A Root Cause Medicine Approach
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January 2, 2024

Optimizing Respiratory Immunity: A Functional Medicine Approach to Preventing Respiratory Infections

Medically Reviewed by
Updated On
September 18, 2024

Respiratory immunity is a critical aspect of our health, particularly given the prevalence of respiratory infections globally. Protecting and strengthening this aspect of our immune system is more important than ever. 

Functional medicine offers a unique, holistic approach to enhancing respiratory immunity. It focuses on the individual as a whole, integrating various aspects of health and lifestyle to support our natural defenses. 

This includes a comprehensive look at diet, exercise, stress management, and the use of supplements, all tailored to individual needs and circumstances. In this article, we discuss the various strategies and interventions that functional medicine recommends for robust respiratory health.

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Understanding Respiratory Immunity

The respiratory immune system is a complex network designed to protect us from infections, particularly in the respiratory tract. This system comprises various components, including the anatomical structure of the respiratory tract (nose, larynx, trachea, bronchioles, and alveoli), mucociliary apparatus, and elements of both innate and acquired immunity. These components work together to eliminate foreign substances from the respiratory tract while maintaining homeostasis and normal function.

The mucosal immune system plays a pivotal role in respiratory health. It serves as the first line of defense against environmental threats. The mucociliary apparatus, which includes cilia and mucus in the nose, larynx, and tracheobronchial tree, traps and expels pathogens and particulates. This mechanism is complemented by innate immune cells like macrophages and dendritic cells, which detect and respond to invaders, and by acquired immunity, which provides long-term defense and memory against specific pathogens (12). 

However, respiratory immunity isn't infallible. Pathogens, environmental toxins, and pharmaceutical compounds can disrupt the delicate balance of the respiratory immune system, causing damage and potentially leading to diseases like asthma. Understanding the basics of respiratory immunity helps in appreciating the vital role of our respiratory system in maintaining overall health (12). 

Factors Affecting Respiratory Immunity

Respiratory immunity can be influenced by a variety of factors. Poor diet, stress, lack of sleep, and environmental toxins all contribute to weakening respiratory immune defenses. For instance, an unhealthy diet lacking in essential nutrients can impair the body's ability to fight infections. Stress can alter immune responses, making the body more susceptible to infections. Similarly, inadequate sleep affects the efficiency of immune functions.

Lifestyle choices play a significant role in the health of the respiratory immune system. Smoking, exposure to air pollution, and living in environments with poor air quality can all negatively impact respiratory immunity. Additionally, chronic health conditions like obesity and diabetes can modify immune responses, potentially leading to a higher susceptibility to respiratory infections (8). 

Environmental toxins, often overlooked, are another critical factor impacting respiratory immunity. Exposure to pollutants, chemicals, and industrial compounds can compromise the respiratory system's ability to defend against infections. This exposure can lead to a weakened mucosal barrier and reduced function of immune cells like alveolar macrophages. Furthermore, lifestyle habits like alcohol consumption and physical inactivity can also indirectly weaken respiratory immunity by affecting overall health and immune competence. These factors, along with the direct impact of stressors and dietary choices, form a complex web of influences that collectively determine the resilience and effectiveness of the respiratory immune system in the face of infections (8). 

Personalized Strategies in Functional Medicine 

In functional medicine, personalization is key to optimizing respiratory immunity. As we will discuss specifically in the following sections, this approach tailors strategies to individual needs, considering factors such as lifestyle habits, environmental exposures, and genetic predispositions.

For instance, dietary assessments can reveal nutrient deficiencies impacting immune health. Personalized nutrition plans, possibly incorporating supplements like vitamin C, vitamin D, and zinc, are designed to support respiratory immunity. Similarly, stress management techniques like mindfulness or yoga are recommended based on an individual’s stress levels and lifestyle, recognizing the impact of stress on immune function.

Sleep quality is another critical aspect. Personalized strategies may include sleep hygiene practices tailored to individual patterns, acknowledging the role of adequate rest in immune resilience. In addition, environmental assessments focus on identifying and reducing exposure to pollutants or allergens, which can be especially crucial for those living in areas with poor air quality.

Genetic predispositions are also taken into account. For individuals with a family history of respiratory issues, preventive strategies, and early interventions are more intensely focused. This may include regular health screenings or specific lifestyle modifications to mitigate risks.

Functional medicine also emphasizes physical activity, tailored to suit each individual's capability and health status to enhance overall respiratory health. This comprehensive, personalized approach ensures that each aspect of respiratory immunity is addressed in a manner that is most effective for the individual, offering a more holistic path to improved respiratory health.

The Role of Gut Health in Respiratory Immunity 

The gut-lung axis plays a critical role in respiratory immunity, emphasizing the impact of gut health on lung function. This concept, central in functional medicine, acknowledges that a balanced gut microbiota can significantly influence respiratory health. A healthy gut, rich in diverse microbes, aids in maintaining an effective immune response in the lungs (28). 

Dietary choices are paramount in nurturing a healthy gut microbiome. Foods rich in probiotics and prebiotics, like yogurt, sauerkraut, and high-fiber fruits and vegetables, support a diverse microbial environment. This diversity is crucial for a robust immune system, which in turn, is beneficial for respiratory health (28). 

Lifestyle factors such as regular exercise, stress management, and adequate sleep also contribute to a healthy gut microbiome. These practices, alongside a balanced diet, create an environment conducive to beneficial gut bacteria, positively impacting respiratory immunity (28). 

Conversely, disturbances in gut health, such as dysbiosis, can lead to weakened respiratory immunity. This imbalance can exacerbate respiratory conditions like asthma and allergies, highlighting the importance of maintaining gut health for respiratory well-being (28). 

Nutritional Support for Respiratory Immunity

Nutrition is fundamental in bolstering respiratory immunity. Vitamins C and D, zinc, and omega-3 fatty acids are pivotal nutrients for enhancing the immune system's ability to combat respiratory infections. Vitamin C, an antioxidant found in citrus fruits, strawberries, and bell peppers, aids in the production and protection of white blood cells, which are crucial for fighting infections. Vitamin D, obtainable from sun exposure, fatty fish, and fortified foods, plays a vital role in immune regulation and lung function. A deficiency in Vitamin D has been linked to increased susceptibility to respiratory diseases.

Zinc, a mineral found in meat, legumes, and seeds, is essential for immune cell development and communication and has been shown to reduce the severity of respiratory infections. Omega-3 fatty acids, present in fish oil, flaxseeds, and walnuts, are known for their anti-inflammatory properties and are beneficial in reducing the symptoms of chronic respiratory conditions and promoting lung health (27). 

Besides specific nutrients for respiratory immunity, incorporating diets like the Mediterranean or anti-inflammatory diets can further enhance the body's ability to ward off respiratory infections. These diets emphasize the intake of whole, nutrient-dense foods that are high in antioxidants and anti-inflammatory compounds, which are vital for immune health.

The Mediterranean Diet, known for its rich variety of fruits, vegetables, whole grains, and healthy fats, particularly olive oil, provides a balanced intake of essential nutrients that support respiratory immunity. This diet is not only heart-healthy but also beneficial for the immune system due to its high content of vitamins, minerals, and omega-3 fatty acids.

Similarly, anti-inflammatory diets, which focus on reducing the intake of processed foods and increasing whole foods, can help mitigate chronic inflammation—a known risk factor for weakened respiratory immunity. Foods rich in antioxidants, such as berries, nuts, and green leafy vegetables, are staples in this diet and contribute to a stronger immune response.

Additionally, the Microbiome Diet, which supports gut health, is also crucial for respiratory immunity, as discussed earlier. This diet focuses on foods that enhance the growth of beneficial gut bacteria, such as probiotics and prebiotics, thereby positively influencing the gut-lung axis.

Herbal and Natural Supplements

Herbal remedies and natural supplements have a supporting role in improving respiratory immunity. Echinacea, elderberry, and probiotics are among the popular choices, each offering unique benefits to respiratory health.

Echinacea is an herb often used at the onset of respiratory infections. Studies suggest that echinacea can help in reducing the duration and severity of symptoms, especially in colds. It's believed to work by enhancing the body's immune response, though its effectiveness can vary based on the specific echinacea species and preparation used.

Elderberry is another powerful supplement, rich in antioxidants and vitamins, which has been shown to combat viruses like the common cold and influenza. Research indicates that elderberry can reduce the length of flu symptoms and boost immune response. Its antiviral and anti-inflammatory properties make it a valuable addition to a respiratory health regimen.

Probiotics, beneficial for gut health, also play a role in respiratory immunity due to the gut-lung axis. Regular intake of probiotics, through supplements or fermented foods, can help maintain a balanced gut microbiota, which is crucial for a healthy immune system. 

Other herbal supplements like Andrographis and Astragalus are traditionally used for their immune-enhancing properties. Andrographis is known for its anti-inflammatory and antiviral effects, while Astragalus is used for its potential to strengthen the body’s natural defenses.

Stress Management and Respiratory Immunity

Stress management is crucial for maintaining respiratory health, as stress significantly impacts respiratory immune function. Chronic stress can suppress the immune system, increasing susceptibility to respiratory infections and exacerbating conditions like asthma and allergies. 

Mindfulness and meditation are effective techniques for reducing stress. Regular practice can help lower cortisol levels, the body's primary stress hormone, and promote a sense of calm, which is beneficial for immune function. Even short sessions of mindfulness meditation can positively impact mental and physical well-being.

Yoga is another valuable tool for stress management. It combines physical postures, breath control, and meditation to reduce stress and enhance respiratory health. Certain yoga poses can help improve lung capacity and respiratory function, making it particularly beneficial for respiratory immunity. Relaxation techniques, such as deep breathing exercises and progressive muscle relaxation, can also help alleviate stress. These practices help calm the nervous system and can reduce inflammation, supporting overall immune health (23). 

Incorporating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support immune health and provide the nutrients necessary to combat stress. Foods rich in omega-3 fatty acids, magnesium, and vitamins C and D can particularly help in managing stress levels (7). 

Adequate sleep is essential for managing stress and maintaining a robust immune system. Adults should aim for 7-9 hours of quality sleep per night to help the body recover and strengthen its defenses against respiratory infections (7). 

Physical Activity and Respiratory Health

Regular physical activity is essential for maintaining respiratory health and enhancing respiratory immunity. Exercise strengthens the lungs, increases oxygen delivery efficiency, and can improve overall lung function.

During physical activity, the heart and lungs work harder to meet the increased oxygen demand of muscles. This not only strengthens the respiratory muscles but also helps the body use oxygen more efficiently. Regular exercise can also lead to a decrease in breathlessness in daily activities over time (5,11). 

National guidelines recommend 30 minutes of moderate physical activity five days a week for adults. This could include activities like brisk walking, cycling, or gardening. Such regular, moderate exercise is beneficial for the heart and lungs and can reduce the risk of respiratory infections. (5,11). 

Both aerobic and muscle-strengthening exercises are important for lung health. Aerobic exercises, such as walking or swimming, enhance cardiovascular fitness and lung capacity. Muscle-strengthening activities, like Pilates or weight-lifting, improve posture and respiratory muscle strength (5,11). 

It's crucial to tailor exercise routines to individual health and fitness levels, especially for those with existing respiratory conditions. Consulting with a healthcare provider before starting or modifying an exercise routine is advisable.

Exercising in safe environments, especially for those with respiratory diseases, is important. Avoiding outdoor activities when pollution levels are high and opting for indoor exercises can help maintain lung health.

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Preventing Respiratory Infections: Final Thoughts

Optimizing respiratory immunity through a functional medicine approach offers a comprehensive, personalized strategy. It encompasses a holistic plan that includes a balanced diet rich in essential nutrients, regular physical activity tailored to individual needs, effective stress management techniques, and the use of herbal and natural supplements. This approach not only strengthens the respiratory immune system but also enhances overall health and well-being. Understanding and implementing these varied aspects are key to building a robust defense against respiratory infections and maintaining long-term respiratory health.

Respiratory immunity is a critical aspect of our health, particularly given the prevalence of respiratory infections globally. Supporting and maintaining this aspect of our immune system is more important than ever. 

Functional medicine offers a unique, holistic approach to enhancing respiratory immunity. It focuses on the individual as a whole, integrating various aspects of health and lifestyle to support our natural defenses. 

This includes a comprehensive look at diet, exercise, stress management, and the use of supplements, all tailored to individual needs and circumstances. In this article, we discuss the various strategies and interventions that functional medicine suggests for promoting robust respiratory health.

[signup]

Understanding Respiratory Immunity

The respiratory immune system is a complex network designed to protect us from infections, particularly in the respiratory tract. This system comprises various components, including the anatomical structure of the respiratory tract (nose, larynx, trachea, bronchioles, and alveoli), mucociliary apparatus, and elements of both innate and acquired immunity. These components work together to help manage foreign substances in the respiratory tract while maintaining homeostasis and normal function.

The mucosal immune system plays a pivotal role in respiratory health. It serves as the first line of defense against environmental threats. The mucociliary apparatus, which includes cilia and mucus in the nose, larynx, and tracheobronchial tree, traps and expels particulates. This mechanism is complemented by innate immune cells like macrophages and dendritic cells, which detect and respond to invaders, and by acquired immunity, which provides long-term defense and memory against specific pathogens (12). 

However, respiratory immunity isn't infallible. Pathogens, environmental toxins, and pharmaceutical compounds can disrupt the delicate balance of the respiratory immune system, potentially leading to conditions like asthma. Understanding the basics of respiratory immunity helps in appreciating the vital role of our respiratory system in maintaining overall health (12). 

Factors Affecting Respiratory Immunity

Respiratory immunity can be influenced by a variety of factors. Poor diet, stress, lack of sleep, and environmental toxins all contribute to weakening respiratory immune defenses. For instance, an unhealthy diet lacking in essential nutrients can impair the body's ability to manage infections. Stress can alter immune responses, making the body more susceptible to infections. Similarly, inadequate sleep affects the efficiency of immune functions.

Lifestyle choices play a significant role in the health of the respiratory immune system. Smoking, exposure to air pollution, and living in environments with poor air quality can all negatively impact respiratory immunity. Additionally, chronic health conditions like obesity and diabetes can modify immune responses, potentially leading to a higher susceptibility to respiratory infections (8). 

Environmental toxins, often overlooked, are another critical factor impacting respiratory immunity. Exposure to pollutants, chemicals, and industrial compounds can compromise the respiratory system's ability to defend against infections. This exposure can lead to a weakened mucosal barrier and reduced function of immune cells like alveolar macrophages. Furthermore, lifestyle habits like alcohol consumption and physical inactivity can also indirectly weaken respiratory immunity by affecting overall health and immune competence. These factors, along with the direct impact of stressors and dietary choices, form a complex web of influences that collectively determine the resilience and effectiveness of the respiratory immune system in the face of infections (8). 

Personalized Strategies in Functional Medicine 

In functional medicine, personalization is key to optimizing respiratory immunity. As we will discuss specifically in the following sections, this approach tailors strategies to individual needs, considering factors such as lifestyle habits, environmental exposures, and genetic predispositions.

For instance, dietary assessments can reveal nutrient deficiencies impacting immune health. Personalized nutrition plans, possibly incorporating supplements like vitamin C, vitamin D, and zinc, are designed to support respiratory immunity. Similarly, stress management techniques like mindfulness or yoga are suggested based on an individual’s stress levels and lifestyle, recognizing the impact of stress on immune function.

Sleep quality is another critical aspect. Personalized strategies may include sleep hygiene practices tailored to individual patterns, acknowledging the role of adequate rest in immune resilience. In addition, environmental assessments focus on identifying and reducing exposure to pollutants or allergens, which can be especially crucial for those living in areas with poor air quality.

Genetic predispositions are also taken into account. For individuals with a family history of respiratory issues, preventive strategies, and early interventions are more intensely focused. This may include regular health screenings or specific lifestyle modifications to mitigate risks.

Functional medicine also emphasizes physical activity, tailored to suit each individual's capability and health status to enhance overall respiratory health. This comprehensive, personalized approach ensures that each aspect of respiratory immunity is addressed in a manner that is most effective for the individual, offering a more holistic path to improved respiratory health.

The Role of Gut Health in Respiratory Immunity 

The gut-lung axis plays a critical role in respiratory immunity, emphasizing the impact of gut health on lung function. This concept, central in functional medicine, acknowledges that a balanced gut microbiota can significantly influence respiratory health. A healthy gut, rich in diverse microbes, aids in maintaining an effective immune response in the lungs (28). 

Dietary choices are paramount in nurturing a healthy gut microbiome. Foods rich in probiotics and prebiotics, like yogurt, sauerkraut, and high-fiber fruits and vegetables, support a diverse microbial environment. This diversity is crucial for a robust immune system, which in turn, is beneficial for respiratory health (28). 

Lifestyle factors such as regular exercise, stress management, and adequate sleep also contribute to a healthy gut microbiome. These practices, alongside a balanced diet, create an environment conducive to beneficial gut bacteria, positively impacting respiratory immunity (28). 

Conversely, disturbances in gut health, such as dysbiosis, can lead to weakened respiratory immunity. This imbalance can exacerbate respiratory conditions like asthma and allergies, highlighting the importance of maintaining gut health for respiratory well-being (28). 

Nutritional Support for Respiratory Immunity

Nutrition is fundamental in supporting respiratory immunity. Vitamins C and D, zinc, and omega-3 fatty acids are pivotal nutrients for enhancing the immune system's ability to manage respiratory challenges. Vitamin C, an antioxidant found in citrus fruits, strawberries, and bell peppers, aids in the production and protection of white blood cells, which are crucial for immune function. Vitamin D, obtainable from sun exposure, fatty fish, and fortified foods, plays a vital role in immune regulation and lung function. A deficiency in Vitamin D has been linked to increased susceptibility to respiratory challenges.

Zinc, a mineral found in meat, legumes, and seeds, is essential for immune cell development and communication and has been shown to support respiratory health. Omega-3 fatty acids, present in fish oil, flaxseeds, and walnuts, are known for their anti-inflammatory properties and are beneficial in supporting lung health (27). 

Besides specific nutrients for respiratory immunity, incorporating diets like the Mediterranean or anti-inflammatory diets can further enhance the body's ability to support respiratory health. These diets emphasize the intake of whole, nutrient-dense foods that are high in antioxidants and anti-inflammatory compounds, which are vital for immune health.

The Mediterranean Diet, known for its rich variety of fruits, vegetables, whole grains, and healthy fats, particularly olive oil, provides a balanced intake of essential nutrients that support respiratory immunity. This diet is not only heart-healthy but also beneficial for the immune system due to its high content of vitamins, minerals, and omega-3 fatty acids.

Similarly, anti-inflammatory diets, which focus on reducing the intake of processed foods and increasing whole foods, can help mitigate chronic inflammation—a known risk factor for weakened respiratory immunity. Foods rich in antioxidants, such as berries, nuts, and green leafy vegetables, are staples in this diet and contribute to a stronger immune response.

Additionally, the Microbiome Diet, which supports gut health, is also crucial for respiratory immunity, as discussed earlier. This diet focuses on foods that enhance the growth of beneficial gut bacteria, such as probiotics and prebiotics, thereby positively influencing the gut-lung axis.

Herbal and Natural Supplements

Herbal remedies and natural supplements can play a supporting role in promoting respiratory immunity. Echinacea, elderberry, and probiotics are among the popular choices, each offering unique benefits to respiratory health.

Echinacea is an herb often used at the onset of respiratory challenges. Studies suggest that echinacea can help in reducing the duration and severity of symptoms, especially in colds. It's believed to work by enhancing the body's immune response, though its effectiveness can vary based on the specific echinacea species and preparation used.

Elderberry is another supplement, rich in antioxidants and vitamins, which has been shown to support the body's defense against viruses like the common cold and influenza. Research indicates that elderberry can reduce the length of flu symptoms and boost immune response. Its properties make it a valuable addition to a respiratory health regimen.

Probiotics, beneficial for gut health, also play a role in respiratory immunity due to the gut-lung axis. Regular intake of probiotics, through supplements or fermented foods, can help maintain a balanced gut microbiota, which is crucial for a healthy immune system. 

Other herbal supplements like Andrographis and Astragalus are traditionally used for their immune-supporting properties. Andrographis is known for its anti-inflammatory and supportive effects, while Astragalus is used for its potential to strengthen the body’s natural defenses.

Stress Management and Respiratory Immunity

Stress management is crucial for maintaining respiratory health, as stress significantly impacts respiratory immune function. Chronic stress can suppress the immune system, increasing susceptibility to respiratory challenges and exacerbating conditions like asthma and allergies. 

Mindfulness and meditation are effective techniques for reducing stress. Regular practice can help lower cortisol levels, the body's primary stress hormone, and promote a sense of calm, which is beneficial for immune function. Even short sessions of mindfulness meditation can positively impact mental and physical well-being.

Yoga is another valuable tool for stress management. It combines physical postures, breath control, and meditation to reduce stress and enhance respiratory health. Certain yoga poses can help improve lung capacity and respiratory function, making it particularly beneficial for respiratory immunity. Relaxation techniques, such as deep breathing exercises and progressive muscle relaxation, can also help alleviate stress. These practices help calm the nervous system and can reduce inflammation, supporting overall immune health (23). 

Incorporating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support immune health and provide the nutrients necessary to combat stress. Foods rich in omega-3 fatty acids, magnesium, and vitamins C and D can particularly help in managing stress levels (7). 

Adequate sleep is essential for managing stress and maintaining a robust immune system. Adults should aim for 7-9 hours of quality sleep per night to help the body recover and strengthen its defenses against respiratory challenges (7). 

Physical Activity and Respiratory Health

Regular physical activity is essential for maintaining respiratory health and supporting respiratory immunity. Exercise strengthens the lungs, increases oxygen delivery efficiency, and can improve overall lung function.

During physical activity, the heart and lungs work harder to meet the increased oxygen demand of muscles. This not only strengthens the respiratory muscles but also helps the body use oxygen more efficiently. Regular exercise can also lead to a decrease in breathlessness in daily activities over time (5,11). 

National guidelines recommend 30 minutes of moderate physical activity five days a week for adults. This could include activities like brisk walking, cycling, or gardening. Such regular, moderate exercise is beneficial for the heart and lungs and can reduce the risk of respiratory challenges. (5,11). 

Both aerobic and muscle-strengthening exercises are important for lung health. Aerobic exercises, such as walking or swimming, enhance cardiovascular fitness and lung capacity. Muscle-strengthening activities, like Pilates or weight-lifting, improve posture and respiratory muscle strength (5,11). 

It's crucial to tailor exercise routines to individual health and fitness levels, especially for those with existing respiratory conditions. Consulting with a healthcare provider before starting or modifying an exercise routine is advisable.

Exercising in safe environments, especially for those with respiratory diseases, is important. Avoiding outdoor activities when pollution levels are high and opting for indoor exercises can help maintain lung health.

[signup]

Preventing Respiratory Infections: Final Thoughts

Optimizing respiratory immunity through a functional medicine approach offers a comprehensive, personalized strategy. It encompasses a holistic plan that includes a balanced diet rich in essential nutrients, regular physical activity tailored to individual needs, effective stress management techniques, and the use of herbal and natural supplements. This approach not only supports the respiratory immune system but also enhances overall health and well-being. Understanding and implementing these varied aspects are key to building a robust defense against respiratory challenges and maintaining long-term respiratory health.

The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.

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The American Journal of Clinical Nutrition
Peer Reviewed Journal
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The Journal of Bone and Joint Surgery
Peer Reviewed Journal
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Kidney International
Peer Reviewed Journal
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The Journal of Allergy and Clinical Immunology
Peer Reviewed Journal
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Annals of Surgery
Peer Reviewed Journal
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Chest
Peer Reviewed Journal
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The Journal of Neurology, Neurosurgery & Psychiatry
Peer Reviewed Journal
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Blood
Peer Reviewed Journal
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Gastroenterology
Peer Reviewed Journal
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The American Journal of Respiratory and Critical Care Medicine
Peer Reviewed Journal
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The American Journal of Psychiatry
Peer Reviewed Journal
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Diabetes Care
Peer Reviewed Journal
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The Journal of the American College of Cardiology (JACC)
Peer Reviewed Journal
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The Journal of Clinical Oncology (JCO)
Peer Reviewed Journal
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Journal of Clinical Investigation (JCI)
Peer Reviewed Journal
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Circulation
Peer Reviewed Journal
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JAMA Internal Medicine
Peer Reviewed Journal
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PLOS Medicine
Peer Reviewed Journal
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Annals of Internal Medicine
Peer Reviewed Journal
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Nature Medicine
Peer Reviewed Journal
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The BMJ (British Medical Journal)
Peer Reviewed Journal
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The Lancet
Peer Reviewed Journal
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Journal of the American Medical Association (JAMA)
Peer Reviewed Journal
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Pubmed
Comprehensive biomedical database
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Harvard
Educational/Medical Institution
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Cleveland Clinic
Educational/Medical Institution
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Mayo Clinic
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The New England Journal of Medicine (NEJM)
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Johns Hopkins
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