The Root Cause Medicine Podcast – Détails, épisodes et analyse

New research is raising important clinical questions about the long-term effects of GLP-1 receptor agonist therapy during significant weight loss. A recent five-year observational study reported associations between GLP-1 use and higher rates of osteoporosis, osteomalacia, and gout in some adults with obesity and type 2 diabetes, particularly in the setting of rapid weight reduction (Wajahath et al., 2026). While GLP-1 therapies may support glycemic control, cardiometabolic health, and surgical outcomes, these findings highlight the importance of proactive monitoring and individualized patient support.

In this episode, we explore practical clinical considerations, including:

• How clinicians may approach bone health monitoring more proactively during significant weight loss
• Which patients may warrant closer nutritional or musculoskeletal assessment
• Symptoms that may merit further evaluation during GLP-1 therapy, including fatigue, weakness, diffuse bone pain, or mobility-related concerns

We also discuss another emerging area of research: the role of exercise in mental health care. Drawing from a large umbrella review involving nearly 80,000 participants, we examine how aerobic exercise, walking, resistance training, and group-based movement may support depression and anxiety outcomes when implemented consistently and tailored to patient capacity (Munro et al., 2026).

This conversation focuses on practical, evidence-informed strategies clinicians can integrate into care plans immediately - from resistance training and hydration strategies to helping patients build sustainable movement habits during periods of stress, fatigue, or overwhelm.

Clinical Takeaways From This Episode

• Rapid weight loss may increase the need for nutritional and musculoskeletal support: Emerging observational evidence suggests GLP-1 therapy during significant weight loss may be associated with higher rates of bone- and uric acid-related complications in some patients, highlighting the importance of muscle preservation, hydration, and nutritional status monitoring (Wajahath et al., 2026).
• Some musculoskeletal symptoms may warrant additional evaluation: Fatigue, weakness, diffuse bone discomfort, and mobility changes may justify further clinical assessment in patients experiencing rapid weight loss or reduced nutritional intake (Wajahath et al., 2026).
• Exercise may support both mental and metabolic health: Research suggests moderate-intensity aerobic exercise, resistance training, walking, and group movement may support mood, resilience, and long-term metabolic health outcomes when patients can engage consistently over time (Munro et al., 2026).

FAQ

Do GLP-1 medications affect bone health?

• Some emerging observational evidence suggests GLP-1 receptor agonist therapy may be associated with increased rates of osteoporosis and osteomalacia during rapid weight loss in certain populations. Additional research is still needed to better understand causality, mechanisms, and which patients may be at greatest risk (Wajahath et al., 2026).

What labs may help clinicians monitor patients on GLP-1 therapy?

• This episode discusses clinical considerations that may include alkaline phosphatase, vitamin D, calcium, phosphate, parathyroid hormone (PTH), and other markers of bone or metabolic health when clinically appropriate and individualized to the patient context (Wajahath et al., 2026).

Can exercise support anxiety and depression symptoms?

• Research suggests aerobic exercise, walking, resistance training, and mind-body movement practices may support improvements in mood and anxiety symptoms when practiced consistently over time as part of a comprehensive care plan (Munro et al., 2026).

Timestamps

00:00 — Clinical questions emerging around GLP-1 therapy and rapid weight loss

03:00 — Osteomalacia symptoms that may overlap with fatigue and chronic pain presentations

10:33 — Why rapid weight loss may influence gout risk in some patients

15:29 — The large exercise and mental health review clinicians are discussing

20:50 — How to help patients build sustainable movement habits

Want to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care.

Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.

Citations

1. Wajahath M, et al. GLP-1 Receptor Agonist Use Is Associated with Increased Risk of Osteoporosis, Gout, and Osteomalacia in Adults with Type 2 Diabetes and Obesity. 2026.
2. Munro NR, Teague S, Somoray K, et al. Effect of exercise on depression and anxiety symptoms: systematic umbrella review with meta-meta-analysis. British Journal of Sports Medicine. 2026;60:590–599.

In this episode, Dr. Kate Kresge speaks with Mosaic Diagnostics CEO Scott Mattivi and Chief Medical Officer Dr. Kurt Woeller to explore how specialty laboratory testing is used in functional and integrative medicine. Mosaic Diagnostics offers tests such as organic acids, environmental exposure biomarkers, and microbiome assessments, which may help clinicians evaluate complex, multi-system presentations. These tools are typically used as part of a systems-based clinical framework, supporting pattern recognition rather than serving as standalone diagnostic tests. The discussion also explores how clinicians interpret multi-system lab data, the role of practitioner education, and how emerging technologies—such as AI-assisted tools—may support clinical efficiency and decision-making.

Mosaic Diagnostics provides specialty lab testing commonly used in integrative and functional medicine, including:

• Organic acids testing (OAT)
• Environmental toxin and mycotoxin testing
• Microbiome and gastrointestinal assessments
• Metabolic and immune-related biomarkers

These tests are designed to provide insight into biochemical pathways, microbial activity, and environmental exposures. Results are generally interpreted alongside clinical history, symptoms, and conventional labs to support individualized care.

Organic acids testing evaluates urinary metabolites involved in intermediary metabolism. It may provide insight into:

• Mitochondrial function
• Nutrient metabolism (e.g., B vitamins, amino acids)
• Oxidative stress patterns
• Microbial activity

When interpreted within clinical context, OAT may support identification of metabolic patterns and inform clinical hypotheses (Gallagher, 2018).

Environmental exposure testing evaluates biomarkers associated with compounds such as:

• Mycotoxins
• Heavy metals (in some panels)
• Industrial chemicals

These tests may help characterize exposure patterns, though interpretation can be complex due to variability in exposure timing, metabolism, and elimination. Clinical relevance should be assessed cautiously and within the broader evidence base (Warth, 2013; Owolabi, 2024).

• Organic acids testing may offer a systems-level view of metabolism and support pattern recognition when interpreted in context (Gallagher, 2018).
• Environmental testing may help identify exposure patterns, though clinical actionability varies (Warth, 2013; Owolabi, 2024).
• Specialty lab testing is most effective when used to evaluate patterns across systems, rather than isolated biomarkers.
• Practitioner education plays a key role in appropriate interpretation and application of these tests.
• AI tools may enhance data interpretation and workflow efficiency but should be used alongside clinical expertise.

Who Should Listen to This Episode?

This episode is designed for healthcare providers who:

• Use or are considering functional or integrative lab testing
• Work with complex, chronic, or multi-system conditions
• Want to better understand organic acids testing or mycotoxin testing
• Are interested in clinical data interpretation strategies
• Are exploring AI tools in clinical practice

FAQ: Mosaic Diagnostics and Specialty Lab Testing

Mosaic Diagnostics is known for specialty laboratory testing used in functional and integrative medicine, including organic acids testing, environmental exposure assessments, and microbiome analysis.

Timestamps

00:00 – Introduction to Mosaic Diagnostics

03:22 – Origins of organic acids testing

08:26 – Expansion into environmental and microbiome testing

23:41 – Environmental exposures and clinical applications

31:57 – Overview of testing portfolio

42:09 – Organic acids testing in practice

47:41 – Innovation and AI in clinical workflows

This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one free, centralized system—helping reduce administrative burden while supporting clinical decision-making. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. The goal is not to replace clinical judgment, but to make it easier for clinicians to focus on what matters most: thoughtful, individualized patient care.

The views expressed on this podcast are those of the hosts and the guests, and they don't necessarily reflect the views of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only, and it's not intended to be medical advice. For your safety, always check with your health care provider before making any changes to your health care routine.

1. Gallagher RC, Pollard L, Scott AI, Huguenin S, Goodman S, Sun Q; ACMG Biochemical Genetics Subcommittee of the Laboratory Quality Assurance Committee. Laboratory analysis of organic acids, 2018 update: a technical standard of the American College of Medical Genetics and Genomics (ACMG). Genet Med. 2018 Jul;20(7):683-691. doi: 10.1038/gim.2018.45. Epub 2018 Mar 15. PMID: 29543224.
2. Warth B, Sulyok M, Krska R. LC-MS/MS-based multibiomarker approaches for the assessment of human exposure to mycotoxins. Anal Bioanal Chem. 2013 Jul;405(17):5687-95. doi: 10.1007/s00216-013-7011-1. Epub 2013 Jun 18. PMID: 23774829; PMCID: PMC3695324.
3. Owolabi, Iyiola & Siwarak, Kawisara & Greer, Brett & Rajkovic, Andreja & Dall’asta, Chiara & Karoonuthaisiri, Nitsara & Uawisetwathana, Umaporn & Elliott, Christopher & Petchkongkaew, Awanwee. (2023). Applications of Mycotoxin Biomarkers in Human Biomonitoring for Exposome-Health Studies: Past, Present, and Future. Exposure and Health. 16. 1-23. 10.1007/s12403-023-00595-4.
4. Muñoz JP, Bleak TC, Calaf GM. Glyphosate and the key characteristics of an endocrine disruptor: A review. Chemosphere. 2021 May;270:128619. doi: 10.1016/j.chemosphere.2020.128619. Epub 2020 Oct 19. PMID: 33131751.

In today's episode with Dr. Wendy Warner, you’ll hear us take a deep dive into: 1. Transforming women's health with a natural approach 2. The whole-body process of menopause 3. The power of adaptogens and maca for hormonal balance 4. Restoring the mucus lining and the dangers of long-term medication use 5. How to improve bone health naturally Dr. Warner spent 14 years working as a traditional ObGyn and also learned about integrative holistic medicine. In 2004, she started Medicine in Balance, which brought together different medical techniques and perspectives in one place so patients could get the best care. In 2022, she made the clinic fully online, making it more convenient for patients to access medical care from their own homes. Order tests through Rupa Health, the BEST place to order functional medicine lab tests from 30+ labs - https://www.rupahealth.com/reference-guide

In this special episode of The Root Cause Medicine Podcast, we dive into Rupa Health's partnership with Fullscript to change the game in whole-person care. To help us with that, we have Dr. Jeff Gladd, Dr. Tieraona Low Dog, Dr. Jeffrey Bland, and Tom Blue. You’ll hear us discuss: 1. How Rupa and Fullscript are transforming patient care 2. Rising chronic disease rates in Americans and why we need more technology in healthcare 3. How functional medicine is changing the standard of care 4. The role of AI and technology in enhancing patient care Dr. Jeff Gladd has over twenty years of experience in the medical field. He is the owner of GladdMD Integrative Medicine and Chief Medical Officer at Fullscript. Dr. Gladd has become a sought-after speaker on physician entrepreneurship, social media, and technology in healthcare and regularly speaks at Holistic Primary Care’s annual Heal Thy Practice conference. In 2008, Dr. Gladd founded and launched PureHealthMD.com, a website housing professionally authored content to educate people on the lifestyle aspects of health, which he and his partners sold to the Discovery Channel. In 2011, he created and launched the web’s first nutrient depletion calculator, Mytavin.com. Dr. Tieraona Low Dog is an Integrative Physician, Author, Educator, and the Founding Director of the Medicine Lodge Academy. Over her 40-year career, she has focused on teaching, training, and practicing integrative and holistic medicine. Dr. Low Dog has been a presidential appointment under Bill Clinton, a four-time National Geographic author, international speaker, academic scholar, and consultant to numerous Fortune 500 companies. As a founding member of the American Board of Integrative Medicine, she was hand-picked by Dr. Andrew Weil to lead the University of Arizona Center for Integrative Medicine Fellowship. Dr. Jeffrey Bland is an internationally recognized leader in the nutritional and functional medicine field. He co-founded The Institute for Functional Medicine in 1991 and is known to many as the “Father of Functional Medicine.” Dr. Bland has authored several best-selling books about nutritional medicine and over 120 peer-reviewed research publications. He is also the CEO of KinDex Pharmaceuticals, Co-Founder and Chief Science Officer of Bering Select Seafoods Company, and Founder and President of Big Bold Health and the Personalized Lifestyle Medicine Institute. Tom Blue is a leading expert in personalized disease reversal and functional medicine, with over 19 years of experience building and advising private-pay medical practices. His deep insight into medical consumerism and innovative physician practice models positions him at the forefront of advancing healthcare in the US. As SVP of Healthcare at AndHealth, Tom oversees the development of scalable disease reversal protocols delivered through continuous remote care by providers and coaches. Additionally, Tom advises the Institute for Functional Medicine, the global authority on functional medicine education for healthcare professionals. Order tests through Rupa Health, the BEST place to order functional medicine lab tests from 30+ labs - https://www.rupahealth.com/reference-guide

In today's episode with Kiran Krishnan, you’ll hear us take a deep dive into: 1. The power of the microbiome for health outcomes 2. The role of the microbiome in hormone regulation 3. What is a toxic microbiome and how does it affect health? 4. Gut health and chronic inflammation 5. Leaky gut and leaky skin 6. How to effectively nourish the gut microbiome 7. Probiotics for improved gut health Kiran is a well-known research microbiologist with 16 years of experience in the dietary supplement and nutrition industry. He is also the Co-Founder and Chief Scientific Officer of Microbiome Labs. Moreover, Kiran is a sought-after speaker at numerous medical and nutrition conferences and he leads the widely popular monthly Microbiome Series webinars. Order tests through Rupa Health, the BEST place to order functional medicine lab tests from 30+ labs - https://www.rupahealth.com/reference-guide

In today's episode of The Root Cause Medicine Podcast, Dr. Carrie Jones sits down with Dr. Peter Bongiorno, a naturopathic doctor specializing in mental health, to explore holistic approaches to managing mental health conditions. You'll hear them discuss: 1. The growing mental health crisis and the limitations of conventional treatments 2. The difference between conventional medicine's focus on symptom management and naturopathic medicine’s root cause approach 3. The role of diet, nutrient deficiencies, sleep, hormones, and lifestyle in mental health 4. How neurotransmitters work and why medications often don’t address underlying issues 5. The microbiome and the direct line that gut health has to your nervous system 6. A healthy and holistic approach to food supplements Dr. Peter Bongiorno is a licensed naturopathic doctor and acupuncturist, and he takes a holistic approach to health that looks towards the most natural way of healing available. He is the author of multiple books on holistic mental health and a renowned educator on integrative medicine’s role in addressing the root causes of anxiety and depression. Order tests through Rupa Health, the BEST place to order functional medicine lab tests from 30+ labs - https://www.rupahealth.com/reference-guide

In today's episode with Dr. James Greenblatt, you’ll hear us take a deep dive into: 1. The root causes behind ADHD 2. Natural treatments for ADHD 3. The role of magnesium in managing ADHD 4. The link between copper and zinc in ADHD 5. Food allergies and sensitivities in ADHD 6. Gut health and ADHD 7. Exercise and sleep in ADHD 8. Parenting strategies for children with ADHD Dr. James Greenblatt is the Founder and Medical Director of Psychiatry Redefined. In addition to his leadership role there, he holds the title of Chief Medical Officer at Walden Behavioral Care and is an Assistant Clinical Professor at Tufts University School of Medicine. A prolific writer, Dr. Greenblatt has authored numerous books on integrative medicine. Throughout his distinguished career, he has been dedicated to investigating the complex relationship between mental health and nutrition, consistently pursuing alternative and complementary methods to conventional psychiatric therapies. Order tests through Rupa Health, the BEST place to order functional medicine lab tests from 30+ labs - https://www.rupahealth.com/reference-guide

In today's episode of The Root Cause Medicine Podcast, we dive into breast wellness and how to prevent breast cancer with Dr. Elizabeth Boham. You’ll hear us discuss: 1. How your food choices impact cancer risk 2. Why vitamin D and sulforaphane are key to cancer prevention 3. How chronic stress is sabotaging your body's cancer defenses 4. The key markers every woman should request for breast health 5. Why an anti-inflammatory diet is the best defense against breast cancer Dr. Elizabeth Boham is the Medical Director at The UltraWellness Center and a leading expert in functional medicine. She earned her MD from Albany Medical College and holds degrees in Nutrition Education and Nutrition Biochemistry. Dr. Boham specializes in using nutrition and lifestyle to treat and prevent chronic diseases, with a particular focus on breast cancer, and is the author of “Breast Wellness: Tools to Prevent and Heal from Breast Cancer.” Order tests through Rupa Health, the BEST place to order functional medicine lab tests from 30+ labs - https://www.rupahealth.com/reference-guide

In today's episode with Dr. Felice Gersh, you’ll hear us take a deep dive into: 1. The impact of PCOS on women's health 2. Diagnosing and treating PCOS 3. The link between PCOS and leaky gut 4. PCOS and pregnancy 5. Lab tests and personalized treatment plans for PCOS 6. PCOS and lifestyle Dr. Gersh represents one of the pioneering integrative gynecologists in the US. Renowned for her educational contributions to women's hormonal health, she has earned praise as a best-selling author with her books, including "PCOS SOS," "PCOS SOS Fertility Fast Track," and "Menopause: 50 Things You Need to Know." Dr. Gersh serves as the Medical Director of the Integrative Medical Group of Irvine. Thanks to her exceptional work, she was awarded the Orange County Medical Association's "Physician of Excellence" and the "SuperDoctor" title by LA Magazine for multiple years. Moreover, Dr. Gersh will host the PCOS SOS Summit in November 2023 here. Order tests through Rupa Health, the BEST place to order functional medicine lab tests from 30+ labs - https://www.rupahealth.com/reference-guide