Cogence

12/30/2020

2020 has been challenging for all of us. I'm grateful to my colleagues and coauthors for your partnership, energy, and commitment to the ongoing process of discernment as we move through this difficult experience together. I had this graphic made a while ago, in anticipation of the Cogence community crossing the 5k member threshold. Ordinarily, I would expect such a milestone to be a moment of satisfaction that energizes and fortifies my efforts to continue the work. It does have some of that effect, but shaded with the realization that participation in Cogence carries with it a sharpened necessity, as we work to navigate dark waters together. It is my fervent wish that all of us be skilled navigators. I will continue to interact with folks in Cogence and other professional venues, while continuing to be mostly absent from FB. As of this writing, Cogence has members on 6 continents, with brilliant clinicians doing great work in all phases of patient care. I'm proud of you folks and grateful for your remarkable ongoing work. I wish you all a much better 2021.

08/06/2020

This is an excellent article to share with patients about COVID-19. It captures the complexity of the immunology in an accessible way that lets patients appreciate the challenges, so they can be motivated to follow the care plans you create. As always, remember that there are robust COVID-19 learning resources that you can access at cogenceimmunology.com. https://www.theatlantic.com/health/archive/2020/08/covid-19-immunity-is-the-pandemics-central-mystery/614956/

Which is too bad because we really need to understand how the immune system reacts to the coronavirus.

06/13/2020

Cogence has passed the 4,000 member threshold! Our clinicians come from every field and from all over the world. They engage in self-paced functional immunology education, watching videos on demand, posting Q&A forum questions, connecting to the weekly Q&A webinar, and receiving clinical pearls by email. Your membership cost is sponsored by Pure Encapsulations, so come join our vibrant community!

05/17/2020

An excellent synopsis of where we are in the COVID-19 process.

05/15/2020

Check out my interview for the Good Medicine On the Go podcast. We talked about genomics of COVID-19 and other interesting clinically actionable topics. The show can be found on

Apple

https://podcasts.apple.com/us/podcast/good-medicine-on-the-go/id1509832933

Google Play

https://play.google.com/music/listen?u=0 #/ps/I7kvlcroga6d2jtwwj6lzspslui

Stitcher

https://www.stitcher.com/podcast/good-medicine-on-the-go

Spotify

https://karawarecoaching.libsyn.com/spotify

https://open.spotify.com/show/63wpuRpvhPOy8jUHfGJo49

05/12/2020

Dr. Joseph Pizzorno, Dr. Helen Messier, Dr. Kara Fitzgerald and I have recently published this paper on COVID-19. Those of you who are in the clinical and scientific communities may find it useful. My abundant thanks to my remarkable coauthors. https://athmjournal.com/covid19/research/evidence-supporting-a-phased-immuno-physiological-approach-to-covid-19-from-prevention-through-recovery/

03/21/2020

FOR EVERYONE: This is not a game. We as a community need real, factual information about this challenging situation. Before you post anything, ask yourself if you are adding to the clear, scientific, discerning dialog or if you’re stirring the pot. If you’re stirring the pot, stop. That doesn’t mean we all need to agree with each other or be silent. It does mean that questions and points of view need to be considered vigorously before being expressed. Do not share anything you have not vetted yourself. That means DO NOT share anything the moment you read it. Nobody can do the work of vetting something on the fly. We’re all in this together, so the quality of our work as a community is something to which we are all contributing. Let’s all do good work together. Thank you.

11/23/2019

11/23/2019

I had a wonderful time at PLMI, talking about cytokine influence on autophagy at this lunchtime lecture. Interferon gamma is required to form the autophagosome. IL-4 blocks it. This means Th2 dominant patients will have trouble accomplishing autophagy and will be less able to to repair their neurons.

10/25/2019

Another excellent, solid step in the right direction. I’m very proud to be part of the functional medicine community and to see this profoundly meaningful journey continue to unfold.

A Functional Medicine outcomes study was published today in JAMA and I am feeling such pride, admiration, and gratitude for everyone involved! This article is the culmination of an aspiration I’ve had for 40 years. It is a first step—but a BIG first step—toward a more rational, systems-based approach to patient-centered health care. My most sincere thanks go out to The Institute for Functional Medicine, the team at the Cleveland Clinic Center for Functional Medicine, the authors of the study, and the many countless others who contributed to making this moment a reality.

This is an open access article. Please read, download, and share it: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753520

10/15/2019

Here’s a paper I wrote that was just published in Frontiers in Psychiatry. It will be indexed in medline about a month from 10/3/19. If you work with patients with TBI, CNS autoimmunity, neurodegenerative diseases, depression, or anxiety, this will teach you about underlying neuroimmunological factors in common among these diseases. Link to full paper: https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00712/full

08/16/2019

The full $3,000 cost of the Cogence Immunology course is now sponsored by Pure Encapsulations®. Go to cogenceimmunology.com to find out more. Because full course access is now available through the Pure Encapsulations sponsorship, we have stopped posting clinical pearls here. They are all available to Cogence members within the course portal.

02/08/2019

Another remarkable piece from the father of functional medicine.

January 2019 - This month’s episode is the final segment of Dr. Bland’s three-part series on the history of Type 2 diabetes. In this video, Dr. Bland…

01/24/2019

Research suggests that celiac disease could be caused by a bacterial enzyme used to manufacture sausages, cheese, bread and other processed foods; Frontiers in Pediatrics

07/18/2018

In this clinical pearl, we explore the importance of iron and the danger of giving iron without proper support from other components of your supplement support plan. The discovery of a new form of cell death, ferroptosis, that is driven by iron, makes the proper navigation of iron supplementation even more crucial, particularly in patients with auotimmune disease. Click here to learn more. https://cogenceimmunology.com/clinical-pearls-iron-and-glutathione/

Unlocking the Causes of Disease and Dysfunction

06/26/2018

In this clinical pearl, we look at two papers from Nature and Frontiers in Physiology showing that sodium drives T cells to turn into Th17 cells that drive tissue destruction in autoimmunity. Further, the Th17 cells they turn into “display a highly pathogenic and stable phenotype.” Here’s a link to the full clinical pearl…
https://cogenceimmunology.com/clinical-pearls-sodium-autoimmunity/

Unlocking the Causes of Disease and Dysfunction

06/02/2018

A big Thank You to the Institute for Functional Medicine for inviting me to speak at their Annual International Conference this year. The audience for my talk asked great questions and the other speakers were amazing.

05/31/2018

In this Clinical Pearl, we look at a paper from Science in which the authors show that hyperglycemia, rather than obesity, is responsible for increased paracellular intestinal permeability. In 27 humans, average plasma glucose (extent of hyperglycemia) correlated with intestinal permeability more strongly than body mass index. This has important clinical implications for patients with obesity as well as for the general population. Here's the link to the full Clinical Pearl...
https://cogenceimmunology.com/clinical-pearls-hyperglycemia/

Unlocking the Causes of Disease and Dysfunction

05/31/2018

Clinical Pearl:
This paper, from PLoS One, found that the flavonoid quercetin is as effective as chromolyn sodium at inhibiting mast cell histamine release. Quercetin also more effectively inhibits the release of inflammatory cytokines IL-6, IL-8, and TNF from LAD2 mast cell lines. The authors also found that quercetin “is effective prophylactically, while cromolyn must be added together with the trigger or it rapidly loses its effect.” Here's the link to the full Clinical Pearl: https://cogenceimmunology.com/clinical-pearls-quercetin/

Unlocking the Causes of Disease and Dysfunction

05/31/2018

Transcutaneous vagal nerve stimulation (tVNS) is a remarkably simple and powerful way to turn the tide with difficult patients, particularly those with autoimmune disease, SIBO, or chronic inflammatory problems. The purpose of this Clinical Pearl is to give you insights into how tVNS influences patient immune function and to give you the nuts and bolts information for how to get the work done clinically. Here's the link to the clinical pearl... https://cogenceimmunology.com/clinical-pearls-transcutaneous-vns/

Unlocking the Causes of Disease and Dysfunction

04/11/2018

April 12 @ 4pm ET: Prepare for IFM’s Annual International Conference on autoimmunity with educator Samuel Yanuck, D.C., FACFN, in the live webinar presentation, “Stress, Microbiota and Immune Balance: How to Navigate the Underlying Immunology on an Individualized Basis‡” Presented by IFM Corporate Leader Pure Encapsulations. Register at http://bit.ly/2I2e2vt

04/05/2018

Did you know that when compared to face-to-face learners, online learners often perform better? How do you attain that success?

03/10/2018

Here's a remarkable paper from Nature Immunology on disruption of GI Barriers in TBI and other forms of trauma. Of particular clinical importance is the realization that overproduction of pancreatic proteases can drive autodigestion of the intestinal mucosa. If you want to dig deeper into functional immunology, check out www.cogenceimmunology.com/ifm. If you scroll down the page you land on, you'll see some free videos there that will give you a sense of what the course is like.

01/17/2018

A remarkable discussion with Jeff Bland. Well worth the 20 minutes.

01/09/2018

Here's a remarkable study on the anti-histamine and anti-inflammatory effects of quercetin. Read the post for the rest of the story. If you want to dive deeper into functional immunology, check out cogenceimmunology.com

12/06/2017

Continuing our conversation about the role of hypoxia in immune response, here's a study from Nature Reviews Immunology on connections between hypoxia and inflammation. If you want to dive deeper into functional immunology, check out cogenceimmunology.com

11/16/2017

Here's a study with stunning clinical implications. It shows that NK cells depend upon oxygen to mature. Read the post for the rest of the story. If you want to dive deeper into functional immunology, check out cogenceimmunology.com