Explore every episode of the podcast Intelligent Medicine with Dr. Ronald Hoffman | The Best of High Tech Medicine and Alternative Modalities

Polypharmacy risks escalate with “prescribing cascades”; A case of life-threatening allergic reaction after sex; Death cap mushroom murderer sentenced; AI-enhanced retinal photography may unlock key to looming disease risk; The ultimate exercise for blood pressure; Cataract surgery.

When do you need a hip replacement? Anti-aging effects of EGCG from tea; Coffee calories soar—and it’s not just about sugar; Why doesn’t Medicare cover acupuncture, naturopathic medicine, nutrition? Best diet for liver fat is . . . (surprise!) high in fat; Curcumin for COPD; Less than 42 minutes of daily sunlight hikes dementia risk.

Creatine Benefits Muscle and Cognition Even Without Exercise, Study Suggests: Nutritionist Leyla Muedin discusses a 12-week Texas A&M study of 73 sedentary, generally healthy adults ages 45–65 (64 completed) examining creatine monohydrate (5 g twice daily) with and without a supervised exercise program during a calorie-deficit American Heart Association-style diet. Four arms compared creatine vs maltodextrin placebo and exercise vs no exercise. Creatine plus exercise produced the largest improvements in lean mass, strength, and body fat reduction, but creatine alone also significantly improved lean tissue mass, body composition, muscular performance, and selected cognitive and memory measures. The study used 10 g/day partly to target cognition, noting limited creatine crossing the blood-brain barrier. Creatine was well tolerated; urinary creatinine and estimated kidney filtration changes stayed within normal ranges, with cautions for those with renal impairment. Limitations included short duration, small sample, and self-selected exercise participation; longer-term and frailer-population studies are needed.

• A tragic case of rhabdomyolysis at the NYC Marathon.
• What advice do you have for getting off antidepressant medication?
• What are some ways I can prevent cognitive decline?

• Studies - remission of type 2 diabetes and reversal of fatty liver
• How long do I have to nurse my hamstring injury?
• I've had diarrhea for three weeks now. Should I see a doctor?
• What are your thoughts on Botox and various other fillers? Any dangers?

In this episode of the Intelligent Medicine podcast, Dr. Ronald Hoffman hosts Dr. James Kimmel, a lecturer in psychiatry at the Yale School of Medicine, to discuss the psychology and science behind revenge. Dr. Kimmel explains how revenge operates similarly to an addiction in the brain, triggering the same pleasure and reward circuits. He recounts his own traumatic experience with bullying and how it led him to understand the destructive nature of revenge. The discussion covers the implications for criminal justice, the role of social media in exacerbating revenge behaviors, and practical strategies for managing revenge cravings, including the potential benefits of forgiveness. Dr. Kimmel's new book, "The Science of Revenge," explores these themes and offers insights into breaking free from the cycle of retribution.

Dr. Ronald Hoffman continues his conversation with Dr. James Kimmel, a lecturer in psychiatry at the Yale School of Medicine and author of "The Science of Revenge."

Dr. Ronald Hoffman interviews King’s College London epidemiologist and ZOE co-founder Prof. Tim Spector about his book, "Ferment," and the science of fermented foods. Spector describes his shift from genetics and twin studies to microbiome research after finding identical twins had very different gut microbes. He outlines key drivers of Western microbiome loss—antibiotics, pollution/pesticides, sterile urban living, smaller families, and especially low-fiber, ultra-processed diets with additives. They discuss COVID-era findings linking diet quality to outcomes, and clinical and population evidence that fermented foods can reduce inflammatory markers and quickly improve mood, energy, hunger, bloating, and modest weight. Spector explains mechanisms involving immune effects in the small intestine, plus postbiotics. He critiques artificial sweeteners and processed “analog” cheeses, contrasts benefits of real and raw-milk cheeses, notes coffee/chocolate as fermented, and highlights future precision nutrition, prebiotics, and microbiome impacts on cancer immunotherapy.

Dr. Hoffman continues his conversation with King’s College London epidemiologist and ZOE co-founder Prof. Tim Spector about his book, "Ferment," and the science of fermented foods.

Bone density can be IMPROVED with the right combination of resistance and high-impact exercises; Why bone preservation matters when it comes to healthspan, longevity; Would BWH 85 Beta Glucan fend off multiple myeloma? Hard-to-treat depression may stem from circadian rhythm disruptions; Personalized mRNA cancer vaccines: Cancer breakthrough or pricey dead-end? Why Moderna stock is so volatile; Creatine plus resistance exercise fends off menopause woes.

The arbitrariness of the “10,000 step rule”; Forest-bathing delivers more brain and body benefits than ordinary walking; How does BWH Beta Glucan compare to AHCC? Why ApoB might yield better heart risk prediction than just LDL and HDL; Can vitamin C and glutathione be given together intravenously? When your fingertips turn white and blue in the cold; Exercise improves sleep—but so, too, does a healthy microbiome.

Meeting Senior Protein Needs on a Budget and the Role of Butyrate: Nutritionist Leyla Muedin addresses a listener struggling to reach the suggested 20–30 grams of protein per meal on a fixed income, explaining updated guidance of roughly 1–1.2 g/kg/day and offering a simple estimate that 1 ounce of animal protein provides about 6–7 grams. She advises not to force-feed, to be guided by hunger over the week, and to prioritize complete animal proteins over filling up on bread, rice, and beans, especially for seniors concerned about blood sugar. To reduce costs, she recommends shopping at discount stores (e.g., Dollar General, Aldi/Lidl) for eggs, canned fish, bacon, and fatty ground beef, noting non-organic options are preferable to high-starch processed foods. She then discusses short-chain fatty acids (acetate, propionate, butyrate), emphasizing butyrate’s importance for colon energy, barrier integrity, and inflammation, noting it can come from gut fermentation, butter/ghee, and ketosis via beta-hydroxybutyrate.

• Exercise training for bone health
• Why has my Lipoprotein (a) trended upward in the last 4-5 years? Isn't it genetically determined?
• I have chronic insomnia, and my doctor told me to avoid any supplements due to my pacemaker/defibrillator

• My husband is getting a total knee replacement. What do you recommend as far as food and supplements for recovery?
• Can I safely use Xlear nasal spray after getting a stent in one of my arteries?
• If a person has GERD occasionally, would it be advisable to avoid meat since it is acid-forming?
• I have a family history of rheumatoid arthritis. How can I prevent this?  

Why Brains Need Friends: The Neuroscience of Loneliness, Empathy, and Social Connection. Dr. Ronald Hoffman interviews neuroscientist Dr. Ben Rein about his book, "Why Brains Need Friends," focusing on how loneliness and social isolation affect well-being and health. Rein describes his research on the neurobiology of autism, empathy, and how MDMA enhances empathy via serotonin signaling in the nucleus accumbens, and argues that humans are evolutionarily wired for social reward through oxytocin, serotonin, and dopamine. They distinguish objective isolation from subjective loneliness and discuss how isolation can trigger chronic stress responses, elevated cortisol, inflammation, and increased risks including stroke, dementia, heart disease, depression, anxiety, and suicide. Rein explains why digital communication (text, phone, Zoom) is less fulfilling due to reduced social cues and can erode empathy online; offers practical strategies to “level up” interactions from shallow to deep, track one’s social cadence based on introversion/extroversion, and addresses pets, social anxiety treatment, alcohol as a social lubricant, and concerns about robot companions.

Dr. Hoffman continues his conversation with neuroscientist Dr. Ben Rein about his book, "Why Brains Need Friends: The Neuroscience of Social Connection."

Exercise as Medicine for Osteoporosis: Dr. Ronald Hoffman interviews Professor Belinda Beck of Griffith University, a director of The Bone Clinic, and co-founder of ONERO, an award-winning, evidence-based exercise program for osteoporosis. Beck explains bone as living tissue that remodels in response to mechanical loading (Wolff’s Law), arguing much age-related loss reflects insufficient stress and that targeted high-load training can rebuild bone. She contrasts exercise with calcium-only approaches, noting supplementation limits and potential cardiovascular risks, and reviews osteoporosis drugs (bisphosphonates, denosumab/Prolia, PTH analogs, romosozumab/Evenity), including rebound loss after stopping denosumab and microdamage repair issues with antiresorptives; medications don’t prevent falls. Beck describes her “LIFTMOR” trial: twice-weekly, 30-minute supervised high-intensity resistance and impact training for eight months improved spine BMD, produced hip structural strengthening, and improved functional fall-risk measures versus low-intensity controls. ONERO is a standardized, supervised program delivered by trained clinicians, can be additive with medication or hormone therapy, and locations can be found via the ONERO Academy website.

More Resources:

• The ONERO® Summit website (an educational meeting for ONERO® licensees, doctors and patients/the public)
• The Bone Clinic FB page (for information and important advances in the field of bone health in lay terms)

Dr. Hoffman continues his conversation with Dr. Belinda Beck, Professor, Griffith University, Director of Research at The Bone Clinic, and founder and director of Onero, an award-winning, evidence-based exercise program for osteoporosis.

A quick, 4-minute daily exercise fix for over-65s boosts performance in just 12 weeks; can eye drops dissolve cataracts to forestall surgery? A new motion sickness drug is named after the Greek god who was sailors’ friend; Scientific American highlights mitochondria as key to healthy aging; Urolithin A notches gains for GI and heart health in new studies.

The biggest mistake GLP-1 weight loss medication users make; Scientists discover link between vitamin C and blood cancers; B12 alone, or taken with a B complex? 10 diets are put to the test, and which scored highest for staving off biological aging? When medications cause constipation; Overcoming fatigue after radiation treatment for cancer.

Carbs vs Protein During Exercise: Hormones, Cortisol, and Insulin. Registered dietitian nutritionist Leyla Muedin discusses an emailed study request about a 2013 Iranian paper comparing carbohydrate vs protein drinks consumed during resistance exercise in 20 fasted young men. The study found cortisol rose much more in the protein group while insulin rose more in the carbohydrate group, with no significant differences in growth hormone, testosterone, or IGF-1, and it concluded carbohydrates created a “better hormonal environment.” Leyla challenges this interpretation, arguing cortisol’s rise is a normal and useful exercise stress response for muscle breakdown and subsequent repair, while carbohydrate-driven insulin spikes can blunt cortisol and promote fat storage; she also notes methodological limits (drinking during exercise, unclear drink ingredients, low protein dose, and unmeasured amino acids/protein turnover). She recommends exercising fasted, avoiding sweet/starchy intake during and immediately after exercise, hydrating, then eating a protein-focused meal 45–60 minutes post-workout.

• Pope Leo's cancer diagnosis and treatment
• Helpful nutrition for cancer
• My LDL cholesterol is higher now, but my calcium score is "0".  Should I be concerned?

• My husband's homocysteine went up to 15, and he already takes Methyl Action.  What else can he take to lower it?
• I had candida in the past.  Is it okay for me to take a supplement that contains baker's yeast?
• Is there anything I can do to alleviate spinal stenosis?
• What kind of creatine supplement should I take, and how much to regain muscle strength?

Henry Abbott, former ESPN journalist, basketball expert, and author of the highly anticipated book "Ballistic: The New Science of Injury-Free Athletic Performance," details how advanced biomechanical analysis can help prevent athletic injuries. Abbott explains the significance of movement patterns, particularly how techniques used by elite athletes at the Peak Performance Project (P3) in Santa Barbara can be applied to everyday people. The conversation covers various topics, including plyometrics, the importance of hip stability and mobility, and the potential for new technologies like AI and computer vision to bring these advanced assessments and training techniques to a wider audience. The episode is rich in practical advice for maintaining physical health and mobility through a lifelong commitment to better movement practices.

Dr. Hoffman continues his conversation with Henry Abbott, former ESPN journalist, basketball expert, and author of "Ballistic: The New Science of Injury-Free Athletic Performance."

Jonathan Emord on ANH Legal Strategy, FDA Overreach, and the Fight for Health Freedom: Dr. Ronald Hoffman interviews constitutional attorney Jonathan Emord, newly appointed general counsel for the Alliance for Natural Health (ANH), about advancing health freedom and access to truthful information on natural products. Emord recounts his landmark 1999 Pearson v. Shalala victory establishing First Amendment protections for qualified supplement health claims and describes FDA resistance and broader administrative-state dynamics, including Chevron deference and its reversal in Loper Bright v. Raimondo. He argues FDA regulation is economically protectionist, suppressing nutrient-disease information while favoring patented drugs, and cites COVID-era censorship and agency capture via the revolving door. Emord outlines ANH initiatives, including petitions and potential litigation to expand lawful structure/function claims and address restrictions involving peptides, homeopathy, CBD, and natural thyroid, urging listeners to support ANH at anh-usa.org.

Dr. Hoffman continues his conversation with constitutional attorney Jonathan Emord, newly appointed general counsel for the Alliance for Natural Health (ANH).

The Pope’s lung cancer diagnosis offers a window on advances in cancer detection, treatment; The supplements I recommend the Pope take to prevent recurrence; Novel injection therapy melts fat cells; Is cholesterol the be-all/end-all for heart risk assessment? Is the new mRNA flu vaccine worth taking? 

Humans are hardwired for generosity—but brain rewards are greater for voluntary philanthropy than paying our tax bills; Apple cider vinegar—are benefits real? Loneliness may steal 6 years of good health—but is it inevitable for introverts? Neanderthals may have used birch “glue” for wound healing; The many possible causes of hip pain; Popular pain remedy may yield scant benefits, hike risk of adverse side effects; Solutions for travelers’ constipation.

Post-Workout Nutrition, Antioxidants, and Insomnia’s Health Risks: Leyla Muedin, a registered dietitian in New York City, answers listener questions about post-exercise nutrition, advising against sweet or high-carb foods immediately after workouts because they raise blood sugar and insulin, shift the body back to fat storage mode, and can blunt human growth hormone needed for muscle and bone repair; she suggests protein and fat after morning exercise and saving carbohydrates for later, ideally 3–4 hours post-workout or at dinner. She also addresses concerns about oxidation after exercise, recommending antioxidant nutrients (vitamin C, mixed tocopherols/tocotrienols, vitamin D) and vegetables like spinach, onions, and mushrooms, noting inflammation and microtears are part of training adaptation. Finally, she discusses research linking insomnia to higher stroke risk and hospitalization, and reviews possible causes and sleep hygiene, plus options like melatonin, L-theanine, magnesium, and herbal ingredients.

• Folic acid vs. methylfolate. Which is better?
• What do you recommend I take to get back to sleep when I wake at 2 AM to go to the bathroom?

• Is it safe for me to take DHEA given my family history of breast and uterine cancers?
• I still have stomach and bowel upset after completing a round of antibiotics 2 months ago.  
• What's the best type of exercise for a type 2 diabetic? Aerobics or resistance training?
• I have IBS, but my doctor confirmed no gluten sensitivity.  hen why do I have symptoms when I eat wheat?

Nutritional Support for Mood: Magnesium, 5-HTP, Adaptogens, and the Folic Acid Debate: Dr. Ronald Hoffman interviews Neil Levin of NOW Foods/Protocol for Life Balance about rising depression and anxiety and the roles of lifestyle, social media, stress, diet, sleep, and exercise in mood. They discuss nutrient cofactors for neurotransmitter production, emphasizing B vitamins, magnesium, zinc, omega-3s, and gut health/fiber, plus concerns about heavy metals like lead and possible links to mood and violence. Levin contrasts tryptophan vs 5-HTP (blood-brain barrier, dosing, serotonin/melatonin) and reviews supplements for mood support including magnesium glycinate and magnesium threonate (Magtein/Cogumin), ashwagandha KSM-66 for stress and sleep, inositol (often gram-level dosing; PCOS and neurotransmitter effects), and GABA/PharmaGABA. They also address controversy over folic acid fortification, arguing folic acid is proven to reduce neural tube defects, methylfolate marketing has caused misinformation, and very high folate doses may warrant caution in active cancer.

Dr. Hoffman continues his conversation with Neil Levin, Senior Nutrition Education Manager and a product formulator for NOW Foods and Protocol for Life Balance.

Dr. Ronald Hoffman interviews pediatrician and public health expert Dr. Megan Moreno, co-author of “Connecting: Raising Kids in the Digital World” and co-medical director of the American Academy of Pediatrics Center of Excellence on Social Media and Youth Mental Health, about how social media and technology affect children’s mental and physical health. They discuss evidence linking tech use to sleep disruption and mixed effects on nutrition and physical activity, plus risks including body image comparisons, addictive “frictionless” design in social media and gaming, exposure to disturbing content, cyberbullying, sexting, and impacts of parent device use on connection and language development. Moreno outlines practical, non-punitive strategies: assessing readiness for a phone based on maturity, setting rules on time and location, co-viewing, using device settings with role modeling, watching for problematic use, and maintaining open, supportive conversations.

Dr. Hoffman continues his conversation with pediatrician and public health expert Dr. Megan Moreno, co-author of “Connecting: Raising Kids in the Digital World” and co-medical director of the American Academy of Pediatrics Center of Excellence on Social Media and Youth Mental Health, about how social media and technology affect children’s mental and physical health. 

Death at clandestine Siberian bio lab raises specter of weaponized plague leak; Oats for constipation—friend or foe? How long can supplements keep? New weight-loss med that preserves lean body mass nears approval; Reading for pleasure—a waning pastime—enhances memory, mood, and empathy. 

The brouhaha over fortifying foods with folic acid—is it a cancer promoter?  Follow-up to botched Tennessee execution; Whole 30 or Paleo diets for autoimmunity; Mistletoe for cancer; Lifestyle changes may be as effective as cognitive behavioral therapy for depression; Sugar avoidance in first 1000 days of life slows organ aging, reduces later-life disease risk.

What to Eat After a Fasted Workout—and Why Energy Drinks May Affect Heart Rhythm: Registered dietitian nutritionist Leyla Muedin discusses what to eat after exercise, especially morning fasted workouts, advising water first and avoiding sweet or carb-rich post-workout options (smoothies, bananas, flavored yogurts, cereal, sports drinks) because they can raise blood sugar and insulin, reduce fat burning by suppressing glucagon, and blunt exercise-related benefits like human growth hormone; instead she recommends a savory protein-and-fat meal (e.g., a 3–4 egg omelet, steak, chicken salad without bread) within 45–60 minutes to support muscle repair while keeping insulin low. She then reviews a 2025 systematic review of 37 studies (1,597 participants; average age 22.5) in which 63.2% of studies reported QT prolongation after energy drink consumption, with frequent increases in blood pressure and heart rate, noting that the findings show repeated measurable cardiovascular changes but do not prove energy drinks cause heart disease.

• A discussion on diet and health
• Folic acid-fortified foods and cancer
• How do I use your store?
• Why are calcium and strontium often put together in some supplements when they're supposed to be taken apart?

• They're back!  Fruit and veggie pills
• The benefits of Pycnogenol in lipedema
• What are some good supplements for my 14- and 18-year-old grandsons?
• What can I do about my restless legs syndrome?

Preventive Medicine and the “Preventioneers”--From Benjamin Franklin to Modern Public Health: Dr. Ronald Hoffman interviews public health physician Dr. Barry Davis, MD-PhD, author of "The Preventioneers: Diseases, Disasters, and the Discoveries That Changed Our World," about why preventive knowledge often fails to translate into action. Davis explains Benjamin Franklin’s “ounce of prevention” quote originated in fire prevention and led to innovations like fire companies, building codes, lightning rods, the Franklin stove, and fire insurance. They discuss hypertension as a “silent killer,” the VA clinical trials proving blood-pressure lowering prevents strokes and heart attacks, and the modern gap in awareness and control, alongside systemic barriers like access, adherence, and clinical inertia. Davis outlines a prevention framework—recognition, evidence, translation, implementation—and persistent resistance from industry, addiction, glamour, and the “invisibility problem,” noting only 2.9% of U.S. health spending goes to prevention. They cover clinical trials, peer review, bias, confounding, Mendelian randomization, statin evidence, Semmelweis and handwashing, seatbelt adoption, AI as an emerging prevention challenge, and rebuilding public trust after COVID through better communication and coordination.

Dr. Hoffman continues his conversation with Barry R. Davis, MD, PHD, Public Health Physician | Biostatistician | Clinical Trials Expert | Professor Emeritus, University of Texas School of Public Health, author of “The Preventioneers: Diseases, Disasters, and the Discoveries That Changed Our World."

Nitric Oxide: Supporting Vascular Health, Performance, and the Oral Microbiome with Dr. Nathan Bryan: Dr. Ronald Hoffman interviews nitric oxide researcher and entrepreneur Dr. Nathan Bryan about nitric oxide (NO) as a short-lived signaling gas that dilates blood vessels, reduces inflammation, mobilizes stem cells, supports mitochondria, and is linked to longevity. Bryan explains two NO production pathways: nitric oxide synthase from L-arginine and an entero-salivary nitrate pathway requiring dietary nitrate, specific oral bacteria, and stomach acid; he says sugar-heavy diets, fluoride toothpaste, antiseptic mouthwash, and proton pump inhibitors inhibit NO. Symptoms of deficiency include erectile dysfunction, rising blood pressure, metabolic disease/diabetes, exercise intolerance, and dementia/Alzheimer’s. They discuss limitations of many beet products, Bryan’s N-101 lozenges and NOBeats powder that generate NO, topical NO for wound healing and skincare, a fluoride-free prebiotic toothpaste, an upcoming mouth rinse, potential benefits for resistant hypertension, insulin resistance, cognition, and eye conditions like glaucoma, and access/discount details via hoffmannno.com.

Dr. Hoffman continues his conversation with nitric oxide researcher and entrepreneur Dr. Nathan Bryan.

Ever more powerful weight loss drugs are on the launchpad as FDA issues warnings about bootleg versions—and potential hazards of drastic weight loss to seniors and those with eating disorders; Botched Tennessee execution—how can that happen? Immune support for respiratory syncytial virus (RSV) in a lung cancer survivor; Should beta-glucans be taken with—or away from—food for optimal absorption? Boosting bone density with an exercise program targeted for osteopenia/fall prevention.

Do you have to worry about too much vitamin A from supplements? Urolithin A scores against a common form of heart failure; Most blood tests don’t require fasting; The health scourge of E-bikes; Slashing sugar before antibiotics reduces harms to microbiome; Study shows inadequate REM sleep associated with 83 diseases—but doubts persist over accuracy of sleep wearables.

Time-Restricted Eating Study: Nutritionist Leyla Muedin details a Johns Hopkins Medicine study (published July 27 in Obesity) on time-restricted eating (TRE), a form of intermittent fasting that limits eating to a consistent 8–10 hour daily window, in adults with obesity and prediabetes or diet-controlled type 2 diabetes. In a 12-week trial of mostly female and Black participants, groups followed either a 10-hour TRE schedule or a usual 16-hour eating pattern, while all received a provided, personalized-calorie DASH diet intended to maintain starting weight. Both groups experienced similar modest weight loss and reported improved eating behaviors (more restraint, less stress eating, less hunger), with no differences in appetite hormones (ghrelin, leptin) or inflammation markers (CRP, cortisol). Leyla argues a higher-carb DASH diet may have limited measurable benefits and suggests repeating the study with a true low-carbohydrate diet; she also explains how fasting periods can lower insulin, support fat burning, and improve sleep by avoiding late meals.

• The benefits of kimchi for detoxing microplastics
• What do you recommend my husband take to recover from Bell's Palsy?  
• Follow-up on coronary artery inflammation question

• The benefits of Pilates
• What does it mean that certain brands of nattokinase are "free of K2"?
• Should I avoid soy products due to my history of breast cancer?
• How can I choose the best fish oil?  Is there a certain dose you recommend?
• Is there any other supplement I can take besides 5-HTP for mood?  What about SAMe?
• Is there any relief for my friend with ulcerative colitis?