Listen to the full episode here https://bengreenfieldfitness.com/functionalmedicine My guest on today's show, Dr. Patrick Hanaway is one of the world's top authorities in the realm of functional medicine. He is a board-certified family physician with a medical degree from Washington University and residency training at the University of New Mexico. He is a past President of the American Board of Integrative Holistic Medicine and co-founded Family to Family: Your Home for Whole Family Health with his wife in Asheville, NC. As an initiated Marakame (Shaman) by the Huichol people in the Sierra Madres of central Mexico, he incorporates these healing approaches in his clinical practice. From 2002-2012, he was the Chief Medical Officer at Genova Diagnostics, followed by the Director of Medical Education for the Institute for Functional Medicine as well as the Medical Director at the Cleveland Clinic Center for Functional Medicine. He just last week published a keystone JAMA article on the improved outcomes of patient care with an integrative functional medicine approach, and in 2017, he won the Linus Pauling Award. Teaching around the world on ‘Good Medicine,’ he brings his full presence to teaching clinicians about healing, with an emphasis on therapeutic relationships, connection, community, and wholeness. During our discussion, you'll discover: -Dr. Hanaway's background in functional medicine...6:40 Disillusioned with medical practice in early 1980's Books by Jeffrey Bland Focus on root cause of disease and why disease occurs Other ancestral means of treating disease (Ayurveda, Chinese, Tibetan, etc.) Understand the synthesis between various methods of healing/treating disease; incorporate outside means as necessary Understand the story, gather information on the patient; emotional shifts are key -Why Dr. Hanaway is a shaman and how it synchronizes with his practice...11:30 Huichol people in the Sierra Madre region never indoctrinated with the practices of the church Living tradition thousands of years old Had series of dreams after connecting with Huichol; went to sacred spot to make offerings Began working with Huichol people intermittently; initiated as a healer 8 years into the practice "The way of listening" and perceiving emotional/spiritual issues is used for understanding the big picture of a patient's condition -What makes functional medicine unique...14:45 Functional medicine is an "operating system" Listen to the person's story: precursors, genetics, heritage, emotional triggers, etc. Focus on diet and lifestyle Initial visit is 2 hrs. to gather info Insurance pays for quantity, not quality; not always conducive to functional medicine -JAMA Network Article on Functional Health -Tools and resources Dr. Hanaway often uses in his practice...22:40 Understand a patient's nutrition: B vitamins, antioxidants GiEffects 3 Day Stool Panel by Genova Diagnostics Onegevity (Use discount code: BEN20 to receive $20 off your own test.) Metagenomics -Which test is best to get the most accurate results...34:15 The jury is still out as to which is the best test It's not possible to get comprehensive results with just one test. Onegevity is the best on the market, according to Dr. Hanaway -What a test result will reveal, and what steps to take from a functional medicine standpoint to address it...39:00 Microbiome and inflammation score is high: fish oils, turmeric Comprehensive analysis; how does the problematic area fit in with the rest of the body Psychobiotics Psychobiotics and the Manipulation of Bacteria–Gut–Brain Signals -Why Dr. Hanaway doesn't begin a diagnosis with the brain...44:15 Relationship between permeability in the gut and brain permeability TBI changes intestinal permeability - increased risk of infection Address gut permeability first and foremost Gut blood barrier and blood brain barrier can be addressed simultaneously Look at prebiotics and foods rather than probiotics (which are tourists) Diet changes the gut microbiome within only 1-2 days Fecal microbial transplant is a powerful tool, when used with caution -Foods that Dr. Hanaway finds to be the most efficacious in his practice...51:30 Focus on fermented foods (work within people's tastes) Acacia root Bioflavinoids Allow beneficial bacteria to grow in the gut Pomegranate peel extract (produces urolithin A in the gut) Urolithin A Is a Dietary Microbiota-Derived Human Aryl Hydrocarbon Receptor Antagonist (PubMed) -Tests other than Onegevity Dr. Hanaway finds particularly informative...57:15 Nutreval Test 23andMe Intellix DNA Look for tools that are validated, not those that are created just to sell a product Heavy metal tests MyHeritage DNA Panel FoundMyFitness genetic tools Health Nucleus genome sequencing DUTCH Test -Hot topics currently being discussed in the functional medicine community...1:02:30 Autoimmune disease and cognitive impairment are hot button issues (Dale Bredesen) Focus on the community of the microbiome, not the individua