Peter Kozlowski, MD is a functional medicine physician based in Chicago, Illinois. In this episode, we discussed the importance of detoxification and gut health in his practice. He emphasizes the need to address the mental, emotional and spiritual aspects of health because they play a significant role in detoxification.

Dr. Kozlowski recommends focusing on the basics of detox, such as sleep, hydration, bowel movements, and sweating, before considering more advanced testing and treatments. He also highlights the importance of community and social support for maintaining a healthy detoxification system in the body. Dr. Kozlowski encourages practitioners to work together and collaborate rather than compete in order to better serve patients and improve outcomes.

Download and listen to learn more about the following:

  • How recovering from an alcohol-use disorder led Dr. Kozlowski to functional medicine
  • The value of testing for heavy metals, mycotoxins and glyphosate
  • Addressing the skin and gut barrier during detoxification protocols
  • Dr. Kozlowski’s experimentation with different payment models and in-person versus virtual visits
  • Using cortisol labs, stool cultures and other tests to show patients how trauma impacts their health
  • And much, much more


Heart, Mind and Body: The Power of Lifestyle and Integrative Medicine  | Ep. 322


Dr. Peter Kozlowski: So, to me, a lot of times getting the gut right, you have to get the small intestine right. The biggest piece, and I would say the secret and the part that really nobody wants to hear is to me the true key to all gut health is our mental, emotional and spiritual health. And that sympathetic nervous response on the gut. And so, to me, everybody talks about the gut-brain connection. To me, the gut-brain connection is the vagus nerve. The vagus carries signals from your brain to your gut and your gut to the brain. And for most of us, that vagus nerve is constantly in that sympathetic nervous response.

James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs and health technology, as well as practical tools to help you transform your practice and the health of your community.

This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective functional and integrative medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.

Hello and welcome to the podcast. This week we are starting our conversation about 2024 detoxification, preparing your practice for an influx of new business, whether it be individuals and groups. In the first quarter of 2024, we have Dr. Peter Kozlowski, who is a functional medicine physician. His practice is in Chicago. What you’ll hear during this really insightful podcast is one, a little bit about his history coming to functional medicine, some of the mentorship he received, and also some of the journey that he went on during COVID, but also some really deep insight into both gut health and detoxification. As we start to look at what are some of the keys to be able to do that effectively with patients, I think there was a lot of good stuff in here. If you have thoughts, feel free to reach out to us. And if you’re preparing your practice for 2024, we’d love to hear from you if we can help. Enjoy.

So, a warm welcome to the podcast for the first time, Dr. Peter Kozlowski. Welcome doc.

Dr. Peter Kozlowski: Thank you for having me. It’s an honor.

James Maskell: So, yeah, we’re really excited to connect today. There’s a number of things that this time of year we really like to look into detoxification as a topic because so many clinics around the country are using this time of year to prep for either bringing new patients into the practice through detoxification, education support, or bringing patients back into the practice who have had historical success in groups and getting organized. Just to get our mind around. That is a good starting point and just have the opportunity to check out some of your work and your books. But I know every doctor that I’ve ever had on the show has an interesting story of how they ended up participating in the functional medicine ecosystems. So, do you want to just give us the quick rundown of your story, doc?

Dr. Peter Kozlowski: Yeah, absolutely. Probably most of us, I would’ve never dreamed that this is what I’d be doing. It was very traditionally trained thought I grew up, both my parents were doctors, so it was always in my mind and I randomly got introduced to it. And so, most of us, the reason we get into functional medicine is because we get our own health issues, and we don’t get better. So, then we search out for something different. Mine was not a physical illness, mine was a mental illness, so I’m a recovering alcoholic. When I got into residency, I tried to stop drinking and I couldn’t. And so, I had to go away to treatment. I never considered myself an alcoholic because I was not someone under the bridge. I was crushing all my tests. I was doing great in school. I didn’t have problems. I just liked to unwind on the weekends, but I tried to stop and I couldn’t.

So, that’s when I went to treatment and that’s where the idea of root cause disease started for me because I went to this six-week treatment, and we never talked about alcohol. It was always about why, and they sat there and they were telling me that I had trauma, that I had emotional problems. And my first day, I pounded my feet into the ground like a little child, and I was 28 and I was acting like a 12-year-old, not wanting to admit it. But through that treatment program and seeing how I was able to cut alcohol out of my life, it was all about the why. And so, for me, a big root cause is I’m a first generation American. My parents are from Poland. I never felt secure in my own skin. So, I learned that basically I spent my whole life totally insecure and the way I found security was alcohol.

And so, I used that in order to fit in or feel comfortable or feel like an American. And it worked for me until it didn’t. So, I finish up treatment and I go back to residency and we had this doctor that worked with us as an attending and I’m a family practice doctor. That was what I did my residency. But every time we had a patient admitted he would put them on vitamin D and a multivitamin, and we used to make fun of him, we would be like, why are you wasting our time with this? We could be writing hypertension, drugs and opiates and you’re telling us to write vitamin D scripts. So, I talked to him one day and he is like, I’m studying this thing called functional medicine. And he took me to the website and we were required to do CME to go to conferences.

And I didn’t really know what I wanted to do, so I was kind of just like, let me check this out. So, I went to the A-F-M-C-P in 2011 or 12, and from the first hour I knew my life could never be the same. Everything was being taught from a physiology, a biochemistry level. I was probably the youngest person there in my career and at least as far as I was still an intern in residency. And so, there’s all these older doctors and surgeons and all these different fields and I was so confused. I was like, what are you guys doing here? Why? And everybody’s telling me, this is the future of medicine, this is the future of medicine, this is what you should stick with. So, that’s what I did. And I was very blessed. I had a very supportive residency program where they allowed me to do away rotations.

And so, through the conferences I got to meet Dr. Hyman and some of his staff and Elizabeth Boham, who ended up becoming one of my biggest mentors and friends in this field. So, I got to go spend a couple of weeks at the Ultra Wellness Center in Lennox. I got to know Susan Blum and I got to spend some time with her. I got to meet some of the doctors at Deepak Chopra’s Clinic in Carlsbad. So, I went and trained there. So, I got to do all of this during residency. And so, by the time I was done with residency, I went off and tried to start a hybrid practice where I was insurance-based and cash-based and tried different things and eventually went into just a cash-based practice since 2015 now and have tried all types of different things and done subspecialties in maps. So, working with pediatrics and functional medicine, I got very into environmental medicine and exploring these different avenues of functional medicine, but it’s a journey that I could have never dreamed of. I’d never thought I’d be on your podcast saying I was recovering alcoholic and a functional medicine doctor and now written two books and gotten to go back and teach with IFM and do lectures and then all this amazing stuff that’s happened. And one other just major… Go ahead.

James Maskell: Yeah, just an amazing sort of conversation about the lineage. I mean, first of all, I know there are some interesting residencies popping up now around the country and let’s say lifestyle medicine and that kind of stuff, but it sounds like you kind of got the best of all world there. Being able to work with Dr. Blum, Dr. Hyman, Dr. Bur mean, these are some of the Aries of the field.

Dr. Peter Kozlowski: I got very, very lucky. And the other part of my story is the whole reason I actually ended up going into medicine was during my senior year at college, my best friend got diagnosed with lupus during spring break and passed away two months later, which is obviously an unheard of course of lupus, but I don’t think through traditional medicine I could ever really help someone with lupus. And now I have more patients in remission from lupus than I could count. So, also just an amazing grateful part of my story.

James Maskell: Yeah, it’s funny you mentioned lupus. I sometimes use that as an example with the frustration of conventional medicine where I say patients who go on that journey, it’s frustrating to, from their point of view, it feels like healthy, healthy, healthy, healthy lupus. But actually no one was able to really take it to them and say, look, this was progressing underneath. It’s just that you were not in a place to assess your function to a degree to understand that that was happening. So, I think that when people start to understand how it happened over a period of time and that there’s a journey back, that can be an empowering moment for them.

Dr. Peter Kozlowski: Absolutely. Yeah, it’s beautiful.

James Maskell: Yeah. Wonderful. Well, so that was the beginning of your journey and now you’re practicing, you’re in the Chicago area, and I think your practice took a little bit of a right turn during the pandemic, if I’m not mistaken.

Dr. Peter Kozlowski: Without a doubt. So, I was living in downtown Chicago for most of my life, and with the pandemic number one is obviously everybody’s business got destroyed and hurt. And me, I went from having usually typically a two to three month waiting list to sometimes not having a full week of patience. And that was a struggle that I think a lot of people went through. But also part of my journey is it always for me goes back to mental health. So, if people read my gut book or my detox book, I always go back to the mental health part of it. And for me, I have someone that has to work on my mental health very strongly. And part of what was losing my mental health is just the anger and the attitude and the disagreement in people over how to handle what was happening. So, in 2020, my wife and I, we rented an RV and drove west, and while she was sleeping in the RV and while she was sleeping, I applied for a medical license in Montana.

And when she woke up, I said, “Hey, do you want to come live here for a few years?” So, we went and hid out in Montana and spent a lot of time in nature. A beautiful thing of 2020 for me is that I learned that I was having the same kind of success over Zoom with my patients than I was in office because prior to 2020, I mean, I would have people reaching out from all over the place and they’d ask for virtual visits and I’d always say, no, it has to be in person. And then in 2020, there kind of wasn’t a choice. And then doing it long enough now, I mean, I’d say my practice is half and half of half in-person and half virtual. A lot of it’s just because people live all over the city and don’t want to drive, but also with just the way you could share screens and treatment documents and labs, I found it to be pretty efficient on Zoom, which has been a blessing because if you do want to get away from the winter, you can still go somewhere and work and still practice.

And so, that was a cool part of the journey. But we ended up moving back to Illinois just to be closer to family and friends. We grew up around here, so it’s just a lot closer to people.

James Maskell: Yeah. Well, awesome. Well, it’s an interesting story. I know everyone had to make different plans. I certainly resonate with getting in an RV and doing a random trip. I’ve done that in my life before too. So, let’s jump into the books. I know that that was a process of starting to share some of the wisdom that you’d learned through your IFM training, but I’m sure some of the wisdom from being face-to-face with patients and also some of the mentorship. Obviously, today we’re going to focus in on the detoxification stuff, but I think the first book was on gut health. Can you just share a little bit about that journey and what you wanted to share in the book and maybe some things that you’ve learned along your way that might be new to practitioners who are studying in the same journey and are looking to get great outcomes with their patients?

Dr. Peter Kozlowski: Yeah, I definitely wanted to start with writing about the gut because for anybody that’s done any kind of IFM conference, I feel like it’s drilled into your head. Start with the gut, start with the gut, start with the gut. So, that’s definitely where I wanted to focus. And so, to me, I break down functional medicine into five main areas that I look at and their food, gut health, mental, emotional, spiritual health, hormones and toxins. And so, in that first book, I covered nutrition, elimination diet, food sensitivities, the microbiome, the mental, emotional, spiritual part, and SIBO. And for me, having done this for a while, the number one condition that I treat is SIBO. And I think SIBO is extremely difficult to treat for most people. I think what really inspired me is what I found SIBO doesn’t always present with just GI symptoms. So, I’ve had more patients that I can count that don’t have any GI symptoms, but will have some kind of skin symptoms or brain symptoms or nervous symptoms, things that you wouldn’t think had anything to do with the gut or SIBO.

But I started finding that through testing and treating SIBO, I could see these systemic symptoms going away. In the traditional medicine world, it’s basically IBS, right? To me, every patient I’ve ever met who was diagnosed with IBS either in my practice test positive for SIBO or some kind of dysbiosis. And so, I believe SIBO is something that I’ve really spent a lot of time with and had a lot of success with. It’s almost never smooth. It’s almost always rocky, but people really want to focus on the large intestine, the microbiome. But it’s been my findings that you can’t fix the microbiome, the large intestine if you can’t get past the small intestine. So, to me, a lot of times getting the gut right, you have to get the small intestine right. The biggest piece, and I would say the secret and the part that really nobody wants to hear is to me the true key to all gut health is our mental, emotional and spiritual health.

And that sympathetic nervous response on the gut. And so, to me, everybody talks about the gut brain connection. To me, the gut brain connection is the vagus nerve. The vagus carries signals from your brain to your gut and your gut to the brain. And for most of us, that vagus nerve is constantly in that sympathetic nervous response. The first thing we do is wake up and check our phones and our minds are telling our guts, it’s a survival day. There’s a new war, there’s new violence, there’s new pandemic, there’s always something, there’s work, and then we’re having breakfast and we’re watching the news. And it’s just more just negativity and just the brain is shutting down the gut. And so, in my general opinion on what happens to a lot of people is for most people, disease starts as trauma. And to me, the way I define trauma is trauma is anything less than nurturing.

So, trauma can be as simple as you’re a kid, you come home from school and your parents don’t have enough time to pay attention to. You activates the sympathetic nervous response, which shuts down your stomach acid production. When we don’t produce stomach acid, you don’t digest, you don’t activate your pancreatic enzymes. All of that allows SIBO to take over. All of that allows dysbiosis to take over. And then when your gut’s all screwed up, then you’re getting more toxins in. You can’t detox. So, it’s not everybody’s story, but I hear the story so many times that in my opinion, it starts as this subtle mental, emotional, spiritual inadequacies changes. I mean, for someone like me, it was as simple as just being an immigrant and not feeling good enough. And I think set off a cascade of disease for me. And we’re trained in functional medicine to really focus on the timeline.

And usually when you plot out a timeline with someone, you can start to find these little subtle things that start to damage the gut. And for some people that could present as disease two years later for some people that could present as disease 50 years later. But to me, that’s the big thing, and that’s always the thing I see get in the way of people healing. And that’s me. I’m a perfectionist and I only think about the people that don’t get better. And so, over these years I’ve seen, I’ve put people on the same or similar candida treatment plan or same or similar SIBO treatment plan, and some people get better and some people get and don’t, or some people get better and then worse. And it’s the cycle. And almost always in my experience, the sympathetic nervous response, the mental, emotional, spiritual part that’s blocking true healing. So, that’s what I get really passionate about in my gut book. To me, the rest of it’s very easy. I mean, we have good testing now we can test you for candida and dysbiosis and SIBO and low acid and we can treat these things, but frequently you’ll see people get worse or not heal. And so, me being that just trying to find the answers to me, typically it comes back to that mental, emotional, spiritual part.

James Maskell: Yeah, it’s really interesting and I appreciate you sharing that insight. It’s almost like you’re saying it’s not the gut brain axis, but it’s the brain-gut axis is going in the other direction. And I think that’s critical. And it seems to me actually that when doctors come into functional medicine, and we’ve said this throughout the years, is that you come in and you’re very physiology focused, and then the gut is something that you feel like you can attack. And you’ve got all these new tools and you’ve got all these new tests, but then the longer that you go into practice, you start to realize let’s just have a conversation. Who is this person? Where are they in their life? What’s going on with them? Because ultimately it’s going bidirectional. And something that popped up the other day that I’d love to get your thoughts on, I mean this month I think that new research was just talking about Alzheimer’s and its relation to the gut and some of the new research on that. So, it’s almost like a mental emotional issue. Starts in the process, affects the gut health. The gut health becomes dysregulated. You get SIBO and then off the back of SIBO, now you have it going back up and affecting data, amyloid plaque, balance and production. So, that’s this sort of feedback loop that can be either virtuous or very pathologic.

Dr. Peter Kozlowski: And I think to me then that transitions into the toxin aspect of it because when we talk about toxins, we have our internal toxins, which could be SIBO and candida and dysbiosis and clostridia and these bacteria, but then all of that stuff kind of sets you up to allow the external toxins to come in the mold mycotoxins like the glyphosate, the heavy metals, the plastics. And then so people are living in this inflamed state, living in this inflamed state. What’s happening is mitochondrial dysfunction. Once we start damaging the mitochondria, then I think at that point everything’s fair game, whether it’s hormonal imbalances, whether it’s neurologic disease, muscular disease, chronic fatigue, brain fog. And so, it is this just ugly spiral that people get into. And so, I think it’s our job to start helping them figure out which points and trying to attack all of ’em at once.

James Maskell: Awesome. Well, let’s get into the detox stuff then. And what are some insights on detoxification that came up from your book that is unique that you feel like other practitioners around the country as they’re gearing up for detox season, maybe they’re starting groups, maybe they’re getting organized to run certain programs in their practice, maybe they’re tweaking their clinical programs. What would be your recommendation for thinking through how to put that together?

Dr. Peter Kozlowski: I think for me, one thing that I love to share is because not everybody has, so I love to do testing. So, for me personally, I do a lot of heavy metal testing. I do mold testing, I do glyphosate testing, I do whatever testing I can, and then I give a specific detox for those toxins. But I think a lot of times people are jumping past just the basics of detox, which to me, the basics of detox is toxins are fat soluble, and what detox is is this two-phase process in the liver that makes them water soluble so you can then pee poop and sweat them out. And so, for me, I think we always, when we talk detox, have to start with just four main basics, which is number one, talk to patients about sleep, sleeps when we recover, right? All day long we’re under attack.

And so, a lot of people aren’t sleeping enough so they’re not restoring and they’re not going to be able to detox as well. Then you’ve got people that aren’t drinking enough water and you should be drinking half your body weight and ounces and water to help flush those toxins out. And then I think a third major way is moving your bowels, and that gets into your gut health because that’s the other way we’re not detoxing, is for people that are constipated, people that aren’t having a bowel movement every day aren’t ready to detox because that stuff’s just going to be getting reabsorbed. And then to me, the fourth one is sweating. And so, whether that’s through exercise or I use a lot of infrared sauna for detox, but so I really like to at least make sure that people are focusing on those basics because those are free things that anybody can be doing.

You can work on your sleep, you can work on enough fluid intake, you can work on your gut to make sure you’re moving your bowels. You can sweat every day. So, I just think that just kind of like what you said earlier, we learn about all these detox mechanisms and all these different supplements and tests that we can use, and all that stuff can really add up financially for people. So, I think that for people that don’t have access to that stuff, it’s the basics of those four things for me that are often missed as far as what I’m doing. I know there’s, people do it different ways in the functional medicine world, but the most common toxins that I find are heavy metals. So, if for me, out of all the testing that I’ve learned in functional medicine, if I could just order one test for somebody I’ve never met before, I would do heavy metal testing. I’ve personally relied on pre and post chelation testing as a tool. So, that’s what I write about in my book. That would probably be my favorite test to order for someone. I think there’s so many heavy metals out there and people don’t realize it.

The second most common thing I work with is mold mycotoxins. That’s also a world that I never really dreamed I’d up in. I went back when I was writing for my book, the mold chapter, I went back to the pathologic basis of disease, which is this mass of textbooks for med school that’s supposed to teach you everything and everything that could go wrong with the body. And in that entire book, there’s two pages about mold, and the two pages are about allergies. They don’t even talk about toxicity from mycotoxins. So, that’s a massive one that I work with. Now for the last few years, there’s been urine glyphosate testing available. There was a national news article few months back that they found glyphosate in 80% of urine samples. In my practice, it’s 90%. And sadly, in my practice, people that are coming to me have already been eating organic and trying to clean up their environment. So, those are the things that I like. And then another one is that our first real detox organs are our skin, our gut, and our lungs. Everybody thinks liver first, but our first detox organs are actually our barriers. So, your skin is a barrier to keep things out. So, that’s where I write a lot about, and there’s been so much written about skincare products and sunscreen lotions and all the chemicals that men and women put on their bodies before they even leave the house.

People think about their, they’ll wash their hands 20 times a day to try to keep that clean. They think about their lungs, but most people don’t think about their gut as a major barrier. And when I talk gut, usually what I love to teach people the most is that the inside of your gut is actually outside of your body. So, your gut is a barrier just like your skin. But the difference is your gut barrier is so thin compared to how thick your skin is. So, it’s so much easier for this toxic world to get into our body through our gut. And so, that’s another area where it goes back to cleaning up the gut as a mechanism of detox just to try to keep this stuff out. So, there’s just so much stuff that we can be doing if you don’t have access to testing or supplements to just try to clean things up. Because the more you learn about environmental medicine, I’m sure you’ve been to many of these conferences and heard these things, it’s kind of like you walk out of it and you’re like, well, I can’t do anything. I can’t eat, I can’t breathe, I can’t drink, I can’t touch anything. So, toxic. So, that’s where I try to really offer people hope of, Hey, there are things that you can do to try to help to just clean your body up and your environment up.

James Maskell: Yeah, absolutely. Well, it’s an empowering message for sure. And I guess there on the psychospiritual, psycho man emotional aspects, what do you think about on detoxification? What have you seen as far as things that can open up pathways in that realm?

Dr. Peter Kozlowski: Yeah, I think it’s the most important part of health, but I think it’s the hardest one for me to help people with because all of our journeys are a little bit different. Some tools that everybody will talk about are meditation, and for some people it’s prayer. And for some people exercise as a mental tool. To me, coming from what I’ve seen in my patients, what is just the total game changer, and this comes from my own journey of recovery in the story of AA and recovery and addiction, the first step is just to admit you have a problem. And that’s what I see over and over in my practice where I don’t mostly work with addicts, I work with non-addicts, but I see the behaviors the same as if it is with somebody who’s an active addict, and that’s just accepting that, hey, maybe there is something that went wrong.

Maybe my relationship with my parents wasn’t the best, or maybe there was something that happened at school, or maybe there is something ongoing inside that. Once I see people just be able to accept that there’s something. So, I feel like a lot of the time my job is just trying to share my story because my story is not of someone that I don’t think should have ended up in rehab. I didn’t have anything severe. My trauma was created in my head. And I think that trauma is almost sometimes harder to deal with than for people that have this big stuff that happens to ’em because somebody would look at me and you don’t really feel bad for me. You just needed to figure it out. But what I’ve seen in myself and my patients is sometimes that’s just harder to accept, to be like, Hey, I do need to ask for help and recovery.

Again, you get through this whole process of your fears, your resentments, and then at the end of the day, the 12th step is helping others. And so, there’s so many different ways, even if you’re not a physician or any kind of practitioner or whatever is just the best place for me a lot of times is just to stay out of my own head. So, for me, I’m blessed to where I have a job where I can always worry about other people and I don’t have to think about myself as much, but that’s in, at least in 12 step recovery programs, that’s what a lot of people, when you get to that step of, you’re just reaching out to others, trying to help others, and when you’re trying to help someone else, you’re not thinking about yourself. So, I love that A tool I’ve been trying to get people to use more that I think is extremely valuable is heart rate variability.

There’s so many different HRV tools now, and with HRV, you could basically teach yourself to see when your sympathetic response is activated and how to turn your parasympathetic response on. None of this is easy work. I had a therapist once tell me that trying to change is about as easy as ripping off your own skin. So, that’s one thing. I try to always practice grace with my patients. I mean, I see their struggle, but I’ve never been one to judge any of them. I understand how difficult the journey can be to accept there’s a problem. And for me more than anything, just even to ask for help. And that part of, so I think a lot of what you do too is just trying to create community. And I think so much healing happens in community because you meet other people who have been in your journey, who have been through things worse than you and are there and then they want to help. So, I wish I could find this magic answer. I mean, I think everybody’s searching, how do we figure this out? And it looks different for all of us. I mean, what my mental, emotional, spiritual strategy changes over time. What I do now is a little bit different than when I did three years ago. And that’s just like with anything, we’re always evolving and trying to change.

James Maskell: What would you recommend for practitioners who are doing a history of a new patient and it comes in and they can tell from that that alcohol is playing a role in this person’s struggle? I mean, obviously you have your own experience that you can draw on, but either on a sort of a mindset side or even on a physiological side, what is the alcohol doing or what has it done that can be repaired through functional medicine, and how do you prioritize that as a clinician if you suspect that this is at the root of the pathology?

Dr. Peter Kozlowski: Yeah, it’s not easy. I still use the IFM intake paperwork, so I’m sure a lot of practitioners are familiar with it. So, I have my patients fill out the 40 pages of intake paperwork, and there’s two questions on there that I always look at first, which probably would shock most people. But the first question says is, do you have too much stress in your life? Yes or no? And the second question says, can you easily manage stress? So, for me, when somebody answers no, I don’t have too much stress, and yes, I can manage it easily. To me, I kind of know they’re screwed. I kind of know it’s like this person is in denial. And I’ve been looking at this for 10 years now, and I’ve had a few patients where they actually proved me wrong where they didn’t have too much stress and they did manage it pretty easily.

But that’s kind of my number one warning sign is right there. Okay, this person is probably not willing to admit to something. I like to use cortisol testing. So, I use saliva cortisol testing. I kind of call the adrenal gland testing my stress test. So, if you go to a cardiologist, they’re going to put you on a treadmill and do a stress test. If you come to me, I’m going to ask you to do adrenal testing and look at your cortisol and look at the DHEA. And another one that I learned is you can see stress in the microbiome. So, when you do a stool culture, there’s three probiotics that are suppressed on a stool culture, Lactobacillus, Bifidobacterium, and Enterococcus. So, when you get a culture back and there’s no growth on Lactobacillus and Enterococcus and Bifidobacterium plus a suppressed secretory IgA, that’s the ultimate combo.

When I see those four things like that, to me objectively shows me that someone’s been living in chronic stress. So, me, again, I’m always very objective testing based. I love to show people, so for the people that answer questions that way and are willing to do my recommendations, I try to get them to do a three day stool test, look at their microbiome, look at the secretory IgA, I like to do the adrenal gland testing, and sometimes that’s the wake up call. And sometimes a lot of people just tell me to F off. They’ll be like, just figure out what supplements I need or what the right diet is and just stop talking about this. And so, people won’t come back to me. Sometimes I feel like even just that conversation can open the door because not everybody’s going to be ready, especially if the conversation comes to alcohol.

Most people won’t be ready, but I think if you can at least put it in their head, I feel like once you know something, you can’t unknow it. So, if for me, I can wake someone up to at least acknowledge, hey, maybe there is a stress thing here. They might not be ready today. They might not be ready in six months, but in three years they’ll reach out to me and be like, listen, I kind of finally started digging into this. I’ve recommended every patient I’ve ever met to work with a therapist while they work with me. Very few people follow through on that. I know therapists aren’t the answer to everything, but to me, they’re kind of a way to peel back the layers of the onion. I’ve found tremendous, tremendous success with EMDR therapy for people with trauma.

Not something I trained in, but I do have a few practitioners who I’ve referred people to. So, I kind of try to figure out where it’s coming from and then try to point, I mean, sometimes you can really tell it’s a relationship issue with the wife or husband or with the kids. So, then it’s really promoting family therapy. There’s so many different types of 12-step groups. Even there’s 12-step groups for people who grew up with parents who had addiction issues or just parents that didn’t pay attention to. So, any direction. For a lot of people, religion, it is not as common, I guess, or it’s not as popular as it used to be. My family comes from Poland where it’s like a 99% Catholic population. America obviously religion’s kind of taken aback role, but I’ve had so many friends and patients who do find whether it’s men’s groups or women’s groups or church groups that again, create community. And so, much of it I think just can get better if we just stop trying to do it on our own. But it’s not easy.

James Maskell: Well, I just want to reinforce that. I believe that’s one of the reasons why I believe that the future functional medicine standard of care includes every patient being in a group as the main driver of their transformation, and then with the doctor doing the different therapies as needed. Because in the examples you just gave, are you going to be effective at helping bring up the alcohol thing or is someone else bringing it up going to be more effective? Where if someone else brings up and says, “Hey, I only really started to get better when I was able to really reduce my alcohol,” that might be more powerful and the doctor telling them to do it. And all the other areas that you mentioned, like if it’s a journey of self-acceptance. Also, if you recommend everyone go to a therapist and no one goes, are you really getting the kind of therapy light that you could be getting from being in a group where you’re able to not be under the care of a trained therapist, but ultimately be in a process that works a lot like therapy?

And so, that’s where I see the future going, and I’m glad to hear that that’s something that’s already happening. And in the spirit of this podcast, I would just say to practitioners who are listening, you have an opportunity at the beginning of each year from January till April, where there is a understanding of a need for detoxification. There is a cultural message that goes out. There is a cultural timeframe by which people are looking to renew and reset. And if you can match that demand with supply in your practice of group-based detoxification group programs, group education, group support, I think this is exactly what the world needs. And coming into our 2024 year of unity, I think in our communities, more than ever, there’s a need for bringing people together, connecting them and trying to create more empathy, more self-efficacy, more altruism, more connectedness and self-regulation of emotions, all the things that are proving harder and harder to connect to in these challenging divisive times. So, I appreciate all your insight, doc, and any other thoughts before we wrap up?

Dr. Peter Kozlowski: No. One thing that I would love to see personally is just even I think amongst functional medicine practitioners, I think there’s too much competition and there’s too much, I don’t think we’re connected enough. I think people are still kind of fighting over maximizing their own sales or maximizing their own business, and where I think sometimes things could work better if we more worked together to help each other because one thing that there is will never not be enough of as patients. There’s so many people that need help, and I just think the more we can work together as well, the more people we can help.

James Maskell: Absolutely. And just to contextualize that, I mean, if I look at some of the cities where you have the most sophistication in that area are other cities where there is a really sophisticated, long running, cohesive practitioner community. I mean, I’ve had Kristen Brokaw here as someone that I’ve connected with because what she’s done in St. Louis over 14 years is brought the functional medicine community together, help them understand their individual strengths and get them all to a point where their businesses are such that they’re not in the spirit of competition. They’re there to really think about the patient first. And…

Dr. Peter Kozlowski: That’s amazing,

James Maskell: A real harmony. And that’s always been the dream. The functional forum, that’s what we’ve always been about, is to create harmony between practitioners to create practice success so that everyone could find the practitioner that they need to get better. And we’ll continue that on, and I know there’s more efforts starting in Chicago as well. So, thank you for being part of it. Thanks for your work. Really a pleasure to have you here on the channel and to share your message out there. If you are listening to this practitioners and you want help with organizing your practice in the first quarter of 2024 and preparing for this cycle and preparing to detox with the doctor, reach out and we’ll be happy to point you in the right direction. Thanks so much for tuning in. This has been The Evolution of Medicine podcast. We’ve been with Dr. Peter Kozlowski. Thanks so much for tuning in and we’ll see you next time.

Thanks for listening to the Evolution of Medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools, like the Group Visit Toolkit. That’s goevomed.com/lmrc. Thanks so much for listening, and we’ll see you next time.

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