Research Briefs for Practitioners – February 2022 - Dr. Michael Ruscio, DNM, DC
Future of Functional Medicine Review Clinical Newsletter

Research Briefs for Practitioners – February 2022

by Dr. Ruscio, DNM, DC, Gavin Guard, PA-C, MPAS, CISSN, Pn1, and the Ruscio Institute for Functional Medicine Clinical Team

Medically reviewed & fact checked by a
board-certified doctor
Medically reviewed & fact checked by a
board-certified doctor
Anchor link

Episode 40

Anchor link

Featured Study


Anchor link

Gastrointestinal Studies


Anchor link

Autoimmunity Studies


Anchor link

Thyroid & Hormones Studies

  • Subclinical hypothyroidism in older individuals
    • Narrative review of subclinical hypothyroidism (SCH) in those >65 yo
    • Studies showed no increased risk of poor outcomes (e.g. cardiovascular, cognitive) if TSH between 4.5-7 
    • In older individuals with SCH, symptoms of hypothyroidism, and cardiac and bone health did not improve after levothyroxine treatment
    • “This data suggest that treatment with levothyroxine should be considered for TSH concentration is persistently 7 mIU/L or higher and to not initiate treatment with TSH concentrations of less than 7 mIU/L.”
    • Commentary: Consider age and the degree of TSH elevation when managing SCH.

Anchor link

Diet & Lifestyle Studies

  • Hair cortisol levels in women with medically unexplained symptoms
    • 4 groups of women::
      • 33 w/ functional somatic syndrome (chronic fatigue, fibromyalgia, IBS)
      • 23 w/ somatic symptom disorder (excessive thoughts and feelings about their symptoms)
      • 27 w/ depression
      • 30 healthy controls
    • Hair cortisol levels measured in all groups
    • No differences in hair cortisol were found between groups. 
    • Neither childhood trauma nor chronic stress was correlated with hair cortisol levels.
    • Commentary: This study challenges the concept of “adrenal fatigue.”

Anchor link

Episode 39

Anchor link

Featured Study


Anchor link

Gastrointestinal Studies

  • Assessment of Markers of Gut Integrity and Inflammation in Non-Celiac Gluten Sensitivity After a Gluten Free-Diet
    • Biomarkers analyzed in:
      • 20 non-celiac gluten sensitivity (NCGS) on gluten-free diet
      • 20 IBS patients
      • 20 healthy controls
    • IBS symptom score was higher in those w/ NCGS and IBS compared to healthy controls
    • NO difference in gut permeability markers, inflammatory markers, or antigliadin IgG antibodies between the three groups
    • However, gut permeability markers correlated with antigliadin antibodies
    • Commentary: There was no difference in intestinal permeability markers in the 3 groups. Labs do NOT always correlate with symptoms.
  • Helicobacter pylori eradication prevents secondary gastric cancer in patients with mild-to-moderate atrophic gastritis
    • Multi-center retrospective study of 483 patients who had endoscopic resection for early gastric cancer
    • Split into 2 groups:
      • Undergone successful H. pylori eradication in the past year
      • Failed or not attempted H. pylori eradication
    • After 5.2 year follow-up, cancer recurrence rates occurred at similar rates between 2 groups (17.7% vs 18.5%)
    • However, in those w/ mild-to-moderate atrophic gastritis
      • Incidence of cancer recurrence was significantly lower in the eradicated group than in the non-eradicated group
    • However, NO difference in the severe atrophic gastritis group
    • Commentary: Overall, this study suggested very little effect of H. pylori treatment on gastric cancer recurrence rates.

Anchor link

Thyroid & Hormones Study


Anchor link

Diet & Lifestyle Studies

  • Quality of life in upper airway resistance syndrome
    • Retrospective study of 888 sleep PSG studies
      • 10.5% had upper airway resistance syndrome (UARS)
      • 90.5% had sleep apnea
    • Compared to 641 healthy controls
    • UARS had 5.5x and OSA patients had 6.2x greater probability of having a low quality of life score (compared to the healthy controls)
    • Commentary: Those w/ sleep disordered breathing are more likely to suffer from lower quality of life.

Anchor link

Episode 38

Anchor link

Featured Study


Anchor link

Gastrointestinal Studies


Anchor link

Autoimmunity Studies


Anchor link

Thyroid & Hormones Studies


Anchor link

Diet & Lifestyle Studies


Anchor link

Episode 37

Anchor link

Featured Study

  • Transient high thyroid stimulating hormone and hypothyroidism incidence during follow up of subclinical hypothyroidism
    • 431 healthy control participants, 225 patients with subclinical hypothyroidism (SCH) 
    • No treatment was given to either groups
    • At a 6 month followup:
      • 12.2% developed frank hypothyroidism
      • 13.4% stayed SCH
      • 73.8% became euthyroid
    • TPO antibodies and a TSH above 6.9 mIU/L was associated with a higher risk of developing overt hypothyroidism.
    • Commentary: The vast majority of those who were SCH became euthyroid WITHOUT treatment. This is an elegant study showing us that many times SCH will correct on its own. Also addressing gut health will most likely improve the rate of those who become euthyroid. There is no need to rush treating SCH in the majority of cases. Dr Ruscio and I encourage you to read the featured study from the FFMR+ two episodes ago which lays out a concise set of recommendations of which SCH patients to treat.

Anchor link

Gastrointestinal Studies

  • Associations with pancreatic exocrine insufficiency: An United Kingdom single-centre study
    • Retrospective study of 1,027 participants, 182 with exocrine pancreatic insufficiency (EPI)
    • Symptoms that predicted EPI
      • Steatorrhea (OR 2.51)
      • Weight loss (OR 1.5)
    • Associated risk factors:
      • Chronic pancreatitis (OR 8)
      • Pancreatic cancer (OR 6.6)
      • Upper GI surgery (OR 2.6)
      • Type 2 diabetes (OR 1.84)
      • PPI use (OR 1.9)
    • Commentary: This study showed hallmark symptoms and risk factors associated w/ EPI. Keep these in mind when seeing patients.

Anchor link

Thyroid & Hormones Studies

  • The Influence of Treated and Untreated Subclinical Hypothyroidism on Metabolic Profile in Women with Polycystic Ovary Syndrome
    • Cross-sectional study of 190 women w/ PCOS divided into 3 groups
      • 38 women with PCOS and subclinical hypothyroidism (SCH)
      • 76 women with PCOS and SCH w/ thyroid replacement therapy
      • 76 women with PCOS and normal thyroid function 
    • Measured metabolic markers
    • NO statistical difference of metabolic health between groups
    • BMI was the main determinant of metabolic outcomes
    • Commentary: In a group of women at risk for metabolic dysfunction (PCOS), those who treated their SCH did not have better metabolic outcomes.

Anchor link

Diet & Lifestyle Studies


Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

Leave a Reply

Your email address will not be published. Required fields are marked *