The Smartest Doctor in the Room

Health Tip Of The Week

Before assuming a new walking problem means Parkinson's disease, Dr. Dean Mitchell shares a key insight from his conversation with neurologist Dr. Alexander Stilbans: not every shuffling gait points to the obvious diagnosis. Many treatable conditions, including degenerative hip disease, spinal stenosis, and certain medications, can cause changes in how you walk, especially after age 60. One patient's case makes this clear: a 72-year-old man whose "magnetic legs" seemed to stick to the floor turned out to have a treatable buildup of fluid in the brain, not Parkinson's. The next time you or a loved one notices a new walking problem, ask your doctor what else it could be. Sometimes the most important diagnosis isn't the obvious one. For the full conversation, listen to Ep. 230 – How You Walk Matters: Movement Disorders That Can Be Mistaken For Parkinson's Disease on The Smartest Doctor in the Room.

Ep. 230 - How You Walk Matters: Movement Disorders That Can Be Mistaken For Parkinson’s Disease

Not every walking problem is Parkinson's disease — and assuming it is can cost patients years of proper treatment. Neurologist and movement disorder specialist Dr. Alexander Shtilbans, assistant professor at Weill Cornell Medicine and attending physician at Hospital for Special Surgery in New York City, joins Dr. Dean Mitchell to break down the many conditions that cause abnormal gait, why they're so frequently misdiagnosed, and what a thorough clinical evaluation actually looks like. Dr. Shtilbans walks through a real case featured in the New York Times Magazine Diagnosis column — a 72-year-old man with "magnetic legs" and progressive difficulty walking who had been treated for Parkinson's for years. The actual diagnosis was normal pressure hydrocephalus, a treatable condition that was identified only after Dr. Shtilbans reviewed the MRI himself and questioned a DAT scan result that didn't match the clinical picture. After a surgical shunt procedure, the patient's walking improved dramatically. The conversation covers the full diagnostic landscape of gait disorders — spinal stenosis, peripheral neuropathy, cerebellar disease, mini strokes, and drug-induced Parkinsonism from medications like antipsychotics and metoclopramide. Dr. Shtilbans also shares his laboratory research on a combination of three supplements — CoQ10, creatine, and TUDCA — that showed a 24% increase in dopamine cell growth and significant reduction in pro-inflammatory markers when tested together on human stem cells derived from Parkinson's patients, despite each supplement failing individually in prior clinical trials. Dr. Shtilbans closes with a strong case for exercise as the only proven intervention to slow Parkinson's disease progression, the emerging role of Apple Watch in tremor monitoring, and practical guidance on how to find a movement disorder specialist no matter where you live. Contact Dr. Mitchell: Email: care@mitchellmedicalgroup.com Website [https://www.mitchellmedicalgroup.com/?utm_source=podcast&utm_medium=referral&utm_campaign=podcast] Instagram [https://www.instagram.com/thesmartestdoctor/] YouTube [https://www.youtube.com/@thesmartestdoctorintheroom] Facebook [https://www.facebook.com/TheSmartestDoctorintheRoom/] LinkedIn [https://www.linkedin.com/in/holisticimmunology/] Order your copy of Dr. Mitchell’s latest book, Conquering Candida, here. [https://www.amazon.com/Conquering-Candida-Protocol-Restoring-Microbiome/dp/B0FWXKGNTY/ref=sr_1_1?crid=939Y1NJYQW61&dib=eyJ2IjoiMSJ9.d3QsT-kXSEWPftUAdH8LOiOadRG_1tNTOOST03lM89vGjHj071QN20LucGBJIEps.upsOSqw32kt4H50sjNx-GsfgDrU8QLc5Y0G39qZYmZI&dib_tag=se&keywords=conquering+candida&qid=1767924321&sprefix=conquering+candi%2Caps%2C615&sr=8-1] Be sure to visit ImmunoLytics [https://immunolytics.com/store/?wpam_id=429] & use coupon code SmartestDoc for 5% off

Health Tip Of The Week

Before assuming a new pain means something is physically wrong, Dr. Dean Mitchell shares a powerful framework from the work of Dr. John Sarno and mind-body medicine: ask yourself what's happening emotionally before asking what's wrong with your body. Dr. Sarno's concept of Tension Myositis Syndrome (TMS) suggests that unresolved stress, inner conflict, and unacknowledged worry can amplify or even create physical symptoms. Take 60 seconds the next time pain arises to reflect on what might be bothering you beneath the surface. You may be surprised by what you find. For the full conversation, listen to Ep. 229 – New Approach to Chronic Pain: Psychological vs. Physical Treatments on The Smartest Doctor in the Room.

Ep. 229 - New Approach to Chronic Pain: Psychological vs. Physical Treatments

Dr. Dean Mitchell shares his own decades-long struggle with chronic back pain before introducing Dr. David Schechter, a physician based in Los Angeles who trained directly under the late Dr. John Sarno at NYU's Rusk Institute. Dr. Schechter now carries on that work, blending Sarno's foundational ideas with modern neuroscience to treat patients with what he calls neuroplastic symptoms, or what Sarno originally termed tension myositis syndrome (TMS). The conversation covers how chronic pain differs fundamentally from acute pain on a neurological level, why imaging findings like bulging discs are often poor predictors of who actually suffers, and how the brain's emotional centers become increasingly involved the longer pain persists. Dr. Schechter describes his diagnostic process, which includes exploring personality characteristics, childhood history, and life circumstances at the onset of symptoms, and explains the concept of the "Type T personality," a profile that includes perfectionism, self-criticism, and people-pleasing tendencies that he frequently sees in patients with chronic pain. Dr. Mitchell and Dr. Schechter also discuss the role of social connection in health outcomes, the nocebo effect and the harm that can come from authoritative but unfounded medical pronouncements, and the practical reality of practicing this kind of medicine outside of a time-pressured clinical setting. Resources mentioned include Dr. Schechter's website mindbodymedicine.com and the nonprofit directory at symptomatic.me, which lists physicians trained in this area. Contact David Schechter: www.mindbodymedicine.com [https://www.mindbodymedicine.com/] x:  @pain_md_la facebook:  facebook.com/thinkawayyourpain [https://www.facebook.com/ThinkAwayYourPain/] insta:  @drdavela youtube:  youtube.com/mindbodydr [http://youtube.com/mindbodydr] Contact Dr. Mitchell: Email: care@mitchellmedicalgroup.com Website [https://www.mitchellmedicalgroup.com/?utm_source=podcast&utm_medium=referral&utm_campaign=podcast] Instagram [https://www.instagram.com/thesmartestdoctor/] YouTube [https://www.youtube.com/@thesmartestdoctorintheroom] Facebook [https://www.facebook.com/TheSmartestDoctorintheRoom/] LinkedIn [https://www.linkedin.com/in/holisticimmunology/] Order your copy of Dr. Mitchell’s latest book, Conquering Candida, here. [https://www.amazon.com/Conquering-Candida-Protocol-Restoring-Microbiome/dp/B0FWXKGNTY/ref=sr_1_1?crid=939Y1NJYQW61&dib=eyJ2IjoiMSJ9.d3QsT-kXSEWPftUAdH8LOiOadRG_1tNTOOST03lM89vGjHj071QN20LucGBJIEps.upsOSqw32kt4H50sjNx-GsfgDrU8QLc5Y0G39qZYmZI&dib_tag=se&keywords=conquering+candida&qid=1767924321&sprefix=conquering+candi%2Caps%2C615&sr=8-1] Be sure to visit ImmunoLytics [https://immunolytics.com/store/?wpam_id=429] & use coupon code SmartestDoc for 5% off

Ep. 228 - A Lyme Expert Discusses Why So Many Cases Get Missed

Dr. Dean Mitchell sits down with Dr. Kenneth Liegner, an internist and critical care physician who has treated thousands of chronic Lyme patients since the early days of the disease's recognition. Dr. Liegner trained in anatomic pathology, internal medicine, and surgical critical care before opening a general practice in Westchester County, where he found himself in the middle of one of the most contested debates in modern medicine. The conversation traces how Dr. Liegner came to understand that Lyme disease could follow a relapsing, persistent course, and why that conclusion put him at odds with mainstream infectious disease guidelines. He discusses the IDSA's 2000 and 2006 guidelines, the role of insurance industry interests in shaping treatment coverage, and what it meant professionally to keep treating patients during an era he describes as dangerous for practitioners. He also shares a 1991 case in which spirochetes were cultured from a patient's spinal fluid after prior intravenous antibiotic treatment, later published in the science press. Dr. Mitchell and Dr. Liegner cover the complexity of tick-borne coinfections including Babesiosis, Ehrlichiosis, Anaplasmosis, and Bartonella; the limitations of standard serological testing and the Dearborn criteria; and the challenge of biofilm as a barrier to antibiotic effectiveness. Dr. Liegner also explains his current approach to prophylactic treatment following a tick attachment, including his use of minocycline and Malarone, and his reasoning for that protocol given what he has seen over decades of practice. Contact Dr. Mitchell: Email: care@mitchellmedicalgroup.com Website [https://www.mitchellmedicalgroup.com/?utm_source=podcast&utm_medium=referral&utm_campaign=podcast] Instagram [https://www.instagram.com/thesmartestdoctor/] YouTube [https://www.youtube.com/@thesmartestdoctorintheroom] Facebook [https://www.facebook.com/TheSmartestDoctorintheRoom/] LinkedIn [https://www.linkedin.com/in/holisticimmunology/] Order your copy of Dr. Mitchell’s latest book, Conquering Candida, here. [https://www.amazon.com/Conquering-Candida-Protocol-Restoring-Microbiome/dp/B0FWXKGNTY/ref=sr_1_1?crid=939Y1NJYQW61&dib=eyJ2IjoiMSJ9.d3QsT-kXSEWPftUAdH8LOiOadRG_1tNTOOST03lM89vGjHj071QN20LucGBJIEps.upsOSqw32kt4H50sjNx-GsfgDrU8QLc5Y0G39qZYmZI&dib_tag=se&keywords=conquering+candida&qid=1767924321&sprefix=conquering+candi%2Caps%2C615&sr=8-1] Be sure to visit ImmunoLytics [https://immunolytics.com/store/?wpam_id=429] & use coupon code SmartestDoc for 5% off