Advertise on podcast: The Smartest Doctor in the Room

Long COVID does not have one cause. Different patients have different drivers, including autoantibodies, persistent spike protein, herpesvirus reactivation, and mast cell activation, which is why the guiding rule at Mount Sinai's long COVID clinic is to treat the drivers, not the symptoms. Dr. Dean Mitchell talks with Dr. David Putrino, a neuroscientist and the Nash Family Director of Mount Sinai's Cohen Center for Recovery from Complex Chronic Illness, about what his team has found and which treatments are now being tested. In this episode:How the Mount Sinai long COVID clinic started, and how patients are evaluated for fatigue, post-exertional malaise, and sleepA Cell study where antibodies from long COVID patients with new onset pain caused pain-like symptoms in miceSpike protein found in gut tissue, and the inflamed tissue around it in long COVID patientsHerpesvirus reactivation after COVID, including HHV-6 in saliva that tracked with severityMast cell activation, POTS, and why Pepcid and Claritin help some patientsClinical trials underway: a spike-binding monoclonal antibody, antivirals for herpesviruses, micro Tesla magnetic therapy, low-dose rapamycin, and auricular vagus nerve stimulationFirst steps for someone with long COVID: tilt table test, blood work, active stand test, breath work, and sodium Follow The Smartest Doctor In The Room wherever you get your podcasts. Guest Contact Website https://www.putrinolab.net/ LinkedIn profile https://www.linkedin.com/in/david-putrino-bb86aa11/ YouTube channel https://www.youtube.com/@CoRESinai Social media X: @putrinolab Instagram: @putrino_lab Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

Yes, food allergies can be treated. Xolair (omalizumab) is the first FDA-approved treatment for any food allergy beyond peanut, and it can lower the risk of a severe reaction after accidental exposure for children age one and older and for adults, including people with multiple food allergies. It is not a cure, and patients still avoid their trigger foods.Dr. Dean Mitchell talks with Dr. Dale Umetsu, the allergist-immunologist who spent decades in academic medicine at Stanford and Harvard before moving to Genentech to help move Xolair toward FDA approval for food allergy. Dr. Umetsu is the author of Beyond Avoidance: A Physician's Pursuit to Transform Food Allergy Treatment. In this episode: How Xolair compares with oral immunotherapy (OIT) and sublingual immunotherapy (SLIT)How much protection it gives, why avoidance still matters, and how long protection lasts after injections stopHow dosing works, and why Xolair does not help eosinophilic esophagitisWhy food allergy treatment took so long to reach patientsFood allergy testing: ImmunoCap, component testing, and basophil activation testing Follow The Smartest Doctor In The Room wherever you get your podcasts. Guest Contact https://www.daleumetsu.com/ https://en.wikipedia.org/wiki/Dale_T._Umetsu https://notablepeopleproject.org/dale_umetsu LinkedIn profile https://www.linkedin.com/in/dale-umetsu-b66731b5/ Purchase Beyond Avoidance on Amazon here. Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

DescriptionFor most people the risk from routine vaccines is extremely low and the benefit is very high, but a smaller group, including people with mast cell activation syndrome or a serious past reaction, may need an exemption. In this solo Q&A, immunologist and functional medicine physician Dr. Dean Mitchell explains how vaccines train the immune system, why childhood vaccines are timed the way they are, why he calls the measles vaccine a no brainer, and why he does not recommend COVID boosters. He covers common and rare vaccine reactions, how to document a reaction when an exemption is needed, and what he thinks about the flu shot, pneumococcal boosters, and the shingles vaccine. Dr. Mitchell also takes live questions on a severe reaction to a flu shot, vaccines during pregnancy, how to space a baby's vaccines, and vaccines and autism, plus MTHFR, B12, and homocysteine.Follow The Smartest Doctor In The Room on Apple Podcasts or Spotify so the next episode comes to you. Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

Vaccines train the immune system to recognize a pathogen before it ever meets the real thing, and mRNA vaccines do it by instructing your own cells to make the target protein themselves. Immunologist and pathologist Dr. Terry Harville of the University of Arkansas for Medical Sciences joins Dr. Dean Mitchell to explain how classic vaccines built from weakened or inactivated viruses compare with mRNA technology, why mRNA is packaged in a lipid particle, and why antibody levels fade while T cell memory stays. They compare mRNA, viral vector, and protein subunit COVID vaccines, discuss why a vaccine reaction can feel like the flu, and cover myocarditis and clotting concerns. Dr. Harville also explains how long protection lasts for tetanus, pneumococcal, shingles, and RSV vaccines, and why viruses that jump from animals to humans, like HIV, Ebola, and SARS-CoV-2, are so hard for the immune system to handle. Follow The Smartest Doctor In The Room on Apple Podcasts or Spotify so the next episode comes to you. Guest Contact Websites:  UAMS Health provider profile Resources / Book Links: Featured in IG Living magazine, a publication for the immune globulin community: UAMS Department of Pathology feature Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

Yes, scar tissue can be treated, even decades after surgery, and it matters because most of what a scar does happens beneath the skin. Massage therapist Marjorie Brook, creator of the STRAIT Method (Scar Tissue Release and Integrated Therapies), joins Dr. Dean Mitchell to explain how scars form, how they differ from adhesions, and why healed tissue can stay restricted and affect movement, circulation, and lymphatic flow. She explains why she believes aggressive early rehab can work against healing, what gentler care looks like, and why itchy, numb, or tight C-section and mastectomy scars are often scar tissue that can be addressed. She also covers when scar work can begin, how stretching works with the body instead of against it, and what to say if you are told scar tissue is simply something you have to live with.Follow The Smartest Doctor In The Room on Apple Podcasts or Spotify so the next episode comes to you. Guest Contact Websites: marjoriebrook.com | brookseminars.com Resources / Book Links: Brook Seminars Bodywork Education offers continuing education courses in the STRAIT Method (Scar Tissue Release and Integrated Therapies), Integrated Therapeutic Stretching, and body mechanics. Practice located in Wantagh, Long Island, NY.  Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

The smartest doctor in the room isn't defined by a famous hospital or a top doctor list. It comes down to ten qualities: judgment, listening, curiosity, experience, pattern recognition, humility, communication, collaboration, compassion, and genuine investment in the patient's outcome. In this solo episode, Dr. Dean Mitchell shares what more than five and a half years of interviewing physicians has taught him about choosing a doctor. He explains how those "top doctor" lists work and why credentials alone can mislead. He also covers why normal lab results don't always mean nothing is wrong, and why a thorough history matters. He closes by highlighting six past guests who show these qualities: Dr. Neil Nathan, Dr. Mark Pimentel, Dr. Richard Horowitz, Dr. Mariana Castells, Dr. Kari Nadeau, and Dr. Paul Offit. Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

Dr. Richard Horowitz reports the first published case of reversing P-tau 217, the most sensitive and specific Alzheimer's biomarker, in a live patient using a nine-week oral dapsone combination protocol, lowering it by 63% compared to the 23% reduction seen over six to seven years with anti-amyloid drugs like lecanemab. Author of the upcoming book Ending Chronic Illness, Dr. Horowitz breaks down his 16-point MSIDS model linking chronic Lyme disease, Bartonella, mold toxicity, and biofilm-persistent infections to Alzheimer's, long COVID, chronic fatigue syndrome, fibromyalgia, and autoimmune disease. He and Dr. Dean Mitchell also cover how to take a proper differential diagnosis history, why dapsone blocks the NLRP3 inflammasome pathway driving brain inflammation, and practical tick-bite prevention with picaridin and permethrin-treated clothing. Social Media: LinkedIn: linkedin.com/in/richard-horowitz-b4634012 Facebook: facebook.com/drrichardhorowitz Instagram: @drrichardhorowitz Websites: Book (Ending Chronic Illness): cangetbetter.com/ending-chronic-illness Primary site: cangetbetter.com Resources / Book Links: Medical Detective Substack: medicaldetective.substack.com Dapsone documentary (2024): DrTalks: Discover Healing 18 - Dapsone Testimonials Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

In this live, interactive Q&A webinar, Dr. Dean Mitchell draws on 25 years of holistic and functional medicine training to answer real time questions from patients, caregivers, and healthcare professionals. He opens by explaining the physiology behind why chronic stress becomes physical illness, connecting the sympathetic and parasympathetic nervous systems, heart rate variability, and the vagus nerve to conditions ranging from skin rashes to gastritis. Drawing on his training with Dr. Dean Ornish, Jon Kabat-Zinn, and Dr. Herbert Benson at Harvard, Dr. Mitchell walks through the Holmes-Rahe stress scale and a simple diaphragmatic breathing technique anyone can use to shift into a calmer, parasympathetic state. From there, the conversation moves into audience questions. Dr. Mitchell explains why chronic sinusitis is so often overtreated with antibiotics and steroids instead of addressed at the root, and how candida or fungal overgrowth, the subject of his book Conquering Candida, is frequently the real driver. He covers his approach to eczema and allergy testing, why he avoids skin testing in favor of blood work, and how sublingual immunotherapy drops can build tolerance for environmental allergies, dangerous food allergies, and candida overgrowth alike. He also addresses toxic mold exposure and the real time urine mycotoxin test he relies on for an accurate workup. One of the most personal moments comes when a caregiver who spent six years caring for her husband through Alzheimer's disease asks about a repeat esophageal dilation. Dr. Mitchell connects her story to the work of Dr. John Sarno, the mind-body medicine pioneer who also treated Dr. Mitchell's own chronic back pain, and the idea that caretakers and "do-gooders" often pay a physical price for holding everything together. Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

Jaw pain, clicking, locking, and limited opening affect millions of people, and most patients are told to reduce stress, wear a night guard, or wait it out, without ever learning why the problem started. Dr. Donald Tanenbaum, a specialist in orofacial pain and a Diplomate of the American Board of Orofacial Pain, joins Dr. Dean Mitchell to explain what TMJ actually means (it's a body part, not a diagnosis) and why he treats jaw disorders as orthopedic problems, no different from a hip or a knee. Dr. Tanenbaum walks through the three pathways that drive most jaw problems: physical trauma, chronic stress and the mind-body connection, and underlying medical conditions like thyroid disease, GI dysfunction, and connective tissue disorders. He explains why the neck is one of the most overlooked contributors to jaw pain, why sleep bruxism is driven by the brain rather than a bad habit, and why most people who grind their teeth never develop a problem at all. The conversation also covers the three distinct types of pain (somatic, neuropathic, and nociplastic), why women make up roughly 70 percent of TMD patients, where Botox does and doesn't belong in treatment, and several memorable cases where an "alleged TMD problem" turned out to be something else entirely, including one patient whose jaw pain was actually a heart attack. Dr. Tanenbaum's new book, "Lockjaw: A Human Problem: What You Need to Know to Start Feeling Better," releases in early September 2026. Guest Contact Donald R. Tanenbaum, DDS, MPH Diplomate, American Board of Orofacial Pain | Fellow, American Academy of Orofacial Pain Practice: New York TMJ and Oral Facial Pain NYC office: 630 Fifth Avenue, Suite 1857, New York, NY 10111 — (212) 265-0110 Long Island office: 812 Wheeler Road, Hauppauge, NY 11788 Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

Johann Ilgenfritz was a fashion photographer with no background in healthcare when he was first diagnosed with melanoma in 2011. After two rounds of radiotherapy appeared to clear it, a follow up screening in 2012 found the cancer had metastasized to his eye, lungs, and spleen, and he was given roughly 12 months to live. Ilgenfritz, now the founder of UK Health Radio, joins Dr. Dean Mitchell to share how he approached that second diagnosis differently, starting his own research the same day he got the news. Seven months in, a single sentence from German biochemist Otto Warburg, that cancer cannot survive in an oxygenated, alkaline cellular environment, changed his outlook overnight. Ilgenfritz explains how he became a vegan within weeks, adopted an alkaline diet built around potatoes, leafy greens, and Himalayan salt, added intermittent fasting, and began daily meditation and long distance running, in part because movement is the only way the body's lymphatic system detoxes without a pump. He and Dr. Mitchell also discuss the pH science behind the alkaline approach, why he avoided extreme raw food and juicing protocols in favor of real meals, and how his energy and later his scans began to turn around within months. The conversation closes with how Ilgenfritz's own healing journey led him to found UK Health Radio in 2012, now reaching 1.7 million listeners, and his advice for anyone newly facing a cancer diagnosis: stay open to every tool available, and use them alongside, not instead of, the treatment you and your doctor agree on. Guest Contact Platform: UK Health Radio (founded by Johann Ilgenfritz) Book: Reversing Cancer UK Health Radio (UKHR) website: https://ukhealthradio.com/ UKHR Facebook: https://www.facebook.com/UKHealthRadio/ UKHR X: https://x.com/ukhealthradio UKHR Instagram: https://www.instagram.com/ukhealthradio/ UKHR YouTube: https://www.youtube.com/ukhealthradio Alkaline Collective Mastermind website: https://alkaline-collective.com/ Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

Cardiologist Dr. Alexis Cutchins joins Dr. Dean Mitchell to break down POTS, postural orthostatic tachycardia syndrome, a condition defined by a heart rate increase of more than 30 beats per minute when moving from lying down to standing, without a drop in blood pressure. Dr. Cutchins explains that POTS is not a single diagnosis but one symptom within a larger picture that frequently overlaps with mast cell activation syndrome, hypermobility, and Ehlers-Danlos syndrome. The conversation covers what may be driving the condition, including an autoimmune component, small fiber neuropathy, and vascular compression syndromes such as jugular vein compression and pelvic venous congestion. Dr. Cutchins shares findings from her own published research showing that 83% of her POTS patients had iliac vein compression on imaging, and that stenting the iliac vein helped 70% of patients with orthostatic intolerance. She and Dr. Mitchell also discuss why COVID-19 and long COVID have driven a sharp rise in cases, alongside other triggers like viral infections, Lyme disease, bariatric surgery, and major life stressors. Dr. Cutchins walks through how she evaluates patients, including holter monitoring, echocardiograms, and a 10 minute stand test rather than the tilt table test, which she says can worsen symptoms. She outlines her treatment approach, starting with antihistamines, salt, fluids, and compression, then medications like nadolol, propranolol, ivabradine, calcium channel blockers, fludrocortisone, desmopressin, midodrine, and droxidopa depending on the patient. She also covers which forms of exercise, like swimming, recumbent biking, and strength training, tend to be best tolerated. Guest Contact Social Media: LinkedIn X (Twitter) Instagram Website: Cutchins Cardiovascular Medicine Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

Psychiatrist and neuroscientist Dr. Dave Rabin returns to the podcast to discuss his new book, A Simple Guide to Being Alive, and why he believes healing from chronic stress and illness is simpler than most people are taught. Dr. Rabin explains that the autonomic nervous system, specifically the balance between the fight or flight sympathetic response and the rest and digest vagus nerve system, sits at the core of how the body handles stress, illness, and recovery, and that most patients are never taught the basics of how these systems work. Dr. Rabin and Dr. Mitchell talk through why techniques like deep breathing, meditation, and mindfulness work, tracing the idea back to teachings from Jon Kabat-Zinn. Dr. Rabin describes how breathing at five to seven breaths per minute helps the body access a calm, present state, and how his company Apollo Neuroscience developed a wearable device that uses touch based vibration, rather than sound, to raise heart rate variability and vagal tone within two to three minutes, based on research conducted at the University of Pittsburgh Medical Center. The conversation turns to why Gen Z is showing declines on standardized cognitive testing, and how chronic nervous system stress, screen time, and a lack of in person mentorship may be contributing factors. Dr. Rabin also shares his approach to helping children work through tantrums and difficult emotions, why parents model stress responses for their kids whether they realize it or not, and why physical touch and safe human connection remain central to healing, even as modern medicine has grown more cautious about it. Guest Contact Facebook Twitter/X Instagram LinkedIn Websites: Book: asimpleguidetobeingalive.com Personal/Clinic: drdave.io Apollo Neuroscience: apolloneuro.com The Board of Medicine: boardofmedicine.org Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

Simple daily breathwork can meaningfully calm your stress response, Dr. Dean Mitchell explains in this week's tip. A few minutes of slow, deep abdominal breathing tops the list, since most of us breathe shallowly under stress in ways that quietly affect the heart, lungs, and oxygen levels. One striking example: just five minutes a day of basic breathing exercises, easily learned from free videos online, can have a profound effect on overall health. The key is making it a daily habit rather than a one-off fix, then noticing how much steadier you feel handling everyday stress. You can't stop the waves, but you can learn to surf. For the full conversation, listen to Ep. 238 with Dr. Dave Rabin on The Smartest Doctor in the Room. Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

Nuclear medicine treatments use very small, carefully controlled amounts of radioactive material that decay to nontoxic levels within minutes to days, making them far less taxing on the body than standard chemotherapy. Cathy Cutler, PhD, FSNMMI, of Brookhaven National Laboratory joins Dr. Mitchell to address the fear many patients feel at the word "nuclear," explaining how these treatments target cancer cells directly while leaving healthy tissue largely untouched. She discusses new alpha-emitting isotopes now helping patients who have run out of other options, the workforce and supply challenges facing the field, and why patients on these therapies often report a far better quality of life than those on traditional chemotherapy. Connect with Cathy Cutler: Social Media: LinkedIn Websites: isotopes.gov Resources/Publications: Radiopharmaceutical Therapy: Rapid Growth, Rising Challenges, and the Critical Need for Expertise — J Nucl Med PET Drugs — 2023 Workshop Proceedings — J Nucl Med Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD

If a tooth gets knocked out, place it between the cheek and gum immediately, since the chance of successfully saving it drops by roughly 10% every ten minutes if it isn't found. In this episode, Dr. Joseph Alton (Dr. Bones) and Nurse Amy Alton join Dr. Mitchell to break down what it actually takes to be medically prepared when help isn't immediately available. They cover why a $30 to $35 military-grade tourniquet belongs in every car and go-bag, how the stretchy SWAT tourniquet is designed to fit children who can't be treated with standard sizes, and why hemostatic dressings should be paired with any tourniquet for serious bleeding. They also explain how raw, unprocessed honey is used in hospitals to treat burns and staph-resistant wounds, how two drops of clove oil mixed with zinc oxide can form a temporary dental filling in a pinch, and why staying calm with an injured person can be just as important as the medical supplies themselves. Dr. Alton and Nurse Amy also share the real story of a nurse whose emergency kit helped her save two lives in a car accident years after she first bought it. Guest Contact: Social Media YouTube Instagram Facebook Group: Survival Medicine DrBones Websites doomandbloom.net altonfirstaid.com Resources/Book Links The Survival Medical Handbook: The Essential Guide For When Help is NOT On The Way Live Q&A with Dr. Mitchell, August 19: How Stress Turns Into Disease, and What Actually Works to Lower It Nobody just gets colitis. Stress goes looking for your weak spot, and thirty years of practice says it usually finds it. Dr. Dean Mitchell is live on Wednesday, August 19 at 6:00 PM Eastern for a free hour: the Holmes-Rahe scale, what HRV shows, which relaxation methods have evidence behind them, and where medication belongs. Register here Contact Dr. Mitchell: Email: [email protected] Website Instagram YouTube Facebook LinkedIn Book: Conquering Candida ImmunoLytics - code SmartestDoc, 5% off Apollo Neuro - code SMARTMD