Canned Tuna, Chicken Or Sardines, Lyme-POTS Connection & The Medical School Failure | Ask Me Anything

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Three very different questions this AMA. All of them went somewhere worth going.

The first was anonymous — a third-year MD student in a good program, frustrated during rotations, spending too long with patients because she actually wants to get to root causes, and getting pushback from attendings for exactly that reason. She asked what to do. My answer is: don't quit. You're going to finish your degree, and your education is not in vain. You'll get anatomy, physiology, pharmacology, diagnostic frameworks — all of it foundational and necessary. What you won't get is nutrition, lifestyle medicine, or functional thinking. The average medical school teaches 24 hours of nutrition over four years. A 2018 study found that the average medical student would fail a basic nutrition test. HHS is now pushing for a 40-hour minimum for schools receiving federal funding — George Washington University has already committed to 60+ hours including culinary medicine. That's movement. But for this student, now: finish the degree, get a year of patient hours under your belt, and concurrently train at IFM. Or look at naturopathy, functional nutrition, FDN, or any of the health coaching paths that will give you the clinical thinking you're missing. You can work within a flawed system and still help people. And there may come a season where you leave it. Let that unfold.

The second was from Chloe, who eats a lot of Wild Planet Organic Roasted Chicken because she gets the raw chicken ick and needs something convenient. My honest take: it's fine. Wild Planet is a reputable brand doing the right things — BPA-free cans, transparent sourcing, third-party testing. But if we're talking nutrient density and heavy metal safety, canned chicken is near the bottom of the hierarchy. Canned sardines and anchovies are at the top — lower mercury bioaccumulation because they're smaller, higher omega-3 content, calcium, vitamin D. The conversation also went into why "wild-caught" is no longer a reliable guarantee of quality given ocean pollution and heavy metal bioaccumulation in larger predatory fish, and why regenerative aquaculture brands like Sea Utopia are changing the calculus.

The third was from Sarah, who was diagnosed with Lyme after a tick bite in late May and has since had a vertigo episode so severe she was vomiting and couldn't open her eyes for 12 hours. Her Lyme doctor said there's no connection. Her acupuncturist said there's something around "dampness." My read: upwards of 20% of Lyme patients have persistent symptoms, and more than half can have POTS-like dysautonomia — dizziness, brain fog, anxiety, fatigue, racing heart. This is not fringe. This is the documented neuroinflammatory picture of a nervous system and immune system that have been pushed out of equilibrium and don't know how to get back. The clinical question is whether the infection is still active, or whether the body just doesn't know it's safe to stand down. Those are very different treatment paths, and labs are how you tell the difference.

A few of my favorite things we cover in this episode: 

• A 3rd-year MD student experiencing cognitive dissonance — wanting root causes, being told to put Band-Aids on problems
• Medical schools average 24 hours of nutrition over 4 years — a 2018 study showed the average medical student would fail a basic nutrition test
• HHS now requires 40+ hours of nutrition for federally funded medical schools — George Washington University committed to 60+ hours including culinary medicine
• Finish your MD, then train concurrently at IFM — or consider naturopathy, DC, RD, FDN, IIN, or MindBodyGreen
• Conventional medicine is world-class at emergency care — and last in the world at chronic disease management
• Wild Planet is a solid canned chicken brand — but BPA-free doesn't always mean safe (BPS and alternatives may not be better)
• Wild-caught is no longer a reliable gold standard — third-party testing matters more than sourcing method
• Regenerative aquaculture (Sea Utopia) as the emerging disruptor in clean seafood
• Sardines and anchovies beat canned tuna and chicken — less mercury, more omega-3s, calcium, and vitamin D
• Lyme and vertigo: 20%+ of Lyme cases have persistent symptoms — more than half can develop POTS-like dysautonomia
• A Lyme doctor saying there's no connection to vertigo is likely wrong — this is neuroinflammatory dysregulation of the neuroendocrine axis
• Active infection vs. immune system that won't stand down — two completely different clinical approaches
• Sodium and electrolytes at 2–3x normal requirements for POTS — sipped throughout the day, not taken all at once
• Recumbent biking for POTS — horizontal exercise reduces gravity's pull on blood flow to the brain and builds blood volume over time

Products Mentioned:  

• Heal Your Cells by Dr. Will Cole & Dr. Josh Axe (5th book — pre-order now)
• drwillcole.com/shop — supplement protocol stacks by condition (Lyme, gut, hormone, nervous system, histamine)
• Cellular Hydration by Longevity RX (electrolyte support for dizziness/POTS — link in show notes)
• Lyme protocol stack 
• Wild Planet Organic Roasted Chicken Breast (BPA-free, third-party tested)
• Safe Catch (mercury-tested canned seafood — alternative to Wild Planet)
• Seatopia (regenerative aquaculture seafood — Dr. Cole's current recommendation for fish sourcing)
• Thrive Market (online grocery — best price on Wild Planet)
• IFM (Institute for Functional Medicine) (Dr. Cole's training — recommended path for MDs post-graduation)
• IIN (Institute for Integrative Nutrition) (health coaching program)
• MindBodyGreen Functional Nutrition Course (Dr. Cole teaches here)
• FDN (Functional Diagnostic Nutrition) (lab-based health coaching certification — Andrea and Emily trained here)
• A4M (American Academy of Anti-Aging Medicine) (conference with CME/CEU credits)
• Eudemonia (functional medicine/wellness conference)
• ILADS (International Lyme and Associated Diseases Society — Lyme-literate physician directory)

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Happy listening, and we hope you learned a little bit more on the art of being well!

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In Health,

Dr. Will Cole