Reversing Chronic Inflammation: The Popkin Method’s Three-Phase Approach for Better Health

Welcome back to The Popkin Method! In this episode, host Dr. Matthew C. Popkin dives deep into one of the most important yet misunderstood topics in modern health: whole body systemic inflammation. You’ll discover what chronic inflammation really is, how it subtly wreaks havoc on everything from metabolism and hormones to mood, gut health, and even cancer risk, and, most importantly, how to reverse it using the core principles of The Popkin Method.

You’ll hear a heartfelt public service announcement addressing the sharp rise in colorectal cancer among younger adults, shining light on the urgent need for early screening and the lifestyle factors fueling this trend. Dr. Matthew C. Popkin clarifies the difference between acute and chronic inflammation, breaks down the warning signs you shouldn’t ignore, and walks you step-by-step through the three-phase Popkin Method approach to lowering inflammation for good.

From dietary changes and gut health restoration to stress management and even cutting-edge regenerative therapies, this conversation is packed with practical strategies and empowering information. You'll also get expert tips on daily habits, optimizing hormones, early signs of healing, and how to start making changes that actually stick.

If you’re ready to understand the real root causes of inflammation and reclaim your health from the inside out, this episode is your essential guide.

Timestamps:

00:00 "Colorectal Cancer Screening Importance"

06:05 "Signs of Chronic Inflammation"

07:32 Inflammation Cycle and Causes

10:18 "Popkin Method: 3-Phase Approach"

13:52 "Inflammation Reduction Through Diet"

18:57 Omega-3 vs Omega-6 Explained

23:54 Melatonin Disruption and Technology

25:39 Hormonal Imbalances and Effects

29:41 "Systemic Healing Through Lifestyle Optimization"

32:14 "Gut Health & Inflammation"

36:08 Hormone Modulation for Optimal Health

37:39 Regenerative Therapies: Responsible Use Only

41:28 "Advances in Biologic Medicine"

46:56 Reversing Inflammation Through Diet

48:07 "Health Requires Holistic Foundation"

You can see Dr. Popkin through his online virtual functional medicine program anywhere in the country or the world for that matter.

You can visit Dr. Popkin in his Hollywood Florida office for an in person weight loss experience.

Visit thepopkinmethod.com to send a message to schedule an appointment with Dr. Popkin or email Dr. Popkin at mcpopkinmd@yahoo.com.

Podcast Website - https://thepopkinmethod.com/

Matthew C. Popkin, M.D. - https://thepopkinmethod.com/about

Podcast Partner - TopHealth - https://tophealth.care/

“Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”

Transcript

SPEAKER_01 0:12

Today, we're talking about something that is at the root of nearly every chronic condition we see in modern medicine: whole body systemic inflammation. Not acute inflammation, the kind that helps you heal from a cut or fight a virus, but chronic, low-grade, smoldering inflammation that quietly affects metabolism, hormones, mood, gut health, and long-term disease risk. Let's break this down in a clear, practical way what it is, how it develops, and most importantly, how to reverse it using the Popkin method. So excited to dive into that. But first, there was a timely news story that broke this week, and Dr. Popkin wants to tell us more first.

SPEAKER_00 0:50

Well, thank you for the introduction. And I just wanted to shed some light, maybe do a little uh PSA public service announcement on colorectal cancer screening. A lot of people have actually reached out to me regarding James Vanderbeek's passing um at the age of 48 of colon cancer. And unfortunately, 48 is young to pass of anything, let alone a preventable cancer like colon cancer. And his death is really shining light on the concerning rise of colorectal cancer in people under the age of 50. And while the disease is still relatively uncommon among younger adults, they make up about 13% of all colorectal cancers uh diagnosed in the United States. So what's happening here is we've actually recently, over the past couple of years, dropped the screening age from uh 50 down to 45 for colorectal cancer. The screening would either be a colonoscopy, which most people are familiar with, or something called a colograde, which is a simple test that looks for DNA of cancer in the stool and obviously much less invasive, less expensive to do. Regardless, it's important if you're 45 years of age or older that you get screened for colorectal cancer. If you're of average risk of colorectal cancer, the colograde stool test is actually quite an easy test to do. It's an at-home test that you do a stool sample and you mail it in. If you're at moderate risk or higher risk, meaning if you've had a first degree relative with colorectal cancer, father, mother, brother, sister, then a colonoscopy would be more in order there. And the question that a lot of people have been asking me is why are we seeing these cancers in in younger people? And I think a lot of it has to do with, again, what we've talked about the past couple of episodes and what we're going to talk about today, which is poor diet, poor lifestyle leading to inflammation. And inflammation causes lots of things, and unfortunately it causes, or it is the one of the root causes of cancer. It's not the only cause, but it's one of the root causes. So things like processed foods or ultra-processed foods that lead to inflammation, which we talked about a lot in the last couple of episodes, smoking, drinking, obvious causes there, microplastics and exposure to other toxins. So again, this kind of highlights the importance of clean, healthy living, which we've been talking about and we will continue to talk about. And I really just wanted to put out there the importance of uh colorectal screening in patients if you're 45 years of age or older and you're at average risk, definitely get screened. And if you have a higher risk, you should be screened earlier. So talk to your physician, get screened. Please do not let something that is diagnosable or easily diagnosable, don't let something like that sneak up on you. So I wanted to put that out there.

SPEAKER_01 3:30

Thanks so much, Dr. Popkin. Yes, so tragic and sad to hear about James Vanderbeek this week. He was a beloved actor. Almost in the thought leadership space, too. Really wonderful quotes and kind of sound bites from him over the years. Very sad to hear about that and excited to talk more about how it can hopefully be preventable for other people. So let's start at the beginning. Let's define systemic inflammation. What is it?

SPEAKER_00 3:54

Okay, well, systemic inflammation is a chronic low-grade activation of the immune system that affects the entire body, not just one isolated area. And unlike acute inflammation, which is protective and short-lived, chronic systemic inflammation is persistent. It's often very subtle. It's driven by ongoing triggers, which we're going to talk about today. And it's very dysregulated rather than protective. And at the cellular level, not to get too granular, but the immune system releases pro-inflammatory cytokines like tumor necrosis factor alpha, interleukin-6, CRP. These are all measurable things that we can look at in the blood. Oxidative stress will increase. The body remains in a constant threat detection state or fight or flight state that we've been talking about. Cortisol and the sympathetic nervous system tone often remain elevated. We discussed that over the previous episodes. And instead of resolving, the immune system stays activated. It remains on high alert. And your body is essentially in a constant, low-level defensive posture. And here's an important distinction. Systemic inflammation is not a disease, it's a process. And that process underlies many chronic diseases like insulin resistance, which we've talked a lot about, hormone disruption, cardiovascular disease, autoimmune patterns, neuroinflammation, even difficulty maintaining lean muscle mass. And as we talked about as well, unfortunately, cancer is driven by uh inflammation. So it's the biological background noise that slowly alters how every system functions in our body. So inflammation is definitely something we need to address.

SPEAKER_01 5:29

That doesn't sound good or perhaps easy to or quick to resolve. Let's talk first about what are some of the symptoms of systemic inflammation. What would I notice if that's going on in my body?

SPEAKER_00 5:41

Sure. Well, systemic inflammation rarely announces itself clearly. That's the challenge. It doesn't usually scream, it whispers. It doesn't come out and say, I'm here. It just gives you these vague symptoms that are easy to attribute to, let's say, older age or the fact that you're tired or you're stressed. Typically, people don't address them until there is some form of illness that comes up that requires going to the doctor. So some of these symptoms can be just, you'll recognize a lot of these, persistent fatigue, brain fog, bloating, or digestive discomfort. Sound familiar from the previous episodes? Joint stiffness, headaches, poor recovery from exercise, mood instability, sugar cravings, difficulty losing fat despite dieting and exercising efforts, and sleep disturbances. So all of these symptoms, they're quite recognizable, right? I mean, everybody feels these at some point at one time or another. But with chronic inflammation, these symptoms are lingering. And in women, you may notice worsening PMS symptoms, irregular cycles, or intensified perimenopausal symptoms. Men may notice declining testosterone, reduced muscle recovery, decreased libido. And often you go to the doctor, and often these laboratory markers are technically within range, right? The doctor does a bunch of blood tests, they tell you everything's normal, and they send you out and you still have these symptoms, but nothing's really been done to address them. But the patient doesn't feel well. There's a gap, right? There's a gap between normal labs and abnormal physiology. And that's often where systemic inflammation lives. And the Popkin method was developed to close the gaps in healthcare. And inflammation creates a huge gap that needs to be addressed.

SPEAKER_01 7:20

So talk to us more about the cycle from what triggers the inflammatory reaction from the trigger to the symptom and you feeling it, and how does it repeat over and over again?

SPEAKER_00 7:32

Yeah, inflammation tends to follow a fairly predictable cycle. Step one, there's a trigger, right? Like a food sensitivity or blood sugar spike, chronic stress, poor sleep, gut permeability issues, which we've talked about extensively, environmental toxins. And then the next step is that trigger leads to an immune activation. So inflammatory cytokines are released, oxidative stress increases, cortisol increases. Remember, we're going to talk a lot about, we have talked a lot about cortisol. We're going to talk a lot about cortisol, which is your stress hormone, which causes a lot of difficulty when chronically elevated. Then step three is the tissue impact, right? The impact on your body. So insulin signaling weakens and the blood sugar becomes unstable. Gut lining becomes more permeable. So toxins are able to get into the body easier and cause inflammation. Hormone receptors become less responsive, mitochondrial efficiency declines. And what I mean by mitochondrial efficiency is the mitochondria are the powerhouses of the cell. That's where we make our ATP or our energy. So obviously, if the powerhouse of the cell is declining in efficiency, we're not making enough energy, and that's going to lead to a lot of the symptoms that we discussed. And then step four is where symptoms actually appear, right? People get fatigue, brain fog, bloating, hormonal symptoms, weight gain, everything I mentioned earlier. And then step five is the reinforcement. Develop this cycle. So poor sleep from stress worsens inflammation. The blood sugar instability that's created worsens cortisol. Cortisol then worsens blood sugar instability, causes inflammation, causes poor sleep, then it involves the gut permeability increases, then we get more immune triggers. So the cycle repeats. That's very much what we talked about in the previous episodes. This cycle will repeat unless it's interrupted intentionally by treatment. And this is what we're going to talk about today.

SPEAKER_01 9:24

So it seems like once there's a trigger, it can almost turn into this hamster wheel that's perhaps very difficult to get off of if you're not following the right process or the right advice to fix it. Is that right?

SPEAKER_00 9:38

That's correct. And a lot of these triggers, people have gotten so accustomed to them, they just attribute it to normal life. I don't sleep well because my kids keep me up, or I have stress at work, or I'm not eating well, I can't get to the gym. So people will attribute these symptoms to just everyday life and not address them. And over time, days, weeks, months, and years, it just gets it turns into a cycle. Again, it has to be recognized and fixed.

SPEAKER_01 10:03

And the body probably gets fatigued from trying to fight and keep you above water for so long under those stressful conditions if they persist for however long. All right. So what is your approach to treating chronic systemic inflammation? How do we wrangle this?

SPEAKER_00 10:18

Well, the Popkin method uses a three-phase approach, and the order of this really matters. And phase one, we need to remove the triggers, right? Seems simple. Find out what those triggers are and then remove them so we don't activate the immune system. And then phase two is where we rebalance the biology of the body and get it used to not being in this cycle. And then phase three is signal resolution and repair, meaning we're not constantly signaling the immune system to go haywire and we're allowing the body to fix itself. So it seems simple, right? Remember, if the triggers are still present, the immune system will remain on high alert. Cortisol and inflammatory remarkers are going to remain elevated, which creates a state of threat, a chronic constant state of threat from elevated cortisol and inflammatory markers. And you can't repair your body if it's constantly under threat. You have to calm the system first. So again, phase one, remove the triggers. Stop what's keeping the immune system activated. Phase two, you want to rebalance the biology of the body, provide nutrients and supplements and inputs that can calm and regulate uh immune signaling. And then phase three is resolution and repair. Signal the body to actively turn off inflammation and rebuild damaged tissue. And the sequence matters here. You can't supplement your way out of active triggers, right? So people jump on Amazon and they buy a whole bunch of stuff that they saw on social media, that's not going to work. You've got to remove, rebalance, and then resolve the issue. So I'll describe each of these phases in detail during this podcast.

SPEAKER_01 11:47

So let's break the phases down one by one. What does phase one look like? You just mentioned it's eliminating the triggers that got us into this mess in the first place. So how do we do that? How do we overcome that?

SPEAKER_00 12:00

Right. So you said it phase one is elimination of triggers. We remove what keeps the immune system chronically activated. First, we have to identify the root causes, right? What are those common triggers? And those would be food sensitivities or food allergies. Food allergies are more obvious. If you're allergic to strawberries and you eat a strawberry, your face swells up. That's an obvious trigger. But some of the ones that we talked about that are the food sensitivities, they're not quite so obvious. You may be eating foods that are causing chronic inflammation, but you just don't know it. And that's where we talked about doing the food sensitivity testing to determine if you have any of these foods that are problematic. Chronic infections. So some people have, they may have chronic infections in their body that they have to address. Gut permeability or leaky gut issues. Again, this is where the gut is damaged by antibiotics, toxins, microplastics, and it's letting toxins into the body that would otherwise be, that would not be allowed in. So that causes systemic inflammation there. Environmental toxins, a lot of these are obvious, right? Pollution, chemicals that you shouldn't be ingesting, but some of them are not quite so obvious. Microplastics, right? Everything I've been telling people on the podcast, adamant with my patients and my friends and family, that don't heat anything in plastics. Don't microwave Tupperware. You're just heating up these microplastics and putting them into your system. These little pods, the coffee pods that are convenient, you're just basically blasting plastic into your coffee and ingesting microplastics on a daily basis. You want to remove those environmental toxins, the one that the ones that are obvious and the ones that are less obvious. You want to manage psychological stress. And that's difficult in this day and age, but we talked about a lot of these things, right? If you're stressed at work, you want to take breaks, breathing breaks, you want to be able to manage stress perhaps with meditation and things of that nature. And some of the more obvious ones, you want to remove refined sugars and trans fats, things that we talked about, right? You want to get rid of the processed or the ultra-processed foods, the high fructose corn syrup, the refined sugars, the harmful fats, the seed oils, and the high glycemic carbohydrates. So the white bread, white rice, things of that nature, pasta that's made from white wheat sources. You want to get rid of those. Microplastics we talked about, and it really you should be removing all plastics from your from your kitchen and replacing them with glass. So after we do this, then we stabilize blood sugar through dietary elimination. We talked about this at nauseum with in episode seven, eight, and nine, um, talking about removing blood sugar triggers that you can stabilize your blood sugar so you're not spiking cortisol, because unstable blood sugar alone can drive inflammation through repeated cortisol spikes. So eliminating things like sugary sodas, candies, cookies, cake, all the things that people really like, but unfortunately are driving inflammation. Dietary elimination focuses on removing all the things I just mentioned, right? Refined sugars, even hidden ones like high fructose corn syrup in things like ketchup. When you go shopping, people don't think about this, but when you're having french fries or eggs or whatever and you're spurting ketchup all over it, it's got high fructose corn syrup in it, or a lot of them do. So you want to just look at the labels, flip it around, and look at the ones that have that don't have high fructose corn syrup in it. And that's even a little bit of this can cause blood sugar spikes. Ultra-processed foods, again, we talked about that. Frozen foods, fast foods, trans fats, seed oils. If it's sunflower, if it's a seed, don't have it. Replace it with olive oil, replace it with avocado oil and excess alcohol. Alcohol is an environmental toxin if you look at it that way. So you want to decrease, limit your amount of alcohol or eliminate completely if you can. So we stabilize the blood sugar first, then we support gut repair using what's called the functional medicine 4R framework. I didn't invent this, but the 4R framework where we remove, restore, reinoculate, and repair, right? So we remove harmful bacteria and irritants, we restore digestive enzymes and stomach acid, we re-inoculate the gut with beneficial bacteria with the use of certain foods and probiotics, and then we repair the intestinal lining using supplements like glutamine and zinc. And obviously, repair occurs when you just switch away from an unhealthy diet to a more healthy diet. And the gut is often the amplifier of systemic inflammation because the foods we eat and the associated toxins that are found in them are the usual suspects that lead to chronic inflammation. So phase one, it's not flashy, but it's foundational. We need to calm the fire before rebuilding the house.

SPEAKER_01 16:34

That's a really good analogy. I love that. We gotta put out the fire first before we can repair any of the damage. All right, let's now talk about phase two, nutritional and biological balancing. What does that look like?

SPEAKER_00 16:48

Sure. So it makes sense, right? Once the triggers are reduced or eliminated, now we shift into phase two, which is biological balancing. And now we supply the body with cooling input, so to speak, right? We would try to transition towards more of a Mediterranean style anti-inflammatory diet. So we need to replace those foods that we removed. So people constantly, when I have, when I'm discussing with my patients and I remove all their favorite foods and all the things that they're eating on a regular basis, their first logical question is, well, what am I going to eat? And I provide lists of foods that will not cause inflammation. So things like leafy greens, colorful vegetables, olive oil, preferably organic extra virgin olive oil that's cold-pressed and single-sourced olive oil. We don't want blends here. And what does that mean? Well, when you look on the olive oil bottle, just turn it around and look at the label, it'll tell you where it's sourced from. If it's sourced from Italy and that's it, it's a single source. But a lot of these oils are sourced from multiple countries, which means they're blending it. And they may not necessarily be blending it with extra virgin olive oil. They're cutting it with cheaper oils, so to speak. So you want to be very careful when you buy olive oil. And again, a lot of people think that all olive oil is the same, and it's not, unfortunately. There's very deceptive marketing out there. So you want to look at labels very closely. Again, I'll say it again: extra virgin olive oil. You want it to be organic so it doesn't have toxins in it. You want it to be cold pressed and single sourced. So that's something that's quite important. You want to eat fish like wild salmon and sardines, things like flaxseed and chia seeds are quite healthy. Moderate amounts of fruit. Remember, there's a lot of sugar in fruit, so there's the difference between fructose and glucose, right? 30, 40 grams of sugar from coke has the same effect on your body, the same as 30 or 40 grams of sugar from fruit. You're still going to stimulate insulin. So one is a healthier sugar, so to speak, but really the activation of insulin is what makes it unhealthy. So you want to have moderate amounts of fruit and legumes or beans, multiple different types, whichever one you like. But these are very good. They have lots of fiber, they stabilize your blood sugar. Then we look into things like omega-3 fatty acids. Everybody's heard of these. A lot of people are confused about what they are. What we want to do is we want to increase the omega-3 intake to rebalance inflammatory signaling. And this is important because we want to shift the omega-6 to omega-3 ratio because omega-6 fatty acids are what's called pro-inflammatory. That's where your inflammatory seed oils come in because they have a lot of inflammatory omega-6 fatty acids. You want the omega-3 fatty acids. I know it sounds like chemistry and it's complicated, but when you start to make these dietary changes, those changes get made automatically. So when you're eating healthier fish, they have a predominance of omega-3 to omega-6 in them. So I'm not asking you to be a chemist here. I just asked you to make some simple changes that'll decrease inflammation. We want to increase polyphenols and antioxidants from things like berries, cherries, green tea, and olive oil, as I mentioned. These nutrients will neutralize free radicals and shift immune signaling away from inflammation. It'll calm down the system. And now that now the immune system then begins to recalibrate, right? Reactivity decreases, energy begins stabilizing. And this is where patients begin to notice subtle improvements in their symptoms.

SPEAKER_01 20:07

So very helpful. Some options of different things that we can replace. In phase two, let's move on to phase three, our resolution and lifestyle optimization. I love that word. Tell us more about phase three.

SPEAKER_00 20:21

If you remember the different phases of the popkin method, everything starts with lifestyle modification. So really phase three is where you actively cause inflammatory signal resolution. Inflammation doesn't just fade, it has to be actively turned off. So we may introduce targeted natural supplements like a curcumin, ginger, green tea, vitamin C, vitamin D, magnesium, and again, omega-3 fish oils, either in food form or supplement form. These support the resolution phase of inflammation. But just as important as lifestyle optimization, nothing works unless you optimize the lifestyle. How do we do that? Seven to eight hours of sleep, moderate exercise, either walking, yoga, resistance training. Again, we have to strengthen our muscles. Muscle is our longevity reservoir. So we want to gain and maintain muscle as much as we can as we age. Stress regulation practices, deep breathing, stress relieving tactics, like walking away from stressful situations, taking a breath, thinking about your response before actively responding, meditation, things of that nature, sunlight exposure, of course, in moderation, nervous system down regulation, especially at night, by creating what I like to call a digital sundown. That's right. Put your phone down, calm your mind, don't take your phone to bed with you. Everyone's laying in bed and they're holding the camera, holding the phone above them, wondering why they can't sleep, because they're stimulating their brain with all these inputs. We didn't do this 30 years ago. We didn't do this back in caveman times, right? We had a normal circadian rhythm because when the sun came up, we woke up. When the sun went down, it activated the sleep response. Um Now we're constantly blasting our uh our brain with inputs and wondering why we can't sleep. So leave your phone in the kitchen, uh, don't take it to bed with you. Um, all of these things will calm the body, they'll calm the mind. This phase signals safety to your body and the body repairs itself when it feels safe. Are you guilty of bringing your phone to bed with you, looking up things and just stimulating your brain before you go to sleep?

SPEAKER_01 22:24

Yes, I am. It lives on the nightstand next to me because it's my alarm. So it's very easy to just have it there. I try to put it down, and if I need something to relax my brain, I'll put on like a very easy show to watch and then turn the TV off when I feel myself getting into my sleepiness. But I do have an app on my phone. It's called Rise, and it lets me know like when my melatonin window is, and it's so funny, and it tracks my circadian like peaks and dips throughout the day. It lets me know what my sleep jet is. And I honestly check it like six times a day. I know what I like, I have all this energy because I'm peaking, and when I'm like totally out of it or maybe in a bad mood towards the I don't know, getting into the two-thirds of the day. I know I'm in my energy dip, but whenever I know that melatonin window is coming up, always try to put the phone away. So I do a lot of tracking to stand it and not leave it to chance, which helps me a lot. But yes, I happen known to be in a scroll hole in the doom, scrolling scroll hole late at night on my phone. But I try not to.

SPEAKER_00 23:23

That'll keep your brain activated for sure. And you mentioned melatonin. Your melatonin is actually regulated first thing in the morning. When your brain, that's why we talk about getting early morning light in your eyes. The first thing you should do when you get out of bed is make a beeline for natural light. Get natural light in your eyes because that sets the clock for your melatonin to start to rise 12 to 16 hours later. It's the circadian rhythm. And it goes back to caveman times. The sun came up, we woke up, and the lights in our eyes, and then it started that cycle. That cycle of melatonin rise can be disrupted by visual inputs from your phone and your computer and television and things of that nature. So that's why we're talking about that. So I find it's uh it's it interesting that you mentioned melatonin and tracking it on your phone. And these tracking devices are helpful, but again, it also entices people to bring their phone into bed with them and then stimulating their brain at night can lead to some of the problems here. There's a lot of lifestyle modifications that go into fixing things, and it's hard because most people I call it FOMO. They're missing out on information. So now they're in bed, and doom scrolling and all of the things that you're learning that at some point it gets to be uh a little much, but that's where lifestyle modification comes in. And the digital sundown is important. Turn the lights down, make the room cold, start your process of going to bed so your brain can relax and and go to sleep.

SPEAKER_01 24:45

I love that. Digital sundown. Very cool. Well, I live I live in New York City in a very small apartment. So if my phone's in the kitchen, it's still only an arm's reach from my bed. So that's the caveat if you live in New York City. All right. How does inflammation affect hormones in men and women? Is there a difference?

SPEAKER_00 25:03

Well, definitely. There's a huge inflammation disrupts hormone signaling at multiple levels. So in women, inflammation will disrupt ovulation. So people that are trying to get pregnant can be affected by this. It increases PMS severity. So obviously, if you're not feeling well and you're overly, if you have a lot of inflammation and now PMS severity is increasing, you're not going to feel well with more PMS symptoms. It worsens estrogen dominance patterns, and we'll discuss what estrogen dominance patterns actually cause in a later podcast episode. But you want a balance between estrogen and progesterone. And again, everything is in a cycle. So estrogen and progesterone should be in a natural cycle where both are equally, well, maybe not equally represented, but they're appropriately represented. And when you get more estrogen than progesterone or an estrogen dominance pattern, it leads to a lot of symptoms that women do not want. But we're going to talk about that in a later podcast episode when we dive deeper into hormones. It impairs thyroid hormone conversion. So now we're having issues with thyroid hormone regulation. It worsens perimenopausal and menopausal transitions, certainly not comfortable there. In men, inflammation can lower testosterone production. So that causes decreased muscle, increased visceral fat, reduces lean muscle mass, and recovery from exercise, impairs libido and sexual function. Chronic inflammation elevates cortisol. Here's the cortisol term again, right? And elevated cortisol will do lots of bad things, as we mentioned in the other podcast episodes. But cortisol elevation will suppress sex hormone production. So testosterone in men, estrogen in women. So it really disrupts a lot of beneficial effects of hormones that we want. But because cortisol is elevated and now we're getting disruption in these hormones, people don't feel well and leads to other symptoms and it creates this vicious cycle that we talked about. So it's not just a metabolic issue, it's a hormone issue. So when patients say, I think my hormones are off, often inflammation is the culprit.

SPEAKER_01 27:00

So next, what are some early signs of improvement before lab markers change? And I know we said earlier you might not have an abnormal lab, right? But um sometimes there is. So what can we see when we've implemented steps one through three? And, you know, they're we're like, okay, we're on the right track. We can get some kind of payoff for our efforts.

SPEAKER_00 27:23

Progress over perfection, I always say. One of the most important things I teach my patients is to look for early subjective improvements in how they feel, not objective changes in things like whether labs or blood pressure or blood sugar or other markers. Let's see how you're feeling first, because typically that improves before your numbers will change. And before the labs change, patients may notice more stable energy, fewer sugar cravings, clearer thinking, less brain fog, less bloating, improved bowel consistency, so less diarrhea, constipation, they're having more regular bowel movements, better sleep onset, they're falling asleep faster, they're staying asleep longer, they wake up better rested, so they have a more restorative sleep, reduced joint stiffness, improved mood stability. So a lot of these things are things that people are welcoming. These are things that people are looking for. And these typically, these changes often occur within a couple of weeks, two to three weeks of making the changes that we mentioned, removing the triggers and adding the cooling inputs and so forth. The objective lab markers like CRP and other inflammatory markers may take longer, generally eight, 10, 12 weeks before we start to see any changes in the lab. So I try to tell patients to be patient, look at your symptoms first rather than looking at objective numbers. So I teach my patients to notice early wins because physiology and symptoms improve way before the paperwork does.

SPEAKER_01 28:49

All right. Dr. Popkin, this is tremendous information, so enlightening. But how does that actually look in a treatment plan? What do you what how do you make these steps into a treatment plan for your patients?

SPEAKER_00 29:01

Sure. Before we wrap this up, let's look at the framework for how the Popkin method would structure a treatment plan that includes all the required elements of the Popkin method. And everyone should know this by heart, but again, including lifestyle modification, diet, exercise, supplements, peptides, hormone modulation, stem cell and exosome therapy. And at the very end of all this is, of course, management of prescription medications if there are any. Talking about the Popkin method, I'm going to give you a clinical treatment summary for systemic inflammation. And if we were to summarize how we decrease systemic inflammation using the Popkin method, it would look like this. It's structured, it's layered, it's sequential, it's not reactive, it's not random, it's not supplement first or peptide first or stem cell or exosome first. It's a system. So systemic inflammation improves when you calm the system, reduce biological reactivity, restore physiologic balance, and then only when appropriate, we introduce regenerative therapies. So phase one, calm the system, move the triggers. Before anything is advanced, before anything advanced is considered, we eliminate the triggers, right? So we talked about this. Lifestyle stabilization, lifestyle modification. Get seven to eight hours of sleep nightly with consistent timing. Go to bed at roughly at the same time, get up at the same time. Light exposure, we talked about this earlier. Get morning sunlight within 30 minutes of waking. I like to tell patients the first thing you should do is get up and get some natural sunlight in your eyes that stimulates your brain to wake up, gets the melatonin signal started for sleep later on in the day or later on in the evening. Stress regulation, breath work, parasympathetic activation, walking outdoors, things that put you in more of a rest and digest stage rather than fight or flight. You don't want to constantly be in flight or fight. You want to reduce environmental toxin exposure, plastics, microplastics, processed foods, poor air quality. So those are the lifestyle modifications that people should incorporate. Blood sugar stabilization, right? We've talked about this, right? The past two or three episodes. We're very big on blood sugar stabilization. So eliminate refined sugars, right? No sugary drinks, sodas, cookies, cakes, things that everybody likes, but those refined sugars cause problems, right? They stimulate cortisol. Cortisol stimulates stress hormones and causes all sorts of issues. So you want to remove them. Move ultra-processed foods and fast foods, move high glycemic carbohydrates, all the wet, all the white breads and rice and pastas and things of that nature. You want to get rid of those. And you're you want to anchor your meals with protein and healthy fats. We talked about this. Go back and listen to episode seven, which talks about the foods. Episode eight talks about your gut health, and episode nine kind of wrapped all that up. So this is a sequence of podcasts that are going to help you to do all these different things. Because remember, blood sugar volatility alone can perpetuate inflammatory signaling through cortisol and insulin dysregulation. So making those changes will fix a lot of this. Then gut restoration using the 4R framework, remove the irritants and pathogens, restore digestive support, reinoculate the gut with beneficial bacteria, and repair intestinal lining integrity, basically giving yourself a healthy diet and decreasing the stress and cortisol activation. The gut is often the ignition site of systemic inflammation. We're taking in these triggers through our gut. So that's where we want to focus to eliminate them. Then phase two, reduce reactivity, right? We want to rebalance the biology. So what does that look like? Once the triggers are reduced, we want to actively cool the immune signaling. So again, we utilize an anti-inflammatory nutritional template, right? The Mediterranean style structure that I like leafy greens, cruciferous vegetables, wild caught salmon, sardines, extra virgin olive oil, berries, green tea, polyphenol-rich plants, adequate protein to preserve lean muscle mass. Actually, last time in the last podcast I mentioned to message me and I'll send you a healthy eating grocery list. We had a number of people that reached out and did that, and I sent it to them, sent it to you as well. We'll get your your input on that as well. But it basically, if I'm going to remove foods that you can't eat, want to replace it with foods that that you can eat, right? So what did you? I'll put you on the spot. What did you think of the grocery list? I took most of your favorite foods away, but replace them with that weren't that difficult, right?

SPEAKER_01 33:17

No, not at all. I love salmon. I love acrutity. I love your use of the word cruciferous. That's a really good one. I think a lot of it just comes down to the discipline, the self-discipline of making sure that you prepare in advance instead of just grabbing something on the fly, which is usually the unhealthy in which we do so much. So back to your first point of lifestyle optimization, right? It starts way before that actual moment when you have to make the decision because usually that decision is easiest to reach for something that is unhealthy.

SPEAKER_00 33:49

Yep. That's usually what happens. Right now we've talked about lifestyle modification, diet, exercise. Now we move into some strategic supplementation, right? Again, we you can't supplement your way out of a bad diet, but once you correct the diet, then we want to add some healthy supplements in. So omega-3 fatty acids that have the appropriate ratios of EPA and DHA. Those are the omega-3 fish oils that you'll find. And again, you want to get a good quality omega-3 fish oil. And you can go on the Popkin Method website, click on supplements. I use a lot of Thorn pharmaceuticals supplements. They are super clean. They have label transparency. You can click on there, look at some of the supplements there. I like curcumin, aquarcetin, again, part of the core five, magnesium, vitamin D. All of these things do help with inflammation. A lot of people ask me about NAC, N acetylcysteine for oxidative stress. Yes, it's helpful. It's one of the things you can add. And then the goal here is not suppression, it's modulation. You want to support. Supplements are supportive. They don't fix the problem, they're supplemental to your diet. And then phase three, what does that look like clinically? We want to restore resilience and optimize your body's physiology, right? So now we focus on long-term system optimization. So exercise prescription. I want people to move and not be as sedentary. Zone two aerobic conditioning for mitochondrial support. We'll talk more about that in later episodes. But again, now the term mitochondria is coming back in here. Mitochondria are the powerhouses of the cell. This is where we make our energy. So there are different types of exercises that will help to support mitochondrial production. Resistance training, two to four times weekly to preserve lean muscle mass. Remember, we want to gain and maintain muscle as we age. Muscle is our longevity reservoir. Mobility work, you want to do stretching, walking, that helps improve lymphatic flow. Remember, fat is inflammatory tissue and muscle is anti-inflammatory tissue. So preserving muscle is foundational. Sometimes when I'm talking to patients that seem resistant to that, I tell them I'm either gonna have them tattoo on their forearm muscle and protein, or I'm just gonna take a Sharpie marker and write it on there so that they can understand how important muscle and protein is for their health. Then we move into hormone optimization when it's indicated. Chronic inflammation, as I mentioned, disrupts hormone signaling. And in certain patients, like men, testosterone, we need to balance out women estrogen, progesterone as well. Thyroid optimization, DHEA support were appropriate. So again, hormone modulation should be guided by labs and symptoms and physiologic need, not based on trends, right? We want to do hormone modulation, not hormone replacement, right? Not everyone that comes into my office gets testosterone and estrogen and progesterone. I like to modulate their hormones, and the first thing I do is to try to eliminate or decrease, not eliminate totally, but decrease cortisol, because cortisol damages the factories that produce these hormones. Correct hormonal balance reduces inflammatory signaling and improves metabolic resistance and makes people feel better. Men that have higher testosterone and women that have higher estrogen, they feel better. Now we move into phase four, advanced biologic modulation in selective cases. This is where peptides and stem cells and exosomes come in. And I do want to mention an important compliance and safety information. Regenerative therapies like peptides and stem cell therapy and exosome therapy, they're evolving areas of medicine. And these interventions, they may not be FDA approved for all indications that we're going to discuss. They should only be performed under appropriate physician supervision. I see a lot of people out there using them haphazardly, especially the peptides, going online and buying research peptides and not knowing how to use them. So we don't want to do this. They require careful patient selection and risk-benefit analysis. So again, we just don't throw peptides and stem cells and exosomes at patients without determining if the risk-benefit is going to be in their favor. And again, we want to support the use of peptides and stem cells and exosomes with everything else that we talked about. Lifestyle, diet, exercise, supplements, hormone modulation before we move into those types of treatments. And again, a foundational lifestyle with nutrition, sleep, metabolic stabilization has to be addressed before considering any of these regenerative interventions. And individual results will vary. These therapies are not guaranteed treatments, and they should not replace evidence-based medical care. So, having said all of that, advanced biologic medicine is where regenerative therapies enter, not as first line treatment, but in cases of, let's say, persistent inflammatory states. We've done all the things and patients still have symptoms. Patients have autoimmune patterns, patients that have Crohn's disease, ulcerative colitis, rheumatoid arthritis, lupus, type 1 diabetes, multiple sclerosis. This is where you have an autoimmune activation of your immune system. Your own body is triggering your own body against itself. So that's where we start to look into peptides and stem cells and exosomes to really help out with that problem. Degenerative joint disease, chronic injuries, incomplete response to foundational therapy. As I mentioned, if we've done everything up to that point, we've done the lifestyle modification, fixed the diet, added exercise, and some basic supplements, and we're still not getting the results we want, then we start to think about peptides and stem cells and exosomes. So talking about peptides, depending on the particular patient, I use a lot of uh BPC157 and TB500 for tissue repair and signaling. So injury repair and recovery, thymusin beta 4, uh, thymusin beta alpha for immune modulation, MOT C for metabolic signaling. And there's a whole bunch of peptides we talked about in a prior podcast. You can go back and listen to those. But these can support tissue healing and what we call immune recalibration. So now we're we've gone through the entire process of the popkin method, lifestyle, diet, exercise supplements, hormone modulation, peptides. Now we're moving into stem cell and exosome therapy or the advanced regenerative therapies. So talking specifically about these things here, these therapies are not anti-inflammatory in the traditional sense. They're more immune-modulating and regenerative. I'm trying to keep this from being overly technical because it is a very technical area of medicine, but I tend to use mesenchymal stem cells, which are often derived from either umbilical cord tissue that's donated or adipose fat tissue sources that are either donated or uh harvested directly from the patient. And they don't simply replace damaged tissues. Their primary function is what's called peracrine signaling. And what they do, and we're getting a little bit technical here, but it's important to mention some of these things. I'll try and demystify this here. They secrete anti-inflammatory cytokines, things that go against inflammation. So they help to decrease interleukin, interleukin 6, they help to decrease C reactive protein, they downregulate overactive immune responses, they promote tissue repair, they enhance angiogenesis or blood vessel formation, they modulate macrophase activity from pro-inflammatory to anti-inflammatory states. We're getting really technical. I'll back off on the technicality here. But in chronic systemic inflammation, these mesenchymal stem cells, they may help shift the immune tone away from chronic activation and towards regulation. So the message here is that it turns that inflammatory signal off. Whether I inject it directly into a damaged muscle or a damaged joint, or I put it intravenously, it turns the inflammatory signal off, which is really the message here. So some of the clinical areas where this has been explored and we look to treat would be autoimmune conditions like I mentioned above, rheumatoid arthritis, Crohn's, ulcerative colitis, things like that, multiple sclerosis, degenerative joint disease, chronic inflammatory states, neuroinflammatory conditions like Alzheimer's, Parkinson's, autism, post-stroke care. Again, this is all we're moving into this phase of biologic medicine now, and we're really trying to expand on this. And we need more randomized, double-blind, placebo-controlled trials. So right now we're going off of a lot of anecdotal data and anecdotal treatment responses. However, what's really important here is patient selection, right? Patient selection is critical because we want to make sure that if we're going to be using any of these therapies, we've fully optimized the patient first before we move into something like this. So stem cell therapy is not a shortcut around foundational lifestyle correction. And if inflammatory triggers remain active, the outcomes are going to be limited. So we have to really improve the environment of the body before we put in things like peptides and stem cells and exosomes. Talking now about exosomes to wrap things up, what are exosomes? Exosomes are what are called extracellular vesicles that are derived from stem cells. Essentially, it's the message that the stem cell produces. So when the stem cell lands on an injured tissue, it creates a signal that gets secreted that does the magic to do the repair. That's the exosome, is what we're talking about. So they function as basically biological markers. They contain microRNA, growth factors, cytokine modulating signals, things that turn off inflammation. They help decrease pro-inflammatory signaling, they promote tissue regeneration, or they can promote tissue regeneration, they can enhance cellular communication, they can reduce oxidative stress and things of that nature. And because they're acellular, then they can sometimes offer regenerative signaling without introducing whole cells into the body. So they may be considered in things like orthopedic inflammation or orthopedic injuries, chronic injuries to tissue, neuroinflammatory support, systemic inflammatory modulation in advanced cases. Again, these therapies work best in a biologically prepared system. We want to decrease inflammation with all the other things that we mentioned lifestyle, diet, exercise, supplementation. We want to remove the triggers first before we start to move into these types of therapies. Basically, give you an analogy the soil must be prepared before planting is. Regenerative Steve. So I know that was a bit lengthy, but that that's kind of what a treatment plan would look like in the Popkin method, going from all the way from lifestyle modification through diet, exercise, supplementation, peptides, hormone modulation, stem cells, exosomes, and then eventually management of prescription medications. So it's involved. That's what we do. We really put together a very comprehensive program. So I think you can see that it's quite involved.

SPEAKER_01 44:25

Yes, absolutely. Where do I sign up? Number one. But I think the important point that you mentioned is that it first starts, even though the treatment plan is extensive and comprehensive, it first starts with your own lifestyle modification. So if someone uh home listening feels overwhelmed, where should they start? Where can they take responsibility? And the three-phase approach to begin addressing this chronic systemic inflammation.

SPEAKER_00 44:52

Well, I mean, if you suspect systemic inflammation is the cause, you want to start simple. And I know I wrapped up the last question pretty technical and advanced, but you want to start simple. So first, stabilize blood sugar by removing the suspect foods like sugary drinks and snacks. That's easy to remove. So no sodas, no sweets, cookies, candies, things of that nature. Next, you want to remove any obvious inflammatory foods that are high in salt, sugar, and fat and additives like ultra-processed foods, including frozen meals, processed meats like cold cuts, hot dogs, stop eating fast food. Most foods that are designed for maximum convenience and palatability are generally not good for you, which is a shame because it's quite convenient, but unfortunately not good for you. So go back and listen to episode seven, learn more about these foods. Also, you can message me at the Popkin Method website, and I'll send you a patient-friendly Popkin Method shopping guide to help you remove any inflammatory foods and pick the proper foods to eat. My co-host endorses the list. I took away all of her favorite foods, and she was able to replace most of them with healthy choices. So I appreciate the endorsement there. The list is really written in clear, supportive language and aligns with my physician-led approach to reducing inflammation through clean eating, gut health restoration, fat loss, and lean muscle support. So you can start making changes to help your body reduce inflammation. And then some more things you can do to decrease inflammation. Again, prioritize sleep to help support your circadian rhythm. Go back and listen to episode five to learn more about that. Also remember, try to walk daily, do some kind of activity on a daily basis, try to reduce stress as much as you can in your life. And finally, don't start off with a full shelf of supplements. Make the simple changes and then add small amounts as you go along. Add in omega-3 fish oils, add in a pre and probiotic, add in vitamin D3, K2, or magnesium, creatin. Add these things in under the supervision of your physician, of course. Add these things in slowly. Don't just blast yourself full of supplements. If all else fails, consider guided dietary elimination of specific foods based on a symptom diary that's linked to the foods you eat. This way you can try to pinpoint which foods are problematic for you. So I tell patients, write down what you're eating, look at your symptoms. And typically the symptoms will occur within a few hours of what they're eating, and you can eventually narrow down which foods are problematic, and then you can remove them and see if those symptoms go away. So to sum things up, takeaway message from this podcast is that systemic inflammation is not random. It's a metabolic response to accumulated stress, whether it's nutritional stress, environmental stress, metabolic stress, psychological stress, right? It's just a response to all of these things that are accumulated. But the good news is that it's reversible, but it requires the sequence that we talked about. So final summary here for the podcast. If I were to summarize the treatment of systemic inflammation using the popkin method, it would look like this. First, calm the system. Second, reduce reactivity. Third, restore resilience. And fourth, selectively introduce advanced regenerative tools when they're appropriate. Lifestyle is not optional. Diet is not optional. Muscle preservation is not optional. Supplements are exactly that. They're supplemental, they're supportive. Hormones are the modulators of your, of how your how your body is going to function in both men and women. Peptides are signaling tools, and stem cells and exosomes are regenerative amplifiers. And none of them work by themselves. They all work together, but none of them can replace the foundation of clean, healthy living. Inflammation resolves when the body feels safe, when it feels nourished and supported. And when you remove the drivers and the triggers and restore biological balance, the body does what it's designed to do. It heals itself. So this is where the Popkin method can help. If you'd like additional support, you can message me through the Popkin Method website or any of my social media platforms. You can schedule an online or an in-person visit to help identify your specific inflammatory triggers and remove them to help you achieve the healthiest version of yourself.

SPEAKER_01 48:59

Love it. Thanks so much, Dr. Popkin. Like we've said, inflammation doesn't mean that your body is broken. It just means that it's been working too hard for too long and without a plan. And healing truly starts when the cycle finally makes sense. If you're ready to explore these therapies the right way, visit thepopkinmethod.com to learn more and schedule an online discovery call or an in-person visit with Dr. Popkin today. This is the Popkin Method, and we will see you next time.

SPEAKER_00 49:27

Yep. Looking forward to seeing you next time. And again, you can message me for the healthy eating guides, but also I have a systemic inflammation guide as well that I can send to you, which will help you identify these triggers and it'll help you systematically remove them as well. We're putting together a list of helpful tools. So if you message me, I'm happy to send them out to you. And we'll look forward to seeing you next time.