Why Chronic Illness Needs a Different Kind of Healthcare
In this episode, Haylie Pomroy is joined by Dr. Craig P. Tanio to explore the evolving field of brain health, including current approaches to supporting patients with chronic illnesses, the importance of multimodal interventions, and the value of partnering with healthcare providers who advocate for their patients.
Dr. Tanio shares his journey into caring for individuals with complex chronic conditions through a “clinic without walls” approach, explains why patients should actively evaluate and engage with their healthcare providers, and discusses the importance of finding clinicians who foster trust, compassion, and hope.
Together, they also examine how data-driven insights can enhance personalized care and highlight strategies that may support cognitive function and long-term brain health.
Discover how patient-centered care, innovative approaches, and brain health strategies can help improve outcomes for those living with chronic illness here on Fast Metabolism Matters.
If your body feels like it's running on empty, overburdened, or just not responding the way it used to, Haylie's latest book, Toxic Overload, tells you exactly what to do. Download your free digital copy today and start understanding what your body is trying to tell you.
Free Download: Get Your Copy of Toxic Overload 👉 https://hayliepomroy.com/pages/toxic-overload
You don't have to figure this out alone. Inside Haylie's private membership community, you get personalized guidance and support, member discounts on supplements and shakes, and the ability to ask questions directly to podcast guests like Dr. Systrom. Join free for 30 days and take the next step on your health journey.
Join the Fast Metabolism Membership — First 30 Days Free 👉 https://hayliepomroy.com/pages/fast-metabolism-membership
Dr. Craig P. Tanio, MD, FACP, IFMCP, is a co-founder of Rezilir Health and a physician trained in general internal medicine, brain health, longevity, precision medicine, and functional medicine. He oversees the clinical team caring for patients with complex chronic conditions, including cognitive decline, neurodegenerative disorders, ME/CFS, Long Covid, autoimmune conditions, and environmentally acquired illnesses. Dr. Tanio earned his BA from UCLA, MD from UCSF, and MBA from the Wharton School, and completed his residency and fellowship at the University of Pennsylvania. He is board certified in internal medicine, certified in functional medicine, and serves as a researcher, educator, and faculty member at Johns Hopkins School of Medicine and Nova Southeastern University.
Website: https://www.rezilirhealth.com/
LinkedIn: https://www.linkedin.com/in/craig-tanio-51088a/
Haylie Pomroy, Founder and CEO of The Haylie Pomroy Group, is a leading health strategist specializing in metabolism, weight loss, and integrative wellness. With over 25 years of experience, she has worked with top medical institutions and high-profile clients, developing targeted programs and supplements rooted in the "Food is Medicine" philosophy. Inspired by her own autoimmune journey, she combines expertise in nutrition, biochemistry, and patient advocacy to help others reclaim their health. She is a New York Times bestselling author of The Fast Metabolism Diet.
Learn more about Haylie Pomroy's approach to wellness through her website: https://hayliepomroy.com
Instagram: https://www.instagram.com/hayliepomroy
Facebook: https://www.facebook.com/hayliepomroy
YouTube: https://www.youtube.com/@hayliepomroy/videos
LinkedIn: https://www.linkedin.com/in/hayliepomroy/
X: https://x.com/hayliepomroy
Transcript:
Dr. Craig P. Tanio: We can impact the brain, but what is really needed is a different approach to brain health that is going to be a bit more of a generalist approach. The brain has really been the purvey of the neurologists and the psychiatrists, but if we're seeing that most complex chronic conditions have issues in the brain, you have to get comfortable with looking at the brain.
Haylie Pomroy: I'm Haylie Pomroy. I'm a #1 New York Times best-selling author, and I'm the former assistant director of the integrative medicine program at the Institute for Neuro-Immune Medicine (INIM). I say former because that's right, you guys, I am back in school again. I am working on my PhD in neuroimmunology. When I decided to do my PhD, I looked for the world's best place in neuroimmune medicine, and of course, that landed me right here at INIM, and I am so glad to be with my team. Today, we're going to talk about brain health.
I think that's a subject that is near and dear to many of our community members. When the subject of brain health came up, and I wanted to have that discussion, Dr. Klimas, Dr. Rey, Dr. Irina, everybody said that there is the perfect doctor for me to ask all of your questions to, and that is Dr. Craig Tanio. He is the co-founder of Rezilir Health. That is a clinic that specializes in brain health, cognitive issues, and works very closely with us in neuroinflammatory and chronic disease. Dr. Tanio, first of all, thank you so much. I know you're crazy busy, but thank you for being here with me.
Dr. Craig P. Tanio: Haylie, it's my pleasure. Excited to be on the show.
Haylie Pomroy: When I started pulling topics, and I wanted to talk about brain health, we are neuroimmunology, we have immunologists, neurologists, everything in our practice, your name came up over and over again, and then we had a moment to chat, and I can absolutely see why.
My first question is, you're also an adjunct professor for us, so I get to have you in clinicals on Friday sometimes, which is great. I always talk to our community about how valuable that time is where we all come together, but an extensive background. How did you come to be an adjunct professor at NSU? How did we start working together?
Dr. Craig P. Tanio: It's really just through networking. Irina made the introduction between myself and Nancy, and we've tried at Rezilir really to be active collaborators in the variety of communities that there are out there, and it made a lot of sense to me to really try to collaborate within them around the whole issues around chronic fatigue and brain health.
Haylie Pomroy: Dr. Rozenfeld, Irina, she said that you have a clinic without walls, which means like your reach for solutions for your patients is global. It's extensive. That's why we love to ask you all the questions that we do on Fridays. I always feel bad when you can be there, I feel like we just pepper you, but it's appreciated. You have to know that, it's on behalf of all of our patients.
Share with me a little bit about, you're now co-founder of Rezilir Health, but how did you get there?
Dr. Craig P. Tanio: I've always been a generalist at heart coming into medicine, really from very interested in how medicine intersects with politics and business and such, and so really been working the issue of how we can get the healthcare system to work well for patients with complex chronic conditions.
Haylie Pomroy: Is that possible?
Dr. Craig P. Tanio: Well, I know that we can do better, and that I do know that there's been multiple examples of where you can actually implement better. And so really been working that angle for about three decades. I started my career in federally qualified community health centers and working with the uninsured in urban Baltimore, and then just kind of pivoted to being a partner at McKinsey & Company, really working with a number of health systems on the issue of how do you actually improve the quality of medical care.
I came down to Florida about a decade and a half ago to really help build a joint venture in Medicare Advantage called JenCare, and really grew that company to, I think, a considerable presence and really kind of perfected the art of getting an urban one-stop-shop for high-risk Medicare and Medicaid dual eligibles. And that was able to really get ideal care following, let's call it, guideline medicine. And then about 10 years ago, I became very interested in what was out of the guidelines, and particularly, it started around brain health.
Dale Bredesen had come out with a book called The End of Alzheimer's as an initial publication. And to me, it just made complete sense that what we were trying to do to get the brain to work better is really trying to fix a number of things in both the body and the brain. And you really needed to be what I would call the expert generalist. You needed to take a pretty comprehensive look. And there was an approach, which was really, I think, about addressing the root causes and trying to really guide the body to health. And I think those principles have held. A lot of the science has continued to evolve, but brain health has really been the area that the company we co-founded in 2017 it's really kind of been central to what we're doing.
Haylie Pomroy: It's interesting because you use the word generalist. And I think we kind of went from generalist maybe your internal medicine or your primary doctor, being just this many decades ago, being this person that just knew you. Knew you, knew your body, knew when there was a problem. And maybe a specialist would be called in once the problem was identified and something needed to be surgicized, or something needed to be maybe even a little bit further diagnosed. And then we went into this siloing of medicine where everybody became a specialist. And your foot was not connected to your head, was not connected to your gut, was not connected to your elbow. Nothing was kind of integrated. And then there was this practice of holistic or when I started 30 years ago, alternative. Now it's integrative or functional. I love to have them under the umbrella, back of a generalist, in a way of understanding that the body is so interconnected.
Dr. Craig P. Tanio: And it's interesting because with that historical view, I think there's really been two eras of integrative medicine. 1.0, I think, was really in the 90s, where it was really a look at multiculturalism, really appreciating what different practices of medicine had to bring to bear. And I think really this version is a bit different because what you're seeing is that systems biology and what the research that's happening in the basic science side is having a challenge getting translated into the practice of medicine in as, I think, effective a way as possible.
And the biggest reason, I think, is because most systems don't encourage a generalist to look at the whole picture and then also to have the time to really work with patients and put it all together. We're OK with having eight specialists see a patient and having eight hours of care, but God forbid we have one person spend four hours with a patient and really put it all together. And that's missing in the system today.
Haylie Pomroy: Hi, it's Haylie Pomroy, your host. I've written six New York Times bestselling books on metabolic pathways. And my latest book, Toxic Overload, tells you exactly what to do when your body's overburdened.
If you go to hayliepomroy.com/book, for a limited time, you can download a digital copy of this book completely free. That's hayliepomroy.com/book. Grab your free copy while supplies last. Now, back to our show.
You just made something very clear for me personally. Years ago, in the practice that I created, I called myself a health strategist. And usually a doc referred me, maybe someone's friend or family member, maybe a team, a sports team, or something like that. And I would get these charts from all the different doctors in. And I think I was just the only person that had the time, or maybe my hourly was low enough or whatever it was. My brain worked in a way to look at things holistically. It was just born that way. And I would sort through all this. Now there are databases for drug interaction. But when I first started, there weren't good databases for drug interaction. And I can't tell you how many times there was a drug interaction. There was misinformation, like labs weren't shared with other docs, especially if they were out of provider networks and stuff like that. That began my whole career. I'm a nutritionist by trade. I have education in basically problem-solving on a lot of different facets. But I always thought, why in the world would anybody need my services, which they do, I get it, if we could compensate doctors that would do that?
Dr. Craig P. Tanio: Well, and the system has tried to integrate some of those pieces before from a data perspective or systems perspective. But what's oftentimes missing is that you need the human perspective and somebody needs to be looking through that data from the perspective of I care about the patient, I want to help the person to get better, and what's really going on. And you cannot teach a system how to do that.
Haylie Pomroy: You can't. And for me, a lot of times it'll be someone that's highly involved in a hospital, a large donor of a hospital, or something like that. And they'll go, look, we've got this, this person gets any access to care, but someone needs to communicate with the patient and then come back and communicate with all of us because we're getting 10 different details, 10 different stories. But what you just said, I think distilled, because I've always wondered, I said, why would anybody need me? Because these are amazing doctors or whatever, sometimes that's not the case. But a lot of times with my clients, it is the case, but it's just kind of pulling that together.
We always joke or not joke, we always say that we integrate so many different things and are trying so hard to translate the data into actual improvement in the patient, not because we just thought it was a good thing to do, but because the patient's body required it. We weren't getting the results. And we have top doctors, top immunologists, top neurologists, environmental medicine, but it wasn't until we started to, I hesitate to use integrative because we're an integrative being. I don't know how we're going to not have integrative medicine. I just don't know how we can possibly do it. It's been tried. It's not been as successful as we'd hoped, I suppose.
But how we integrate it all because with chronic disease, it requires it. I have not seen anybody get better on a singular treatment in 30 years.
Dr. Craig P. Tanio: Absolutely. I mean, if you're saying what's the operating system, the new operating system to take care of complex chronic conditions, the first thing is to say, how are you going to be at implementing multimodal interventions? You have to do multiple things at the same time. You have to get to the tipping point. You have to have objective biomarkers to see that you're making that progress. And you have to work with the patient's psyche, their values, and preferences to kind of strategize and say what's going to really work.
Haylie Pomroy: Putting the patient in the equation.
Dr. Craig P. Tanio: Absolutely. And when you have the number of patients who have complex conditions and many times they've lost hope, it has to be personalized. It has to be precise and personalized. But I think the good thing is that with proper strategizing and implementation, you can make an extraordinary difference in individuals' lives. And I've had the fortune, a chance, to work with first-year residents at Johns Hopkins Bayview for a number of years. And I always ask them the question, how many times have you seen a patient with complex chronic conditions get better? And unfortunately, it's not that high a percentage. And that should be the thing that we're wanting to see as clinicians. That is the high that we're looking for.
Haylie Pomroy: I think it's an epic failure because it's not an expectation, first and foremost. A group of us just traveled internationally to some conferences, and I was so surprised that they were like, " This is the endgame.” Like the end game is to get the patient better. Not just to get the patient treatment. I mean, a lot of it was the patient's treatment just so that they can make it to their next appointment or not. But the end game was never in so many cases to get the patient better, or we're not witnessing it, or we're not seeing it.
Dr. Craig P. Tanio: Well, I think that the whole notion of evidence-based medicine got corrupted the last couple of decades, where I think the initial push of that in the 80s and 90s was very laudable. Look, we just want to structure our research. We want to make sure that what we're recommending has grounds in science. And that's all well and good. But now what's happened is it's basically a retrospective look saying, if you don't have $20 million for a randomized control trial, it's not getting in the guideline.
Haylie Pomroy: And what happened, I'm just going to use acupuncture in that one because I grew up, my mom was an acupuncturist, specialized in fertility. She's got a PhD in reproductive endocrinology, but worked in the acupuncture space. And our fertility docs were like, our statistics are better. But are we going to go do a trial and a study on something that's been centuries, and the patient proving, and someone said, well, it's because they think they feel better. It's placebo. And I said, well, I don't agree, but what if that was true? Talk about how little side effects you have from a placebo. If I feel better, if I can walk better, if my periods are better, if my headaches go away because of a placebo, which I don't believe that to be with Chinese medicine, that it's placebo. I think it's really sound science. But if it was, why is such a bad thing? It’s that evidence-based, and also I think it really has led into medical gaslighting, in my opinion, where the patient's experience is discounted as not science.
Dr. Craig P. Tanio: Because it's seen through the lens of a covered benefit. But so much about getting people better is you're looking at their budgets and what they're spending resources on. And it's food, water, shelter, how they're spending their free time. And as you're putting together a comprehensive plan, you're actually giving them guidelines around how to spend those resources correctly and how to divert that to the best health. And so it can't just be, well, this is what the insurance is covering. This is what it isn't covering. It's about what is going to really be the best use of their time and effort.
Haylie Pomroy: And resources. Sometimes I feel like I'm so indoctrinated. I've been in the industry for a long time. I grew up really exposed to a lot of integrative therapies, did chiropractic as babies, as kids. My parents did for us. We did food allergy testing and all of that. But I recently had a situation where my daughter ended up in the hospital at a great university, UCLA, which I love. I have a lot of great doc friends over there. They treated her fabulously. And they are more progressive. I physically transported her from a tiny hospital in Wickenburg, Arizona, to UCLA because they are much more integrative. But the immunologist and the infectious disease didn't talk at all. And the infectious disease doctor said to me, I said, well, why would her labs be this? And why would that? And she goes, we don't really study the immune system very much in infectious disease. If I didn't have two witnesses sitting in the room, nobody would have believed me. I didn't know if I should cry or bang my head against the wall. I feel like the universe provides me with those very loud awakenings, because that is a little bit of what a lot of people are dealing with.
Now, the reason why I drove her in the middle of the night from Wickenburg, Arizona, with four dogs and three horses to the hospital at UCLA was because of the response that I was getting in Wickenburg. I would have been better in a hospital for sure. Like, no doubt about it, because at least they would have looked at her gums and her pulse. And I'm so versed and so connected in the medical community. In our community we get a lot of questions about how do they talk to their doctor about looking at them just as a whole as a holistic human being, as a whole human being? You are so good with communication and language. But also, I think the fact that you can process a ton of data.
How can someone communicate effectively? I got really quiet. And then I repeated the comment. And then I said, can you help me understand how virology and immunology don't integrate? I mean, I was trying to not be a smart you know what. But the largest question when people were seeing that you were coming on is, how can I talk to my doctor to get them to at least accept me the way you accept your patients? How can you change all the doctors? But I mean, just at least help us be better at communicating when we walk in the door.
Dr. Craig P. Tanio: Well, I think the first thing is to have a sense and a vision of what you're looking for, ideally, from a clinician to be really your guide in the system. And I think that so much of the time on podcasts and such, we talk about what is getting done. And I think here, the more important lens is how it's being done, because if you get the how right, those are principles and values that should stay immutable. And then as evidence just gets refreshed and revised, that's going to change the what.
We have about six or seven sort of principles around how we do practice that I could just share. And then I think that could be helpful for your listeners.
Haylie Pomroy: And even that they could interview their doctor. I was talking to another individual interviewing, and I said, when we're looking for a pediatrician or an OBGYN for pregnancy, oftentimes we'll interview a doctor to see if they're the right pediatrician for a kid, to see if they're the right doctor to deliver our baby. Is this the person we're going to want to be with in that vulnerable moment? But we don't do that for our primary care. We take whoever, or maybe a friend refers or something. But I sent my son off, we had changed plans, and I sent my son off to a visit, and he said, why am I having a visit? I'm not sick or anything. I said, you've got to go interview the guy, this is who we got assigned to. You need to see if he's going to be your doctor. And he was talking to his buddies, and they said, you interviewed your doctor? And my son said, yeah, because that's who I'm going to go to when I have a problem. But we don't even do that.
Dr. Craig P. Tanio: And we've evolved our practice so that most people who see me initially, we do a one-time consult that allows them to interview me and then get that process where we're very upfront with this is who we are and here's how we can help you. And if it's not a good match, it's not a good match. It is okay. And we're very upfront.
And so if somebody says, well, they're looking for somebody who's an expert in naturopathic medicine, that's not going to be me, and that's okay. I have a lot of respect for what they do, but I'm not a naturopath. And so some of the principles is, I think, two are very basic, which is you want somebody who really does care and really care from their heart. And that it's going to be a practice that really fosters hope with a lot of complex conditions that hope gets lost very quickly. And unfortunately, we have seen a lot of patients be told stories where they've, it's just designed to lose hope right from the start.
Haylie Pomroy: Hi, it's Haylie Pomroy, your host. When I was going through my health crisis, the worst part of it was feeling lost and alone. And I decided that I didn't want anybody else to feel as desperate as I did. That's why we set up a private membership group where you can come in, ask questions, get support, be connected with people that can actually help you on your health journey. If you go to hayliepomroy.com/member, you can join me for 30 days for free. I'll see you there. We can jump in and we can start to organize the path for your wellness. That's hayliepomroy.com/member. I will see you there. Now, back to our show.
When I was diagnosed with my autoimmune disorder, they said we'll hold out as long as we can for a splenectomy, then we'll start you on some IV chemotherapeutics. And that was after Imuran, CellCept, Mepron, Prednisone, you know what I mean? And I'm just going like what? Again, I was fortunate. I had a lot of support system. But you just said, like, I think it would be very reasonable to ask a doctor that you're interviewing is, do you care about your patients from your heart? Do you care about your patients? And the other is, when I'm struggling, are you going to hold out hope that I'm going to get better?
Dr. Craig P. Tanio: Exactly. Those are good. The expert generalist, I think, is more of a philosophy and an approach, which is you're open to new ideas. You're trying to integrate it together. You don't see that you have the keys to the medical kingdom. I have no problem with patients bringing me data. Some of the best concepts we have are coming from patients all the time. It's not an issue as long as they don't want an immediate turnaround on what I think. That's kind of our approach.
They don't want you to be a robot.
Haylie Pomroy: OK. I love that. Like, are you open to new ideas and new approaches when it comes to me as your patient?
Dr. Craig P. Tanio: And then we like the concept of evidence-informed medicine because just because we're saying, OK, it's not about guidelines doesn't mean that a number of principles shouldn't have some backing in science and research. And there's a lens on how to look at that. I think the collaborative mindset is really important. I think in the integrative world, the piece that I get very concerned about is this move to proprietary systems. Everybody's wanting to have their intellectual property. And I think that's actually a key barrier in this approach, really getting into mainstream medicine.
I don't believe just from a first principles ethics standpoint that any systems of care should be proprietary. We should be actively sharing it, opening it for criticism. That's how you advance is that people criticize approaches. And then, but the second you say it's my proprietary database, it isn't open to as much critique.
Haylie Pomroy: We can't even get articles from PubMed without paying for it. NIH articles. I mean, fortunately, that's why I always say I'm a perpetual student, because I want free science articles. I mean, probably other reasons, too. But that was so shocking to me when I became a non-student for a period of my life. Was it suddenly I couldn't see the research anymore. The layperson doesn't have access to the research on the drugs that they're taking for chronic disease. I mean, you can't go in. You can see the little abstract or whatever, but you can't see how the study was done. And that just blew my mind in science and research, and then in integrative medicine, or even, I'm an author, and when I published the big first big book, they were like oh, you've got to shut this website down. This ship went so down in this person. We had Facebook groups that popped up that had 275,000 people, several Spanish speaking one.
And they were like, go shut them down. They're using your data, and you're using your knowledge. I said, it's nutrition. Don't put my face where your face belongs because I would like some autonomy. But my goodness, and and a lot of the docs or a lot of the people that write nutrition books and diet books, especially. I mean, they are like vicious about intellectual property stuff. And again, I am supportive of that. We're not going to shut down any of these groups. You know what they were doing? They were helping other people eat healthy. And we sold millions of copies in 47 languages. And I didn't have to hoard what I had learned. I didn't create nutrition. It was the gems that I'd gathered mostly from my clients, quite frankly, over the years.
Dr. Craig P. Tanio: And it's really approaching it from a professional and ethics values perspective and not just saying we're going to be a business maximizer. And that's, I think, critical for all clinicians in the space to just kind of start with those first principles. And then the last one is really how do you practice sort of n-of-1 medicine the best way, which is you take as a given that you're out of the guidelines, so that you're going to have to have a set of approaches and rules to see that people are getting better.
Haylie Pomroy: Just explain to our community, n-of-1 means? In a study, in a trial, let's say we're doing a science-based trial, a university-based trial or whatever trial. N is how many people are in the population that are going through the trial with the set variables?
Dr. Craig P. Tanio: Correct. N-of-1 is probably the best way to say it is we're personalizing it to you. Precision medicine for you.
Haylie Pomroy: For you. But what I love is, in our community, we talk a lot about we need a protocol for progress, like we need some sort of data that sees that we're moving in the right direction, just as importantly, that we're moving in the wrong direction. It didn't work. Fail faster. I mean, not fatally, but in trying to shift something medically, if something doesn't work, I love that data because it helps me pivot.
Dr. Craig P. Tanio: Absolutely. And get to your destination quicker. And so what's great about brain health now is that in the beginning, many of these situations were framed as, well, somebody is coming in with brain fog. And it's like, okay, well, what do we really mean by that? And so if we're trying to break that down into more specifics, we can do cognitive testing in 20 or 30 minutes with computerized tests, CNS vitals, and say, how is your executive function, which is sort of your frontal lobe? How's your memory? How's your processing speed? We can get objective measures and use that as a marker.
We've been using quantitative EEGs to look at the brain maps, and those we will see that if you get interventions that are making a difference, you can see that change within a week. It has great temporal resolution, not maybe as much spatial resolution as a functional MRI, but it's an inexpensive test to really follow progress, and we will oftentimes see the brain maps change well before the symptoms do. That helps to guide the therapy. Symptom surveys are great, but objective biomarkers are critical. And what's terrific now in neurodegenerative conditions is there's a whole set of new biomarkers around neurodegenerative biomarkers that are available in LabCorp and Quest.
Haylie Pomroy: We get more insurance coverage. I mean, sorry, but that's so important.
Dr. Craig P. Tanio: It's critical.
Haylie Pomroy: It is. And what's so interesting is, again, I work in a large community that we're just trying to advocate for people, and they'll say, oh, my doctor said they won't run that because it's an alternative testing. And then we'll go back and say, here, it's on Quest. It's on LabCorp. And they go, oh, boom, they'll check the box. Because it's almost like it's had that blessing of LabQuest. I mean, because they're large companies that have serviced. The doctors feel familiar and comfortable with those. That is one of the biggest tricks that we teach our community is if an integrative medicine, if somebody has suggested an out-of-the-box, I don't want to use the word non-traditional, non-common lab test to be run, do your research. And we'll call Quest ourselves, and we'll call LabCorp ourselves, and we'll say, hey, they want to run a cytokine panel. They want to run, I'm trying to think of something else I ran the other day, a cortisol curve. And I was so excited. And Quest said, oh, yeah, we do. You script it this way, this way, so this way. We went back to the doc, told them that. They had said no, no, no to this person that has Hashimoto's thyroiditis for four years. We went back with the Quest data, and they said, oh, no problem. Forgot the four years ever happened. That's okay. We'll do a little EMDR for trauma. But I know I don't have you much longer, I have a million questions on brain health. Not a million, but a few. Why is the brain so hard to impact?
Dr. Craig P. Tanio: Well, I would maybe reframe it. I would actually say I think that we can impact the brain. But what is really needed is a different approach to brain health that is going to be a bit more of a generalist approach. The brain has really been the purvey of the neurologists and the psychiatrists. And if you look at their training, they basically get a year of general medicine, and then they go on their specialty approach. And if, let's say, contrast that with a cardiologist who gets three years of general medicine.
And so it has kind of been reserved. If you want to look at the brain, it's going to kind of be in that area. But if we're seeing that most complex chronic conditions have issues in the brain, and we're seeing that with the MECFS work, but we're seeing it broadly with multiple other conditions.
Haylie Pomroy: And long COVID.
Dr. Craig P. Tanio: Long COVID, absolutely. You have to get comfortable with looking at the brain. And so there's going to be a whole set of tools there, but that's got to be available to a much broader set of people going forward.
Haylie Pomroy: Do you have a newsletter, or can people get a hold of you? I mean, I don't want to flood your practice with questions. I know that they can reach out to you if they want an appointment. Again, we get lucky. We get you in our, as an adjunct professor, we get you in our clinicals on Friday. How do people get more of this from you?
Dr. Craig P. Tanio: We have an email address, therezilirway@rezilirhealth.com and we can make that available. And if somebody can just send us an email, we'll be happy to respond. And I think if there are a lot of similar questions, then we'll try to put some answers together. But we welcome a dialogue with the community on these issues.
Haylie Pomroy: When we do these podcasts, and I mean, just even the first part of it, I know our community is going to have so many questions because I know it's going to really resonate and pertain to them. We have a lot of individuals that are dealing with POTS, that are dealing with ME/CFS, that are dealing with a lot of autoimmune disorders. And now we are seeing this massive influx with long COVID. For people that can't see you, will you please come back on the podcast?
Dr. Craig P. Tanio: I'd be delighted to.
Haylie Pomroy: Perfect. Because I would love to just, I know it's coming. I know our community. I know you guys very well. A lot of people are going to ask us what types of symptoms are worrisome in long COVID. What can they do from a brain health perspective with long COVID, with chronic disease? I mean, I know that they're going to want to ask, kind of from a generalist perspective, what do you see? What are you seeing be impactful?
If you were to say someone out there right now is struggling with brain health and cognitive issues, are there some things that they can do in their everyday life that you've seen over the years make a positive impact?
Dr. Craig P. Tanio: Well, I think it is important to, with general symptoms still, to get a better specific understanding of what exactly is going on. And so, for example, with COVID, one of the things we have seen in our older population is we see so much asymptomatic COVID where there's a cognitive deterioration, and there are no physical symptoms.
Haylie Pomroy: They have no fever?
Dr. Craig P. Tanio: No. Nothing.
Haylie Pomroy: I had someone that we were talking about with our older patients, and a lot of them were saying that with this particular virus, some of them aren't mounting the immune response. So they're having like this slow burn.
Dr. Craig P. Tanio: But there'll still be clues. You'll see an elevated D-dimer.
You'll see the spike antibody go up. If you do T-cell testing, it's there. And we've seen, most importantly, a very positive response to antivirals and other sort of COVID-directed therapies. We've seen cognitive deterioration respond to an appropriate sort of post-COVID treatment. And that's been a significant observation in our population.
Haylie Pomroy: We had a client that had no, what we would call, first-line COVID responses. No fever, no loss of sense of taste, smell, but was diagnosed ultimately after six weeks at UCLA Psychiatric with sudden onset, what they call COVID psychosis. She had a massive neuroinflammatory response. And they said she's had a nervous breakdown. And then implored them to run, and luckily they were good partners in this process, run D-dimer, run the spike protein, run some of the mast cell testing. And it was shocking to me, or scary to me, that we wouldn't have even looked at it from — it was strictly a psychiatric event.
Dr. Craig P. Tanio: Yes. And when you break down a number of the psychiatric diagnoses, they end up being very symptom-driven and not necessarily root-cause driven. And so ultimately, all those symptoms do have a root cause. And I think part of this is having the humility to say, we don't know the answer, and what are we going to do? What are the treatment options? And can we kind of be systematic about working the issue? And what we've tried to do as a group is sort of every year, we try to add one or two capabilities around the problem and just kind of be systematically working it.
Five or six years ago, it was, let's have an environmental professional on staff because there are mold issues. Let's add hyperbarics. Let's add QEG and neurofeedback, high-intensity light. Now we've been using ketamine for the limbic system, which has been a great response in many of our chronic fatigue patients.
Haylie Pomroy: Do you have patients that fly in from out of the state?
Dr. Craig P. Tanio: Yes. Probably about 30 or 40% are out of state.
Haylie Pomroy: I'm so happy for you, but I'm so sad for the patients that they have to do that. But you have to do it. I mean, I jumped my daughter on a plane. I've done it. We've done it. I've gone out of the country because many years ago, it was not easy to get the care. We had a client that went to Russia 20 years ago for cardiovascular stem cells. You know what I mean? I've been to France. There's no stone unturned. Health is the only option, in my opinion.
Our community out there is listening. I really feel like the tenants of your practice can help them interview a practitioner and also give a lot of people permission, I think, to advocate for themselves in a way that, like, you always do things so systematically that I don't know how anybody could ever argue with you, because it's like fact. Heart fact. Heart fact. Heart fact. Whenever you describe stuff in the clinic, it's like, this is the right thing to do, and this is why we should do it. And the how. This is how we implement it. It kind of takes us from start to beginning. I know we're going to have lots of questions. Please tell me you're willing to come back.
Dr. Craig P. Tanio: Absolutely. I'm willing to come back. And maybe just to share one briefcase to just be upside.
Haylie Pomroy: That would be wonderful.
Dr. Craig P. Tanio: This was somebody who just was here a couple of weeks ago, but she was in her early 50s, and unfortunately, her mother had significant Alzheimer's, and so she came for prevention. She said, I'm not having any symptoms. I don't want to go down this road. And high level the verbal memory you can see here is in the first percentile. We did a, not an exhaustive workup, because she didn't really have any other symptoms. But we did a focused cognitive workup. We found a couple issues that we needed to address. And then five months later, her memory goes from, like first percentile now to the 99th percentile. And the biggest intervention that happened in here was actually an antiviral. It was not COVID. It happened to just be just Valtrex. There was just an asymptomatic.
Haylie Pomroy: Was it EBV?
Dr. Craig P. Tanio: No, I think it was more an HSV.
Haylie Pomroy: Wow. One of the herpes, another one of the herpes.
Dr. Craig P. Tanio: Exactly. And the antibodies were super high, and it was asymptomatic. And the problem is, we don't know when the virus is active in the brain. There's no perfect test to do that. This is where we just have to kind of look at the data and move. But when you are able to make that intervention, things move quite quickly.
Haylie Pomroy: But I think adequate, thoughtful diagnostics, too. And also, I think with the vast amount of patients that you've seen and the people that you tie into, I mean, this is why I'm studying neuroimmunology. The immune system, the nervous system, the autonomic nervous system, how the body regulates, it's just fascinating. There's so much we don't know. How could we ever tell a patient they're wrong?
Dr. Craig P. Tanio: No, it's serious AI that we only have, like, the basic understanding of. And that's why those principles are so important, because what we do is going to, it's a very exciting time, because I see that I look back five years ago and say, what can we do today than we did five years ago? It's significantly better. It's only going to get better. But we have to have the systems that can get this to more people. And we are doing this randomized control trial with cognitive decline right now. And our hope is that when the when it's published that there could be coverage of a precision medicine approach.
Haylie Pomroy: Are you still recruiting for the trial?
Dr. Craig P. Tanio: We are. We are recruiting until the end of July. And if people wanted to know about the trial, they could do that same email.
Haylie Pomroy: Can you say it for me one more time?
Dr. Craig P. Tanio: The the trial, actually, if they wanted to, if they were interested in the trial, because you have a broad audience there, there's sites that are in California, there are sites in Ohio, in Tennessee and in Florida.
And that would be info@dementiareversaltrial.com.
Haylie Pomroy: info@dementiareversaltrial.com OK, great. I'll post that on all when we post the podcast and on YouTube and everywhere.
Hey, this is Haylie Pomroy. And right now we're going to transition into our Q&A portion of the podcast. And you'll notice that we have live viewers asking us questions. They're my Fast Metabolism members and they get all kinds of amazing benefits, like member discounts on my world class supplements and shakes, every product, every day, personalized guidance and support from myself and my team, and even the ability to ask questions of our podcast guests. If you have questions and want to get them answered, you should absolutely join my membership. And if you go to hayliepomroy.com/member, you can join for free for 30 days. Again, that's hayliepomroy.com/member and join for free for 30 days. I can't wait to see you there.
Dr. Tanio, thank you so much for being here. I really appreciate it. I sometimes grieve for the fact that everybody out there doesn't have access to this kind of care. It's hard for me sometimes when I feel like I'm super fortunate to get to ask you guys. I know I drive you all crazy, but I get to ask you all so many darn questions. But it's really on behalf of the people out in the community that don't have access, but that are not going to be deterred. And that we believe them, that you believe them, and that we're advocating for them. I think can get them through another day of whether it's through connecting with Dr. Google or being lucky enough to pay to get on PubMed or reaching out and sending you guys an email, that there's hope out there. And we're watching patients get better. That was a really cool case study to look at, but we're watching patients. We're witnessing. We have the privilege of cheering them on on their journey and watching them cross some really significant barriers.
Dr. Craig P. Tanio: Absolutely. We need to know that if we all can kind of work together, we can get people better.
Haylie Pomroy: We can get people better for sure. Well, thank you so much for taking time. I know you're incredibly busy and we all appreciate it.
Dr. Craig P. Tanio: All right. Thanks for having me.
Haylie Pomroy: Absolutely.
In this episode, Haylie Pomroy is joined by Dr. Craig P. Tanio to explore the evolving field of brain health, including current approaches to supporting patients with chronic illnesses, the importance of multimodal interventions, and the value of partnering with healthcare providers who advocate for their patients.
Dr. Tanio shares his journey into caring for individuals with complex chronic conditions through a “clinic without walls” approach, explains why patients should actively evaluate and engage with their healthcare providers, and discusses the importance of finding clinicians who foster trust, compassion, and hope.
Together, they also examine how data-driven insights can enhance personalized care and highlight strategies that may support cognitive function and long-term brain health.
Discover how patient-centered care, innovative approaches, and brain health strategies can help improve outcomes for those living with chronic illness here on Fast Metabolism Matters.
If your body feels like it's running on empty, overburdened, or just not responding the way it used to, Haylie's latest book, Toxic Overload, tells you exactly what to do. Download your free digital copy today and start understanding what your body is trying to tell you.
Free Download: Get Your Copy of Toxic Overload 👉 https://hayliepomroy.com/pages/toxic-overload
You don't have to figure this out alone. Inside Haylie's private membership community, you get personalized guidance and support, member discounts on supplements and shakes, and the ability to ask questions directly to podcast guests like Dr. Systrom. Join free for 30 days and take the next step on your health journey.
Join the Fast Metabolism Membership — First 30 Days Free 👉 https://hayliepomroy.com/pages/fast-metabolism-membership
Dr. Craig P. Tanio, MD, FACP, IFMCP, is a co-founder of Rezilir Health and a physician trained in general internal medicine, brain health, longevity, precision medicine, and functional medicine. He oversees the clinical team caring for patients with complex chronic conditions, including cognitive decline, neurodegenerative disorders, ME/CFS, Long Covid, autoimmune conditions, and environmentally acquired illnesses. Dr. Tanio earned his BA from UCLA, MD from UCSF, and MBA from the Wharton School, and completed his residency and fellowship at the University of Pennsylvania. He is board certified in internal medicine, certified in functional medicine, and serves as a researcher, educator, and faculty member at Johns Hopkins School of Medicine and Nova Southeastern University.
Website: https://www.rezilirhealth.com/
LinkedIn: https://www.linkedin.com/in/craig-tanio-51088a/
Haylie Pomroy, Founder and CEO of The Haylie Pomroy Group, is a leading health strategist specializing in metabolism, weight loss, and integrative wellness. With over 25 years of experience, she has worked with top medical institutions and high-profile clients, developing targeted programs and supplements rooted in the "Food is Medicine" philosophy. Inspired by her own autoimmune journey, she combines expertise in nutrition, biochemistry, and patient advocacy to help others reclaim their health. She is a New York Times bestselling author of The Fast Metabolism Diet.
Learn more about Haylie Pomroy's approach to wellness through her website: https://hayliepomroy.com
Instagram: https://www.instagram.com/hayliepomroy
Facebook: https://www.facebook.com/hayliepomroy
YouTube: https://www.youtube.com/@hayliepomroy/videos
LinkedIn: https://www.linkedin.com/in/hayliepomroy/
X: https://x.com/hayliepomroy
Transcript:
Dr. Craig P. Tanio: We can impact the brain, but what is really needed is a different approach to brain health that is going to be a bit more of a generalist approach. The brain has really been the purvey of the neurologists and the psychiatrists, but if we're seeing that most complex chronic conditions have issues in the brain, you have to get comfortable with looking at the brain.
Haylie Pomroy: I'm Haylie Pomroy. I'm a #1 New York Times best-selling author, and I'm the former assistant director of the integrative medicine program at the Institute for Neuro-Immune Medicine (INIM). I say former because that's right, you guys, I am back in school again. I am working on my PhD in neuroimmunology. When I decided to do my PhD, I looked for the world's best place in neuroimmune medicine, and of course, that landed me right here at INIM, and I am so glad to be with my team. Today, we're going to talk about brain health.
I think that's a subject that is near and dear to many of our community members. When the subject of brain health came up, and I wanted to have that discussion, Dr. Klimas, Dr. Rey, Dr. Irina, everybody said that there is the perfect doctor for me to ask all of your questions to, and that is Dr. Craig Tanio. He is the co-founder of Rezilir Health. That is a clinic that specializes in brain health, cognitive issues, and works very closely with us in neuroinflammatory and chronic disease. Dr. Tanio, first of all, thank you so much. I know you're crazy busy, but thank you for being here with me.
Dr. Craig P. Tanio: Haylie, it's my pleasure. Excited to be on the show.
Haylie Pomroy: When I started pulling topics, and I wanted to talk about brain health, we are neuroimmunology, we have immunologists, neurologists, everything in our practice, your name came up over and over again, and then we had a moment to chat, and I can absolutely see why.
My first question is, you're also an adjunct professor for us, so I get to have you in clinicals on Friday sometimes, which is great. I always talk to our community about how valuable that time is where we all come together, but an extensive background. How did you come to be an adjunct professor at NSU? How did we start working together?
Dr. Craig P. Tanio: It's really just through networking. Irina made the introduction between myself and Nancy, and we've tried at Rezilir really to be active collaborators in the variety of communities that there are out there, and it made a lot of sense to me to really try to collaborate within them around the whole issues around chronic fatigue and brain health.
Haylie Pomroy: Dr. Rozenfeld, Irina, she said that you have a clinic without walls, which means like your reach for solutions for your patients is global. It's extensive. That's why we love to ask you all the questions that we do on Fridays. I always feel bad when you can be there, I feel like we just pepper you, but it's appreciated. You have to know that, it's on behalf of all of our patients.
Share with me a little bit about, you're now co-founder of Rezilir Health, but how did you get there?
Dr. Craig P. Tanio: I've always been a generalist at heart coming into medicine, really from very interested in how medicine intersects with politics and business and such, and so really been working the issue of how we can get the healthcare system to work well for patients with complex chronic conditions.
Haylie Pomroy: Is that possible?
Dr. Craig P. Tanio: Well, I know that we can do better, and that I do know that there's been multiple examples of where you can actually implement better. And so really been working that angle for about three decades. I started my career in federally qualified community health centers and working with the uninsured in urban Baltimore, and then just kind of pivoted to being a partner at McKinsey & Company, really working with a number of health systems on the issue of how do you actually improve the quality of medical care.
I came down to Florida about a decade and a half ago to really help build a joint venture in Medicare Advantage called JenCare, and really grew that company to, I think, a considerable presence and really kind of perfected the art of getting an urban one-stop-shop for high-risk Medicare and Medicaid dual eligibles. And that was able to really get ideal care following, let's call it, guideline medicine. And then about 10 years ago, I became very interested in what was out of the guidelines, and particularly, it started around brain health.
Dale Bredesen had come out with a book called The End of Alzheimer's as an initial publication. And to me, it just made complete sense that what we were trying to do to get the brain to work better is really trying to fix a number of things in both the body and the brain. And you really needed to be what I would call the expert generalist. You needed to take a pretty comprehensive look. And there was an approach, which was really, I think, about addressing the root causes and trying to really guide the body to health. And I think those principles have held. A lot of the science has continued to evolve, but brain health has really been the area that the company we co-founded in 2017 it's really kind of been central to what we're doing.
Haylie Pomroy: It's interesting because you use the word generalist. And I think we kind of went from generalist maybe your internal medicine or your primary doctor, being just this many decades ago, being this person that just knew you. Knew you, knew your body, knew when there was a problem. And maybe a specialist would be called in once the problem was identified and something needed to be surgicized, or something needed to be maybe even a little bit further diagnosed. And then we went into this siloing of medicine where everybody became a specialist. And your foot was not connected to your head, was not connected to your gut, was not connected to your elbow. Nothing was kind of integrated. And then there was this practice of holistic or when I started 30 years ago, alternative. Now it's integrative or functional. I love to have them under the umbrella, back of a generalist, in a way of understanding that the body is so interconnected.
Dr. Craig P. Tanio: And it's interesting because with that historical view, I think there's really been two eras of integrative medicine. 1.0, I think, was really in the 90s, where it was really a look at multiculturalism, really appreciating what different practices of medicine had to bring to bear. And I think really this version is a bit different because what you're seeing is that systems biology and what the research that's happening in the basic science side is having a challenge getting translated into the practice of medicine in as, I think, effective a way as possible.
And the biggest reason, I think, is because most systems don't encourage a generalist to look at the whole picture and then also to have the time to really work with patients and put it all together. We're OK with having eight specialists see a patient and having eight hours of care, but God forbid we have one person spend four hours with a patient and really put it all together. And that's missing in the system today.
Haylie Pomroy: Hi, it's Haylie Pomroy, your host. I've written six New York Times bestselling books on metabolic pathways. And my latest book, Toxic Overload, tells you exactly what to do when your body's overburdened.
If you go to hayliepomroy.com/book, for a limited time, you can download a digital copy of this book completely free. That's hayliepomroy.com/book. Grab your free copy while supplies last. Now, back to our show.
You just made something very clear for me personally. Years ago, in the practice that I created, I called myself a health strategist. And usually a doc referred me, maybe someone's friend or family member, maybe a team, a sports team, or something like that. And I would get these charts from all the different doctors in. And I think I was just the only person that had the time, or maybe my hourly was low enough or whatever it was. My brain worked in a way to look at things holistically. It was just born that way. And I would sort through all this. Now there are databases for drug interaction. But when I first started, there weren't good databases for drug interaction. And I can't tell you how many times there was a drug interaction. There was misinformation, like labs weren't shared with other docs, especially if they were out of provider networks and stuff like that. That began my whole career. I'm a nutritionist by trade. I have education in basically problem-solving on a lot of different facets. But I always thought, why in the world would anybody need my services, which they do, I get it, if we could compensate doctors that would do that?
Dr. Craig P. Tanio: Well, and the system has tried to integrate some of those pieces before from a data perspective or systems perspective. But what's oftentimes missing is that you need the human perspective and somebody needs to be looking through that data from the perspective of I care about the patient, I want to help the person to get better, and what's really going on. And you cannot teach a system how to do that.
Haylie Pomroy: You can't. And for me, a lot of times it'll be someone that's highly involved in a hospital, a large donor of a hospital, or something like that. And they'll go, look, we've got this, this person gets any access to care, but someone needs to communicate with the patient and then come back and communicate with all of us because we're getting 10 different details, 10 different stories. But what you just said, I think distilled, because I've always wondered, I said, why would anybody need me? Because these are amazing doctors or whatever, sometimes that's not the case. But a lot of times with my clients, it is the case, but it's just kind of pulling that together.
We always joke or not joke, we always say that we integrate so many different things and are trying so hard to translate the data into actual improvement in the patient, not because we just thought it was a good thing to do, but because the patient's body required it. We weren't getting the results. And we have top doctors, top immunologists, top neurologists, environmental medicine, but it wasn't until we started to, I hesitate to use integrative because we're an integrative being. I don't know how we're going to not have integrative medicine. I just don't know how we can possibly do it. It's been tried. It's not been as successful as we'd hoped, I suppose.
But how we integrate it all because with chronic disease, it requires it. I have not seen anybody get better on a singular treatment in 30 years.
Dr. Craig P. Tanio: Absolutely. I mean, if you're saying what's the operating system, the new operating system to take care of complex chronic conditions, the first thing is to say, how are you going to be at implementing multimodal interventions? You have to do multiple things at the same time. You have to get to the tipping point. You have to have objective biomarkers to see that you're making that progress. And you have to work with the patient's psyche, their values, and preferences to kind of strategize and say what's going to really work.
Haylie Pomroy: Putting the patient in the equation.
Dr. Craig P. Tanio: Absolutely. And when you have the number of patients who have complex conditions and many times they've lost hope, it has to be personalized. It has to be precise and personalized. But I think the good thing is that with proper strategizing and implementation, you can make an extraordinary difference in individuals' lives. And I've had the fortune, a chance, to work with first-year residents at Johns Hopkins Bayview for a number of years. And I always ask them the question, how many times have you seen a patient with complex chronic conditions get better? And unfortunately, it's not that high a percentage. And that should be the thing that we're wanting to see as clinicians. That is the high that we're looking for.
Haylie Pomroy: I think it's an epic failure because it's not an expectation, first and foremost. A group of us just traveled internationally to some conferences, and I was so surprised that they were like, " This is the endgame.” Like the end game is to get the patient better. Not just to get the patient treatment. I mean, a lot of it was the patient's treatment just so that they can make it to their next appointment or not. But the end game was never in so many cases to get the patient better, or we're not witnessing it, or we're not seeing it.
Dr. Craig P. Tanio: Well, I think that the whole notion of evidence-based medicine got corrupted the last couple of decades, where I think the initial push of that in the 80s and 90s was very laudable. Look, we just want to structure our research. We want to make sure that what we're recommending has grounds in science. And that's all well and good. But now what's happened is it's basically a retrospective look saying, if you don't have $20 million for a randomized control trial, it's not getting in the guideline.
Haylie Pomroy: And what happened, I'm just going to use acupuncture in that one because I grew up, my mom was an acupuncturist, specialized in fertility. She's got a PhD in reproductive endocrinology, but worked in the acupuncture space. And our fertility docs were like, our statistics are better. But are we going to go do a trial and a study on something that's been centuries, and the patient proving, and someone said, well, it's because they think they feel better. It's placebo. And I said, well, I don't agree, but what if that was true? Talk about how little side effects you have from a placebo. If I feel better, if I can walk better, if my periods are better, if my headaches go away because of a placebo, which I don't believe that to be with Chinese medicine, that it's placebo. I think it's really sound science. But if it was, why is such a bad thing? It’s that evidence-based, and also I think it really has led into medical gaslighting, in my opinion, where the patient's experience is discounted as not science.
Dr. Craig P. Tanio: Because it's seen through the lens of a covered benefit. But so much about getting people better is you're looking at their budgets and what they're spending resources on. And it's food, water, shelter, how they're spending their free time. And as you're putting together a comprehensive plan, you're actually giving them guidelines around how to spend those resources correctly and how to divert that to the best health. And so it can't just be, well, this is what the insurance is covering. This is what it isn't covering. It's about what is going to really be the best use of their time and effort.
Haylie Pomroy: And resources. Sometimes I feel like I'm so indoctrinated. I've been in the industry for a long time. I grew up really exposed to a lot of integrative therapies, did chiropractic as babies, as kids. My parents did for us. We did food allergy testing and all of that. But I recently had a situation where my daughter ended up in the hospital at a great university, UCLA, which I love. I have a lot of great doc friends over there. They treated her fabulously. And they are more progressive. I physically transported her from a tiny hospital in Wickenburg, Arizona, to UCLA because they are much more integrative. But the immunologist and the infectious disease didn't talk at all. And the infectious disease doctor said to me, I said, well, why would her labs be this? And why would that? And she goes, we don't really study the immune system very much in infectious disease. If I didn't have two witnesses sitting in the room, nobody would have believed me. I didn't know if I should cry or bang my head against the wall. I feel like the universe provides me with those very loud awakenings, because that is a little bit of what a lot of people are dealing with.
Now, the reason why I drove her in the middle of the night from Wickenburg, Arizona, with four dogs and three horses to the hospital at UCLA was because of the response that I was getting in Wickenburg. I would have been better in a hospital for sure. Like, no doubt about it, because at least they would have looked at her gums and her pulse. And I'm so versed and so connected in the medical community. In our community we get a lot of questions about how do they talk to their doctor about looking at them just as a whole as a holistic human being, as a whole human being? You are so good with communication and language. But also, I think the fact that you can process a ton of data.
How can someone communicate effectively? I got really quiet. And then I repeated the comment. And then I said, can you help me understand how virology and immunology don't integrate? I mean, I was trying to not be a smart you know what. But the largest question when people were seeing that you were coming on is, how can I talk to my doctor to get them to at least accept me the way you accept your patients? How can you change all the doctors? But I mean, just at least help us be better at communicating when we walk in the door.
Dr. Craig P. Tanio: Well, I think the first thing is to have a sense and a vision of what you're looking for, ideally, from a clinician to be really your guide in the system. And I think that so much of the time on podcasts and such, we talk about what is getting done. And I think here, the more important lens is how it's being done, because if you get the how right, those are principles and values that should stay immutable. And then as evidence just gets refreshed and revised, that's going to change the what.
We have about six or seven sort of principles around how we do practice that I could just share. And then I think that could be helpful for your listeners.
Haylie Pomroy: And even that they could interview their doctor. I was talking to another individual interviewing, and I said, when we're looking for a pediatrician or an OBGYN for pregnancy, oftentimes we'll interview a doctor to see if they're the right pediatrician for a kid, to see if they're the right doctor to deliver our baby. Is this the person we're going to want to be with in that vulnerable moment? But we don't do that for our primary care. We take whoever, or maybe a friend refers or something. But I sent my son off, we had changed plans, and I sent my son off to a visit, and he said, why am I having a visit? I'm not sick or anything. I said, you've got to go interview the guy, this is who we got assigned to. You need to see if he's going to be your doctor. And he was talking to his buddies, and they said, you interviewed your doctor? And my son said, yeah, because that's who I'm going to go to when I have a problem. But we don't even do that.
Dr. Craig P. Tanio: And we've evolved our practice so that most people who see me initially, we do a one-time consult that allows them to interview me and then get that process where we're very upfront with this is who we are and here's how we can help you. And if it's not a good match, it's not a good match. It is okay. And we're very upfront.
And so if somebody says, well, they're looking for somebody who's an expert in naturopathic medicine, that's not going to be me, and that's okay. I have a lot of respect for what they do, but I'm not a naturopath. And so some of the principles is, I think, two are very basic, which is you want somebody who really does care and really care from their heart. And that it's going to be a practice that really fosters hope with a lot of complex conditions that hope gets lost very quickly. And unfortunately, we have seen a lot of patients be told stories where they've, it's just designed to lose hope right from the start.
Haylie Pomroy: Hi, it's Haylie Pomroy, your host. When I was going through my health crisis, the worst part of it was feeling lost and alone. And I decided that I didn't want anybody else to feel as desperate as I did. That's why we set up a private membership group where you can come in, ask questions, get support, be connected with people that can actually help you on your health journey. If you go to hayliepomroy.com/member, you can join me for 30 days for free. I'll see you there. We can jump in and we can start to organize the path for your wellness. That's hayliepomroy.com/member. I will see you there. Now, back to our show.
When I was diagnosed with my autoimmune disorder, they said we'll hold out as long as we can for a splenectomy, then we'll start you on some IV chemotherapeutics. And that was after Imuran, CellCept, Mepron, Prednisone, you know what I mean? And I'm just going like what? Again, I was fortunate. I had a lot of support system. But you just said, like, I think it would be very reasonable to ask a doctor that you're interviewing is, do you care about your patients from your heart? Do you care about your patients? And the other is, when I'm struggling, are you going to hold out hope that I'm going to get better?
Dr. Craig P. Tanio: Exactly. Those are good. The expert generalist, I think, is more of a philosophy and an approach, which is you're open to new ideas. You're trying to integrate it together. You don't see that you have the keys to the medical kingdom. I have no problem with patients bringing me data. Some of the best concepts we have are coming from patients all the time. It's not an issue as long as they don't want an immediate turnaround on what I think. That's kind of our approach.
They don't want you to be a robot.
Haylie Pomroy: OK. I love that. Like, are you open to new ideas and new approaches when it comes to me as your patient?
Dr. Craig P. Tanio: And then we like the concept of evidence-informed medicine because just because we're saying, OK, it's not about guidelines doesn't mean that a number of principles shouldn't have some backing in science and research. And there's a lens on how to look at that. I think the collaborative mindset is really important. I think in the integrative world, the piece that I get very concerned about is this move to proprietary systems. Everybody's wanting to have their intellectual property. And I think that's actually a key barrier in this approach, really getting into mainstream medicine.
I don't believe just from a first principles ethics standpoint that any systems of care should be proprietary. We should be actively sharing it, opening it for criticism. That's how you advance is that people criticize approaches. And then, but the second you say it's my proprietary database, it isn't open to as much critique.
Haylie Pomroy: We can't even get articles from PubMed without paying for it. NIH articles. I mean, fortunately, that's why I always say I'm a perpetual student, because I want free science articles. I mean, probably other reasons, too. But that was so shocking to me when I became a non-student for a period of my life. Was it suddenly I couldn't see the research anymore. The layperson doesn't have access to the research on the drugs that they're taking for chronic disease. I mean, you can't go in. You can see the little abstract or whatever, but you can't see how the study was done. And that just blew my mind in science and research, and then in integrative medicine, or even, I'm an author, and when I published the big first big book, they were like oh, you've got to shut this website down. This ship went so down in this person. We had Facebook groups that popped up that had 275,000 people, several Spanish speaking one.
And they were like, go shut them down. They're using your data, and you're using your knowledge. I said, it's nutrition. Don't put my face where your face belongs because I would like some autonomy. But my goodness, and and a lot of the docs or a lot of the people that write nutrition books and diet books, especially. I mean, they are like vicious about intellectual property stuff. And again, I am supportive of that. We're not going to shut down any of these groups. You know what they were doing? They were helping other people eat healthy. And we sold millions of copies in 47 languages. And I didn't have to hoard what I had learned. I didn't create nutrition. It was the gems that I'd gathered mostly from my clients, quite frankly, over the years.
Dr. Craig P. Tanio: And it's really approaching it from a professional and ethics values perspective and not just saying we're going to be a business maximizer. And that's, I think, critical for all clinicians in the space to just kind of start with those first principles. And then the last one is really how do you practice sort of n-of-1 medicine the best way, which is you take as a given that you're out of the guidelines, so that you're going to have to have a set of approaches and rules to see that people are getting better.
Haylie Pomroy: Just explain to our community, n-of-1 means? In a study, in a trial, let's say we're doing a science-based trial, a university-based trial or whatever trial. N is how many people are in the population that are going through the trial with the set variables?
Dr. Craig P. Tanio: Correct. N-of-1 is probably the best way to say it is we're personalizing it to you. Precision medicine for you.
Haylie Pomroy: For you. But what I love is, in our community, we talk a lot about we need a protocol for progress, like we need some sort of data that sees that we're moving in the right direction, just as importantly, that we're moving in the wrong direction. It didn't work. Fail faster. I mean, not fatally, but in trying to shift something medically, if something doesn't work, I love that data because it helps me pivot.
Dr. Craig P. Tanio: Absolutely. And get to your destination quicker. And so what's great about brain health now is that in the beginning, many of these situations were framed as, well, somebody is coming in with brain fog. And it's like, okay, well, what do we really mean by that? And so if we're trying to break that down into more specifics, we can do cognitive testing in 20 or 30 minutes with computerized tests, CNS vitals, and say, how is your executive function, which is sort of your frontal lobe? How's your memory? How's your processing speed? We can get objective measures and use that as a marker.
We've been using quantitative EEGs to look at the brain maps, and those we will see that if you get interventions that are making a difference, you can see that change within a week. It has great temporal resolution, not maybe as much spatial resolution as a functional MRI, but it's an inexpensive test to really follow progress, and we will oftentimes see the brain maps change well before the symptoms do. That helps to guide the therapy. Symptom surveys are great, but objective biomarkers are critical. And what's terrific now in neurodegenerative conditions is there's a whole set of new biomarkers around neurodegenerative biomarkers that are available in LabCorp and Quest.
Haylie Pomroy: We get more insurance coverage. I mean, sorry, but that's so important.
Dr. Craig P. Tanio: It's critical.
Haylie Pomroy: It is. And what's so interesting is, again, I work in a large community that we're just trying to advocate for people, and they'll say, oh, my doctor said they won't run that because it's an alternative testing. And then we'll go back and say, here, it's on Quest. It's on LabCorp. And they go, oh, boom, they'll check the box. Because it's almost like it's had that blessing of LabQuest. I mean, because they're large companies that have serviced. The doctors feel familiar and comfortable with those. That is one of the biggest tricks that we teach our community is if an integrative medicine, if somebody has suggested an out-of-the-box, I don't want to use the word non-traditional, non-common lab test to be run, do your research. And we'll call Quest ourselves, and we'll call LabCorp ourselves, and we'll say, hey, they want to run a cytokine panel. They want to run, I'm trying to think of something else I ran the other day, a cortisol curve. And I was so excited. And Quest said, oh, yeah, we do. You script it this way, this way, so this way. We went back to the doc, told them that. They had said no, no, no to this person that has Hashimoto's thyroiditis for four years. We went back with the Quest data, and they said, oh, no problem. Forgot the four years ever happened. That's okay. We'll do a little EMDR for trauma. But I know I don't have you much longer, I have a million questions on brain health. Not a million, but a few. Why is the brain so hard to impact?
Dr. Craig P. Tanio: Well, I would maybe reframe it. I would actually say I think that we can impact the brain. But what is really needed is a different approach to brain health that is going to be a bit more of a generalist approach. The brain has really been the purvey of the neurologists and the psychiatrists. And if you look at their training, they basically get a year of general medicine, and then they go on their specialty approach. And if, let's say, contrast that with a cardiologist who gets three years of general medicine.
And so it has kind of been reserved. If you want to look at the brain, it's going to kind of be in that area. But if we're seeing that most complex chronic conditions have issues in the brain, and we're seeing that with the MECFS work, but we're seeing it broadly with multiple other conditions.
Haylie Pomroy: And long COVID.
Dr. Craig P. Tanio: Long COVID, absolutely. You have to get comfortable with looking at the brain. And so there's going to be a whole set of tools there, but that's got to be available to a much broader set of people going forward.
Haylie Pomroy: Do you have a newsletter, or can people get a hold of you? I mean, I don't want to flood your practice with questions. I know that they can reach out to you if they want an appointment. Again, we get lucky. We get you in our, as an adjunct professor, we get you in our clinicals on Friday. How do people get more of this from you?
Dr. Craig P. Tanio: We have an email address, therezilirway@rezilirhealth.com and we can make that available. And if somebody can just send us an email, we'll be happy to respond. And I think if there are a lot of similar questions, then we'll try to put some answers together. But we welcome a dialogue with the community on these issues.
Haylie Pomroy: When we do these podcasts, and I mean, just even the first part of it, I know our community is going to have so many questions because I know it's going to really resonate and pertain to them. We have a lot of individuals that are dealing with POTS, that are dealing with ME/CFS, that are dealing with a lot of autoimmune disorders. And now we are seeing this massive influx with long COVID. For people that can't see you, will you please come back on the podcast?
Dr. Craig P. Tanio: I'd be delighted to.
Haylie Pomroy: Perfect. Because I would love to just, I know it's coming. I know our community. I know you guys very well. A lot of people are going to ask us what types of symptoms are worrisome in long COVID. What can they do from a brain health perspective with long COVID, with chronic disease? I mean, I know that they're going to want to ask, kind of from a generalist perspective, what do you see? What are you seeing be impactful?
If you were to say someone out there right now is struggling with brain health and cognitive issues, are there some things that they can do in their everyday life that you've seen over the years make a positive impact?
Dr. Craig P. Tanio: Well, I think it is important to, with general symptoms still, to get a better specific understanding of what exactly is going on. And so, for example, with COVID, one of the things we have seen in our older population is we see so much asymptomatic COVID where there's a cognitive deterioration, and there are no physical symptoms.
Haylie Pomroy: They have no fever?
Dr. Craig P. Tanio: No. Nothing.
Haylie Pomroy: I had someone that we were talking about with our older patients, and a lot of them were saying that with this particular virus, some of them aren't mounting the immune response. So they're having like this slow burn.
Dr. Craig P. Tanio: But there'll still be clues. You'll see an elevated D-dimer.
You'll see the spike antibody go up. If you do T-cell testing, it's there. And we've seen, most importantly, a very positive response to antivirals and other sort of COVID-directed therapies. We've seen cognitive deterioration respond to an appropriate sort of post-COVID treatment. And that's been a significant observation in our population.
Haylie Pomroy: We had a client that had no, what we would call, first-line COVID responses. No fever, no loss of sense of taste, smell, but was diagnosed ultimately after six weeks at UCLA Psychiatric with sudden onset, what they call COVID psychosis. She had a massive neuroinflammatory response. And they said she's had a nervous breakdown. And then implored them to run, and luckily they were good partners in this process, run D-dimer, run the spike protein, run some of the mast cell testing. And it was shocking to me, or scary to me, that we wouldn't have even looked at it from — it was strictly a psychiatric event.
Dr. Craig P. Tanio: Yes. And when you break down a number of the psychiatric diagnoses, they end up being very symptom-driven and not necessarily root-cause driven. And so ultimately, all those symptoms do have a root cause. And I think part of this is having the humility to say, we don't know the answer, and what are we going to do? What are the treatment options? And can we kind of be systematic about working the issue? And what we've tried to do as a group is sort of every year, we try to add one or two capabilities around the problem and just kind of be systematically working it.
Five or six years ago, it was, let's have an environmental professional on staff because there are mold issues. Let's add hyperbarics. Let's add QEG and neurofeedback, high-intensity light. Now we've been using ketamine for the limbic system, which has been a great response in many of our chronic fatigue patients.
Haylie Pomroy: Do you have patients that fly in from out of the state?
Dr. Craig P. Tanio: Yes. Probably about 30 or 40% are out of state.
Haylie Pomroy: I'm so happy for you, but I'm so sad for the patients that they have to do that. But you have to do it. I mean, I jumped my daughter on a plane. I've done it. We've done it. I've gone out of the country because many years ago, it was not easy to get the care. We had a client that went to Russia 20 years ago for cardiovascular stem cells. You know what I mean? I've been to France. There's no stone unturned. Health is the only option, in my opinion.
Our community out there is listening. I really feel like the tenants of your practice can help them interview a practitioner and also give a lot of people permission, I think, to advocate for themselves in a way that, like, you always do things so systematically that I don't know how anybody could ever argue with you, because it's like fact. Heart fact. Heart fact. Heart fact. Whenever you describe stuff in the clinic, it's like, this is the right thing to do, and this is why we should do it. And the how. This is how we implement it. It kind of takes us from start to beginning. I know we're going to have lots of questions. Please tell me you're willing to come back.
Dr. Craig P. Tanio: Absolutely. I'm willing to come back. And maybe just to share one briefcase to just be upside.
Haylie Pomroy: That would be wonderful.
Dr. Craig P. Tanio: This was somebody who just was here a couple of weeks ago, but she was in her early 50s, and unfortunately, her mother had significant Alzheimer's, and so she came for prevention. She said, I'm not having any symptoms. I don't want to go down this road. And high level the verbal memory you can see here is in the first percentile. We did a, not an exhaustive workup, because she didn't really have any other symptoms. But we did a focused cognitive workup. We found a couple issues that we needed to address. And then five months later, her memory goes from, like first percentile now to the 99th percentile. And the biggest intervention that happened in here was actually an antiviral. It was not COVID. It happened to just be just Valtrex. There was just an asymptomatic.
Haylie Pomroy: Was it EBV?
Dr. Craig P. Tanio: No, I think it was more an HSV.
Haylie Pomroy: Wow. One of the herpes, another one of the herpes.
Dr. Craig P. Tanio: Exactly. And the antibodies were super high, and it was asymptomatic. And the problem is, we don't know when the virus is active in the brain. There's no perfect test to do that. This is where we just have to kind of look at the data and move. But when you are able to make that intervention, things move quite quickly.
Haylie Pomroy: But I think adequate, thoughtful diagnostics, too. And also, I think with the vast amount of patients that you've seen and the people that you tie into, I mean, this is why I'm studying neuroimmunology. The immune system, the nervous system, the autonomic nervous system, how the body regulates, it's just fascinating. There's so much we don't know. How could we ever tell a patient they're wrong?
Dr. Craig P. Tanio: No, it's serious AI that we only have, like, the basic understanding of. And that's why those principles are so important, because what we do is going to, it's a very exciting time, because I see that I look back five years ago and say, what can we do today than we did five years ago? It's significantly better. It's only going to get better. But we have to have the systems that can get this to more people. And we are doing this randomized control trial with cognitive decline right now. And our hope is that when the when it's published that there could be coverage of a precision medicine approach.
Haylie Pomroy: Are you still recruiting for the trial?
Dr. Craig P. Tanio: We are. We are recruiting until the end of July. And if people wanted to know about the trial, they could do that same email.
Haylie Pomroy: Can you say it for me one more time?
Dr. Craig P. Tanio: The the trial, actually, if they wanted to, if they were interested in the trial, because you have a broad audience there, there's sites that are in California, there are sites in Ohio, in Tennessee and in Florida.
And that would be info@dementiareversaltrial.com.
Haylie Pomroy: info@dementiareversaltrial.com OK, great. I'll post that on all when we post the podcast and on YouTube and everywhere.
Hey, this is Haylie Pomroy. And right now we're going to transition into our Q&A portion of the podcast. And you'll notice that we have live viewers asking us questions. They're my Fast Metabolism members and they get all kinds of amazing benefits, like member discounts on my world class supplements and shakes, every product, every day, personalized guidance and support from myself and my team, and even the ability to ask questions of our podcast guests. If you have questions and want to get them answered, you should absolutely join my membership. And if you go to hayliepomroy.com/member, you can join for free for 30 days. Again, that's hayliepomroy.com/member and join for free for 30 days. I can't wait to see you there.
Dr. Tanio, thank you so much for being here. I really appreciate it. I sometimes grieve for the fact that everybody out there doesn't have access to this kind of care. It's hard for me sometimes when I feel like I'm super fortunate to get to ask you guys. I know I drive you all crazy, but I get to ask you all so many darn questions. But it's really on behalf of the people out in the community that don't have access, but that are not going to be deterred. And that we believe them, that you believe them, and that we're advocating for them. I think can get them through another day of whether it's through connecting with Dr. Google or being lucky enough to pay to get on PubMed or reaching out and sending you guys an email, that there's hope out there. And we're watching patients get better. That was a really cool case study to look at, but we're watching patients. We're witnessing. We have the privilege of cheering them on on their journey and watching them cross some really significant barriers.
Dr. Craig P. Tanio: Absolutely. We need to know that if we all can kind of work together, we can get people better.
Haylie Pomroy: We can get people better for sure. Well, thank you so much for taking time. I know you're incredibly busy and we all appreciate it.
Dr. Craig P. Tanio: All right. Thanks for having me.
Haylie Pomroy: Absolutely.
