution of Medicine Podcast, we dive into primary prevention – and why it's the future of health. Dr. Eric Topol recently published an article lamenting medicine's lack of progress in the big three killers: cardiovascular disease, cancer, and neurodegeneration. He's right about the problem, but I'd argue he's been going to the wrong conferences. If he had joined us at the Personalized Lifestyle Medicine Institute (PLMI) conference, he would have seen what real prevention looks like: clinicians reversing chronic disease through root-cause, systems-based care. And if he comes next year, he'll see why I'm calling 2026 "The Year of the Brain." In this episode, we explore: What Topol gets right (and what he's missing) How practitioners like you are proving primary prevention works Why improving everyone's neurobiology, as Dr. Austin Perlmutter says, is our highest work

The Evolution of Medicine podcast returns with a deep dive into the seismic shifts reshaping healthcare – from the explosion of direct-to-consumer lab testing to the most disingenuous pharmaceutical commercial ever made. Host James Maskell unpacks how companies like Function Health, Superpower, Whoop, and Aura are democratizing health data, while practitioners must evolve or risk becoming obsolete in an increasingly consumer-driven landscape. This episode exposes the uncomfortable truth: patients can now access comprehensive lab panels for under $200 annually, complete with longitudinal tracking and AI interpretation. Meanwhile, wearable giants are integrating lab testing to create powerful health ecosystems that compete directly with traditional practice models. The message is clear – practitioners who rely on static PDFs and sporadic appointments are heading toward irrelevance. The episode also features the most-watched video in Functional Forum history: Dr. Izabella Wentz's groundbreaking presentation on how thyroid dysfunction masquerades as mental illness, affecting up to 27% of the population. Her personal journey from misdiagnosis to recovery illustrates the power of root-cause medicine and why functional practitioners remain essential in an automated world. 🎙️ Tune in to learn: The direct-to-consumer lab revolution: How Function Health's 200,000+ customers and Superpower's $17/month pricing are reshaping patient expectations—and what this means for your practice model. Why wearable companies are your new competition: Whoop and Aura's integration of lab testing with biometric data creates comprehensive health platforms that threaten traditional practitioner relationships. The data integration imperative: Why practices relying on static lab reports and infrequent check-ins will become uncompetitive against real-time, longitudinal health monitoring systems. If you're ready to future-proof your practice against the consumerization of healthcare while maintaining the irreplaceable human element of functional medicine, this episode provides both the wake-up call and the roadmap you need. 👉 Listen now or wherever you get your podcasts.