Dr. Kara Fitzgerald

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Sandy Hook, CT
Dr. Kara Fitzgerald

Actively engaged in award-winning clinical research on epigenetics & longevity. IFM Faculty & renowned international speaker.

Director of New Frontiers Functional Medicine & Nutrition Clinic. Subscribe to get latest content at www.drkarafitzgerald.com

01/05/2026

We’ve long counted exercise minutes, but wearable data are changing how we understand intensity.

In a large prospective study using device-measured activity, vigorous movement showed a much stronger association with reduced mortality and cardiometabolic risk than previously estimated from self-reported data.

Instead of the traditional 1:2 ratio, the data suggest that 1 minute of vigorous activity is associated with similar benefits as 4–9 minutes of moderate activity, depending on the outcome.

This doesn’t diminish the value of movement at any level.

But it raises important questions about time efficiency, metabolic signaling, and how intensity shapes long-term health trajectories.

As always, these findings are associational, not prescriptive.

Clinical decisions should remain individualized and practitioner-guided.

Findings are correlational and require prospective validation.

https://doi.org/10.1038/s41467-025-63475-2

Funding: Public research funding (NHMRC, UK Biobank)
Conflicts of Interest: One author reports consulting equity related to physical activity services; others report none

01/04/2026

January is National Mentoring Month, and it’s a good moment to pause and acknowledge something that doesn’t always show up on a CV, but shapes careers profoundly.

Every meaningful step I’ve taken as a clinician and researcher has been influenced by mentors: people who challenged my thinking, sharpened my clinical reasoning, insisted on rigor, and modeled what it means to stay curious while practicing responsibly.

Mentorship in medicine isn’t about having all the answers. It’s about learning how to ask better questions of the literature, of our patients, and of ourselves. It’s how we learn to integrate evidence without losing nuance, and innovation without abandoning ethics.

For those early in their careers: seek mentors who value critical thinking over certainty, and humility over hype.

For those further along: your experience matters more than you realize. Sharing it thoughtfully is one of the most meaningful ways to strengthen our field.

Clinical medicine advances when knowledge is shared, challenged, and stewarded together.

Grateful for the mentors who shaped my path, and committed to paying that forward.

01/03/2026

Dry January may be trendy but the science behind it is worth understanding.

Emerging research continues to link alcohol consumption with measurable effects on long-term health, even at levels many consider “moderate.”

I use this kind of data as an opportunity to be more mindful about how alcohol fits — or doesn’t — into a healthy, balanced lifestyle.

Dry January isn’t about rules or restriction. It’s a chance to observe what changes when alcohol is removed: sleep quality, energy, focus, inflammation, and recovery.

What have you noticed when you’ve taken a break from alcohol?

DOI:10.1001/jamanetworkopen.2023.6185

01/02/2026

Longevity science still talks a lot about “programmed aging,” as if our genes alone set the pace. But the emerging evidence, and decades of functional medicine experience, tell a different story.
It’s time to name it clearly: exposomic aging.

Exposomic aging reflects how the totality of our inputs, like nutrition, circadian rhythm, environmental toxicants, stress biology, microbiome signals, movement, social context, interact with our genome and epigenome over time.

In other words: Aging isn’t just programmed. It’s shaped.

By what we’re exposed to, what we metabolize, what we recover from, and how our systems communicate with one another.

This lens also intersects with several frontier areas of longevity science:
• Chrono-nutrition and the timing of food as a biological signal
• Yamanaka mimetics and partial epigenetic reprogramming
• The biochemical pathways that allow us to shift biological age in real time

Naming the exposome as a driver of aging helps us move the conversation beyond inevitability toward biology that is dynamic, responsive, and, importantly, modifiable.

01/01/2026

A new year brings a fresh opportunity to align our daily lives with the biology we want to cultivate.

Not resolutions built on deprivation or pressure, but intentional, sustainable shifts grounded in functional medicine and supported by what we now understand about aging.

A few pillars I’m personally recommitting to in 2026:
• Deep nourishment: phytonutrient-rich foods that support methylation, mitochondria, and immune balance
• Regulated rhythms: sleep, light, and stress practices that shape our epigenome
• Strength and movement: because muscle remains one of the most powerful longevity signals
• Connection and meaning: the often-overlooked drivers of resilience and biological youth

And perhaps most importantly: Compassion toward our bodies, our patients, and ourselves.

I’m excited for the conversations, discoveries, and clinical insights 2026 will bring. Thank you for walking this path with me and for your commitment to evidence-based, root-cause medicine.

Here’s to a year of possibility, curiosity, and living better.

12/31/2025

As we close out the year, I’m reflecting on what an extraordinary moment we’re living in as functional and longevity medicine continues to evolve.

This past year brought breakthroughs in biomarkers, epigenetics, immune resilience, mitochondrial science, and nervous system regulation, each one reminding us that the body is far more dynamic and adaptable than we once believed.
If there’s one theme I’m taking with me into the new year, it’s this:

Biology is not fixed. It’s responsive. And our daily choices, nutrition, sleep, stress, relationships, movement, remain some of the most powerful tools we have to shape how we age.

Thank you for being part of this thoughtful, curious, science-driven community. Whether you’re a practitioner, a student, or someone simply trying to live with more vitality, I’m deeply grateful for your presence here.

Wishing you a restorative New Year’s Eve and a quiet moment to acknowledge the growth, resilience, and learning that got you to this point.

Here’s to continuing the work, and the wonder, together.

12/29/2025

What a year it’s been! 🚀

From breakthroughs in biomarkers and epigenetics to new tools reshaping how we approach chronic disease, 2025 brought some of our most meaningful advances yet.

This round-up highlights the moments that sparked conversation, challenged long-held assumptions, and moved the field forward, all grounded in science, clinical insight, and hope for healthier aging.
Whether you’re a clinician, a patient, or someone simply curious about living better, there’s something here to learn, explore, and apply.

Comment 2025 ROUNDUP or visit https://www.drkarafitzgerald.com/2025/12/07/2025-functional-medicine-highlights/ to read the article!

12/28/2025

Microplastics are no longer just an environmental issue. They’re being found in human placenta, arteries, brain tissue, and organs, and this new JAMA review highlights what many in functional medicine have been concerned about for years.

The paper outlines how microplastics can carry toxic chemicals, trigger inflammation, disrupt endocrine pathways, and contribute to cardiovascular and neurodegenerative risk.

None of this is surprising to those of us who’ve tracked environmental toxicants for decades, but it is encouraging to see mainstream medicine finally naming this as a clinical concern.

We still need better tools, better regulation, and better long-term data. But awareness is moving in the right direction.

doi:10.1001/jama.2025.14718

12/27/2025

We talk a lot about estradiol (E2), the primary estrogen during the reproductive years, but post-menopause, estrone (E1) becomes the dominant circulating estrogen, primarily synthesized in adipose tissue.

And yet… we still understand surprisingly little about how E1 behaves in the body.

A new study adds important nuance to the conversation.

Here’s what emerging evidence suggests:
🔹 E1 may be more pro-inflammatory than E2.
While E2 tends to have metabolically supportive and anti-inflammatory effects, E1 appears to interact differently with immune pathways, which may help explain some of the inflammatory shifts we see in midlife and beyond.
🔹 E1 is a known driver of estrogen-positive breast cancers in older women.
This can occur even when overall estrogen levels are low, highlighting that where and how estrogen is produced matters just as much as the total amount.
🔹 Adipose-derived estrogen is not always protective.

For years, a little extra adipose was thought to ease menopausal symptoms by providing a “backup source” of estrogen.

But the story is more complicated.

This study reinforces what many of us see in clinical practice:

Menopause is not just a hormone deficiency state; it’s a shift in hormone sources, metabolism, and signaling.
And those shifts can have very different biological consequences.

As always, any clinical decisions around hormone therapy, weight, or metabolic interventions must be individualized and carefully guided by your practitioner.

But this research opens the door to more precise conversations about:
🔸 breast cancer risk
🔸 metabolic health
🔸 inflammation
🔸 hormone replacement strategies
🔸 and the role of adipose tissue in postmenopausal physiology

Source: https://doi.org/10.1038/s41574-025-01208-7

12/26/2025

A new JAMA Neurology study caught my eye this week: adults younger than 70 with hearing loss who used hearing aids had a significantly lower risk of developing dementia over nearly 20 years compared with non-users.

Hearing loss remains one of the most overlooked, and potentially modifiable, contributors to cognitive decline. And yet, only a fraction of adults who need hearing aids actually use them.

I’ve been wanting to explore this topic in depth:
• How does auditory deprivation reshape brain aging?
• When does intervention matter most?
• Can hearing support meaningfully alter dementia trajectories?

Are you an expert in hearing loss as a risk factor for dementia, or do you study hearing interventions and brain aging?

If your research or clinical work intersects with this topic, I would love to connect. This is a conversation our community (and our patients) urgently need.

DOI: 10.1001/jamaneurol.2025.2713

12/25/2025

Merry Christmas to all who are celebrating today and warm wishes to everyone finding a moment of rest, reflection, or connection.

This time of year naturally invites us to slow down, recalibrate our nervous systems, and lean into the relationships and routines that anchor our health. From a functional medicine perspective, days like this remind us how profoundly community, nourishment, joy, and recovery shape our biology.
If today looks abundant for you, I hope you savor it.

If it looks quiet, complicated, or tender, I hope you offer yourself the same compassion you’d extend to a patient or friend.

Either way, your body and brain benefit from a pause: a walk outside, a nutrient-dense meal, genuine laughter, time with people you love, or simply a deep breath you didn’t realize you needed.

Wishing you a day filled with warmth, connection, and steady physiology, in whatever form that takes.

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Sandy Hook, CT

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+12033049502

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http://www.drkarafitzgerald.com/

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