Welcome to the Blog of
Dr. Matthew Lewis
Here, you’ll find news from our office, insights and observations from trusted sources in health, information about innovations in the effort to take back your own good health, testimonials from our clients, resources and recommendations of note, and more. Read a post or two and comment on anything that strikes a chord.
Shoulder Pain Cure: There’s a New Multi-Layered Approach
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If you read my earlier post about a new treatment for rotator cuff injuries (“Is There a Miracle Cure for Rotator Cuff and Other Joint Injuries?”), you know that shoulder pain isn’t something you can just shrug off.
It is such a common occurrence that medical researchers say nearly 70 percent of adult women and men will experience significant shoulder pain at some point in their lifetime.1 While it is usually associated with aging and generally starts between the ages of 30 and 60, shoulder pain can strike at any time and without a known reason.
Although some people feel they can trace their shoulder pain back to a clear cause — an injury, for example — most shoulder pain is due to normal wear and tear over years of use (or misuse), internal inflammation, or other underlying issues.
That said, understanding the factors that can cause or contribute to shoulder pain is important in order to provide effective treatment. In many cases, several factors need to be addressed. In this post, I explore the many causes of shoulder pain and describe the multi-layered approach we now recommend to our patients here at PROVOKE Health to alleviate the pain, repair any damage, and restore strength and range of motion.
Common Causes of Shoulder Pain
While those of us who have never lived with it may think that it only affects baseball pitchers, competitive swimmers, or football quarterbacks, serious shoulder pain can arise from many factors, including one or more of the following causes:
Chronic Inflammation: New Insights and Next Steps
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In a wide-ranging speech on Aug. 23, 2004, in Phoenix, Ariz., Robert F. Kennedy Jr., then an independent candidate for President of the United States, made several comments about chronic disease, a topic typically addressed by doctors and, less often, by public health officials.
“Chronic disease is an issue that affects all of us far more directly and urgently than any culture war issue, as well as all the other issues that we obsess over that are tearing apart our country,” Kennedy said. “This is the most important issue. Therefore, it has the potential to bring us together.”
Mr. Kennedy highlighted several data points that we were able to verify to illustrate the severity of the issue, including:
- The United States spends more on healthcare than any other country, nearly twice as much as Europe. (source)
- Two-thirds (66 percent) of American adults and children suffer from chronic health issues. (source)
- About 18 percent of American teens have fatty liver disease. (source)
- Seventy-four percent of Americans are overweight or obese. (source)
- Cancers among young adults have increased by 79 percent. (source)
We appreciate Mr. Kennedy for bringing attention to the immense impact chronic disease has on both the U.S. economy and the health of our children and adults. As a Tampa, Florida-based medical practice dedicated to functional medicine and integrative healthcare, we have long been committed to diagnosing and treating the root causes of illness. Mr. Kennedy’s message, which you can read in its entirety here, echoes what we and our colleagues have been advocating in our clinics for years.
Inflammation – The Common Factor in Most Cases of Chronic Disease
One word that was noticeably absent from Mr. Kennedy’s remarks was “inflammation,” which those of us who have dedicated our lives to the medically-supervised care and motivation of others know is at the root of most chronic health conditions.
Virtually all chronic disease can be traced to chronic inflammation, and most chronic inflammation can be traced to preventable causes, including the following:
Meet The Team: Dr. Karalynne Blochberger, MD – Medical Director at PROVOKE Health
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Dr. Karalynne Blochberger joined us here at PROVOKE Health in Tampa in June of 2023 where she currently serves as Medical Director of our functional medicine and integrative healthcare practice.
Ask her and Dr. Blochberger gladly tell you that her decision to work alongside our founder, Dr. Matthew Lewis, was pragmatic: She wanted to help people figure out the “why” behind their symptoms in order to determine the “how” of their return to optimal health, quality of life, resiliency and confidence.
And that’s pretty much the philosophy behind Functional Medicine and Integrative Healthcare — especially as provided by the doctors and staff here at PROVOKE Health.
Born in the suburbs of Chicago, Illinois, where she spent her first decade of life, she and her family moved to Holland, Mich., where she completed her undergraduate studies at Hope College, graduating in 2012 with Bachelor of Arts degrees in both chemistry and Spanish. In 2017, Dr. Blochberger was awarded her Medical Degree from the College of Human Medicine at Michigan State University in East Lansing.
In other positions, Dr. Blochberger has worked as a physician at Access Primary Care in Orlando, and Advent Health Primary Care Plus, also in Orlando. She is board-certified by the American Board of Family Medicine (ABFM) and is a member of the American Academy of Family Physicians (AAFP).
We asked this busy physician — who is known as “Doctor B” by her co-workers and patients — some personal questions, to which she was willing to respond. Get to know Dr. Blochberger, in her own words…
PROVOKE HEALTH: In your own words, please share what drew you to work for PROVOKE Health?
Medications That Deplete Nutrients and How to Minimize the Damage
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It’s been nearly 15 years since licensed pharmacist Suzy Cohen wrote her groundbreaking book, Drug Muggers: Which Medications Are Robbing Your Body of Essential Nutrients — and Natural Ways to Restore Them. A member of the Institute of Functional Medicine, the American College for Advancement in Medicine, and the American Association of Anti-Aging Medicine, Cohen effectively focused our attention on over-the-counter and prescription medications that deplete the body of essential nutrients.
In this post, I build on Cohen’s work by highlighting some of today’s common medications associated with nutrient depletion and provide guidance on how to restore the nutrients they are known to affect.
While it’s important to point out in a post like this one that some over-the-counter and prescription medications can be helpful in treating and managing various illness and relieving symptoms, it’s similarly important to acknowledge that many people don’t realize that some of these same medications can deplete their body of essential vitamins and minerals. The resulting nutrient depletion can lead to a number of health issues, creating a cycle of dependency on more medical interventions that often involve some over-the-counter and prescription medications. Being able to recognize the medications that can rob your body of what it needs to thrive and knowing how to address this issue proactively will help you maintain optimal health while managing your health.
Common Nutrient-Depleting Medications
Many medications are known to deplete nutrients. Most of these are prescription medications, but some are available over the counter, including proton-pump inhibitors (PPIs) — medications used to reduce stomach acid.
Statins (Cholesterol-Lowering Drugs)1
- Nutrient Depleted: Coenzyme Q10 (CoQ10)
- Why It Matters: CoQ10 affects energy production in your cells and has properties that protect your heart. A deficiency in CoQ10 can cause fatigue, muscle pain, and even an increased risk of heart failure, so don’t wait for symptoms to develop before acting.
- What You Can Do: If you are taking a statin, speak to your healthcare provider about supplementing with CoQ10. If your healthcare provider prescribed a statin medication and did not recommend a CoQ10, consider finding a physician who understands the pros and cons of statins and can explore additional options to treat cardiovascular disease and its associated risk factors.
If you experience muscle pain or weakness, work with your healthcare provider to switch to a different statin medication or explore alternative treatments. Here at PPROVOKE Health, we have patients who had experienced weakness for years during which neither the patient nor doctor was aware this was a side effect of a statin medication. As an aside, I can’t imagine ignoring, dismissing, or failing to address a patient’s years-long experience of weakness and fatigue. Weakness and fatigue are not normal and should be treated just as you would treat heart disease.
What Does Functional Medicine Say About the Mediterranean Diet?
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Depending on your plan of care, your Tampa functional medicine healthcare provider, like those at PROVOKE Health, may recommend an eating plan based on the Mediterranean diet. If you’re unfamiliar with it, the Mediterranean diet, inspired by the traditional eating habits of countries bordering the Mediterranean Sea, has long been praised for its health benefits.
Rich in plant-based foods, healthy fats, and lean proteins, the Mediterranean diet emphasizes overall well-being rather than calorie counting or restrictive eating. But what does functional medicine say about the Mediterranean diet? That’s the focus of today’s post.
Tampa Functional Medicine at PROVOKE Health
At PROVOKE Health, we practice functional medicine in Tampa because it’s a patient-centered approach to healthcare that’s intentional about addressing the underlying causes of disease rather than just treating symptoms. This approach to healthcare focuses on personalized plans of care that consider the unique health history (both yours and your family), genetics, biochemical factors, lifestyle, and health and fitness objectives of each of our patients.
When it comes to that which fuels our bodies, especially when we’re sick, functional medicine practitioners like our Founder, Dr. Matt Lewis, D.C., DACBN, CFMP®, and our Medical Director, Dr. Karalynne Blochberger, MD, often emphasize the importance of whole, nutrient-dense foods that support overall health and prevent chronic disease. And that’s where the Mediterranean diet comes into play.
For additional information about functional medicine, please read Functional Medicine Explained, here on the PROVOKE Health Blog.
Key Components of the Mediterranean Diet
Before diving into the Functional Medicine perspective, let’s first take a moment to understand the components of the Mediterranean diet:
- Vegetables and Fruits: These form the cornerstone of the diet, providing essential vitamins, minerals, and antioxidants. The Mediterranean diet encourages at least five (5) servings of vegetables and fruits per day, ensuring a variety of colors and types to maximize your intake of nutrients that support your plan of care.
- Whole Grains: Unlike refined grains, whole grains are packed with fiber, which supports digestion and helps you reach and maintain a healthy weight. Whole-grain bread, pasta, and rice are staples of the Mediterranean diet.
- Healthy Fats: The Mediterranean diet emphasizes healthy fats from sources like olive oil, nuts, and seeds. These fats are beneficial to your heart health and can help reduce inflammation, which is common in most of the chronic illnesses we treat at PROVOKE Health.
- Lean Proteins: Fish and seafood are the primary sources of protein that the Mediterranean diet relies on — particularly those rich in omega-3 fatty acids. Poultry, beans, and legumes are also included, while red meat is limited.
- Minimally Processed Foods: The Mediterranean diet is intentional about its avoidance of processed foods and refined sugars, focusing instead on whole, natural ingredients. As we like to say,
Low-Dose Naltrexone (LDN) and Healthy Immune Function
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A leading medical doctor specializing in diseases of the small intestine, stomach, esophagus, and colon, claims a drug formerly used to treat opioid and alcohol dependence, has become an intriguing choice for managing several gastrointestinal disorders.
In a recent article entitled “Low-Dose Naltrexone in Gastroenterology: A Bonafide ‘Wonder Drug,” Dr. Leonard Weinstock, M.D., a St. Louis-based gastroenterologist and researcher, asserts that naltrexone — originally used at a dosage of 200 mg daily to treat opioid users and alcoholics — has been found successful in treating intestinal issues when used at just one-tenth of the full dosage.
In my own private practice and here at PROVOKE Health, we have a long history of using low-dose naltrexone (aka, LDN) to treat immune system dysfunction. In fact, a growing body of evidence suggests that LDN is effective in treating conditions such as inflammatory bowel disease (IBD), Crohn’s disease, ulcerative colitis, and irritable bowel syndrome (IBS). It has even shown beneficial implications in several other areas, such as restless legs syndrome (RLS), psoriasis, weight management, and Long COVID, which is characterized by symptoms lasting at least three months after an initial infection.
So what is naltrexone and what do we here at PROVOKE Health think about the potential role of this medication in the battle to overcome chronic illness? Well, that depends. As a functional medicine and integrative healthcare practice committed to motivating patients by providing the healthcare, guidance, and support they need, we believe in providing personalized treatment that addresses the unique health and fitness needs of each patient. We do not promote any single treatment or protocol as a miracle cure or a one-size-fits-all solution.
However, in the context of our clinical practice, we have found naltrexone to be an effective tool in the treatment of a wide range of immune system dysfunctions, such as the following:
- Long COVID
- Psoriasis
- Toxic mold
- Fibromyalgia
- Chronic fatigue syndrome (CFS)
- Rheumatoid arthritis
- Crohn’s disease
- Hashimoto’s thyroiditis
- Scleroderma
- Lupus
- Sjogren’s syndrome
- Multiple sclerosis
- Ulcerative colitis
- Celiac disease
In this post, I share how naltrexone can aid in preventing common issues that are associated with the use of opioids — namely relapse — as well as naltrexone potential benefits, at much lower doses, for temporarily restoring healthy immune function. This can be especially useful while the root causes of immune system dysfunction are being identified and addressed.
Naltrexone in the Treatment of Opioid and Alcohol Use Disorders
Classified as an opioid antagonist, naltrexone has been approved for the treatment of opioid and alcohol addiction since 1984. Opioids encompass a range of substances, including the illegal drug heroin, synthetic opioids such as fentanyl, and prescription painkillers such as oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, and others.
These drugs work by binding to opioid receptors in the body, providing pain relief, slowing down breathing,
Candida Yeast Overgrowth: A Root Cause of Many Chronic Illnesses
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If you’re experiencing bloating, brain fog, chronic fatigue, and frequent migraines or headaches, it might be wise to ask your doctor to test you for candida yeast overgrowth. Not sure what candida is? Or why it’s a leading suspect in these and other conditions linked to chronic disease? That’s what today’s post is about.
Candida albicans is a microscopic yeast that lives within and around us all. Like many microorganisms, it doesn’t cause a problem until an imbalance occurs in the community of microorganisms (bacteria, viruses, and fungi) that populate the body. Then, it can cause all sorts of illness, from obvious conditions, such as thrush and vaginal yeast infections, to a wide range of illnesses with more mysterious symptoms. These include fatigue, headache, food sensitivities, rashes, and digestive issues. In addition, Candida yeast overgrowth can trigger and contribute to numerous autoimmune disorders, including arthritis, allergies, gastric ulcers, colitis, and Crohn’s disease.
The medical community recognizes and provides treatments for the obvious, acute medical conditions caused by Candida yeast overgrowth, including thrush, vaginitis, frequent urinary tract infections, certain skin and nail infections, and severe systemic infections that affect the blood, heart, brain, eyes, bones, and other parts of the body. But that same community has been slow to recognize the role Candida plays in chronic medical conditions.
In fact, for the last half century and even today, most conventional medical practitioners continue to push back against any suggestion that Candida yeast plays a role in chronic health conditions. They are skilled at identifying conditions that are relatively easy to diagnose and can be treated with pharmaceutical-grade antifungal medications. But they tend to overlook Candida infections that fly below the radar.
Tracing Symptoms to Causes
To be fair, the connection between Candida yeast overgrowth and chronic health conditions can be elusive. Candida overgrowth is typically just one link in a chain reaction of causes. For example, overuse of antibiotics can cause an imbalance in gut flora that triggers an overgrowth of Candida. That can lead to leaky gut that promotes an overactive immune system that attacks the joints, resulting in arthritis. In this complex case, conventional medicine would simply treat the symptoms of arthritis without ever addressing other links in the chain reaction.
In contrast, the functional medicine and integrative healthcare providers here at PROVOKE Health take a different approach. Like curious children, we keep asking questions until we have a complete picture of what’s going on:
Understanding the Role and Benefits of Vasoactive Intestinal Peptide (VIP)
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At PROVOKE Health, we prioritize understanding the latest advancements in functional medicine and integrative healthcare in order to provide our patients with the most effective treatments.
One such advancement is the use of Vasoactive Intestinal Peptide (VIP), a peptide hormone made up of 28 amino acids. Found in high concentrations throughout the body — including in the respiratory system, endocrine organs, heart, and brain, , and— VIP plays a crucial role in maintaining overall health.
If you’re unfamiliar with peptides, read “The Healing and Rejuvenating Power of Therapeutic Peptides” here on the PROVOKE Health blog. In short, peptides are short strings of amino acids — much shorter than protein molecules and easier for the body to absorb and break down — that are bioactive and have a beneficial effect on the body.
In this post, we’ll focus on the benefits of VIP, starting with its impact on improving gut health.
Vasoactive Intestinal Peptide and Gut Health
Vasoactive intestinal peptide has a significant impact on the health of your gut. Here’s how VIP supports a healthy digestive system:
Understanding the Challenges and Needs of Chronically Ill Workers
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A study completed just months ago by Amazon and the Harvard Business Review provides us with some interesting data about working people who are suffering chronic illnesses during the post-Covid age.
Entitled How People Experience Chronic Illness at Work and published in May, the study was conducted by Katie Bach, MBA, MSc, the Director of Science Partnerships and Impact at Amazon, and Gretchen Gavett, a senior editor at Harvard Business Review.
Here at PROVOKE Health, a functional medicine and integrative healthcare practice dedicated to collaborating with patients to rekindle their confidence and improve their resiliency, we create and co-manage personalized plans of care that address or prevent complex health problems, including chronic illnesses. Bach and Gavett’s study is of particular interest because it appears to be the first to explore how recent chronic illnesses such as those discussed below impact workers, and what actions employers can provide to support them better.
Our patients often tell us about their work-related concerns due to conditions that include long Covid, myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS), and postural orthostatic tachycardia syndrome (POTS), which are reshaping the workplace landscape in many parts of the country. These conditions, along with mold-related illness and environmentally acquired illness, often lead to fluctuating symptoms and unpredictable energy levels, thus hindering consistent performance at work.
At PROVOKE Health, we understand the complexities of chronic illnesses and are dedicated to diagnosing and treating these conditions in order for our patients to regain their health and resilience. So when a study comes along that offers additional insight into these topics, we’re listening.
What appears to be the impact of chronic illness at work? Here is what the study reveals:
The Impact of Chronic Illness at Work
Experiences Vary Dramatically: The survey reveals a stark contrast between the perspectives of chronically ill workers and their non-ill colleagues. While 60 percent of non-ill respondents believe their organizations are supportive, only 36 percent of those with chronic illnesses agree. This discrepancy highlights a critical gap in understanding and support within workplaces.
Daily Struggles: Chronically ill workers report a range of symptoms that vary daily, making consistent performance challenging. One respondent in the study described the fluctuation as follows:
“Long Covid means that one day I can work at almost full capacity and the next I can barely get out of bed.”
At PROVOKE Health, we specialize in understanding these fluctuations and developing personalized treatment plans to help manage symptoms. And often, we’re able to
Personalized Treatment for Lichen Sclerosus: A Case Study — Part Two
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Last week on our blog, one of our patients shared her experience with Lichen Sclerosus and how we have been helping her on her journey to recovery (see “Recovering from Lichen: A Case Study — Part One”).
Janet reported that her symptoms had started 10 years before she visited our Tampa functional medicine clinic, and she was diagnosed three years prior to consulting us. In all that time — despite consulting several doctors — the recommended treatments provided little to no relief.
As part of her intake here at PROVOKE Health, she reported a possible past exposure to mold, so we ordered a mold toxin antibody test, which confirmed the exposure. The positive result led us to understand that mold was aggravating her immune system causing dysregulation and contributing to hormonal imbalances. It’s likely that the problem of Lichen Sclerosus was not solely due to the mold exposure; however, we know it was a contributing factor.
Although Janet reported symptoms of Lichen Sclerosus dating back a decade, upon further discussion, we came to find out that she had suffered from itching for nearly 18 years. This led us to an understanding that mast cells were involved. When mast cells are activated, they secrete histamine along with other inflammatory chemicals called cytokines.
We tested for mast cell activation syndrome (MCAS). She did not test positive for MCAS, but it is a complex illness. Most conditions in conventional medicine are either positive or negative. However, we suspect that MCAS may exist more on a spectrum. Janet could have been experiencing symptoms of MCAS without reaching the threshold of testing positive for it. We find this quite common in our patient population.
This is the nuance of functional medicine. A willingness and readiness to practice in areas that require flexibility and open-mindedness. The question we faced was determining what was continually aggravating those mast cells? In Janet’s case, mold was a contributing factor. For others, it can be a food sensitivity or allergy, another environmental allergy, stress levels, infections, physical exertion, or even a commonly prescribed medication (antibiotic or steroid).
Calming the Mast Cells
Because mast cell reactivity was playing a key role in producing symptoms, we had to calm those cells — make them less reactive. This was a two-step process:
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