Dr. Piotr Jarecki

Comprehensive Diagnostics, Genetic Insights & Personalized Treatment Architecture:

• •
  I conduct meticulous patient assessments, delving into detailed medical and family histories to uncover potential genetic predispositions (e.g., for familial hypercholesterolemia, Factor V Leiden, MTHFR variants, hereditary cancer syndromes like BRCA mutations), offering initial genetic advisory and guidance on further testing.
• •
  My physical examinations are systems-oriented, complemented by judicious selection and nuanced interpretation of advanced laboratory markers (e.g., comprehensive hormonal panels, inflammatory markers like hs-CRP, homocysteine, Lp(a), detailed micronutrient status), imaging, and functional testing to achieve precise, early diagnoses.
• •
  Based on this deep understanding, I formulate highly individualized, evidence-based treatment plans for a vast spectrum of conditions, always ensuring alignment with your demanding performance goals and lifestyle.

Metabolic & Endocrine Optimization – The Engine of Your Energy & Cognitive Clarity:

My lifelong passion for the endocrine system (further detailed in my publications) drives my approach to its optimization.

• •
  Hormonal Balance & Vitality: Comprehensive assessment and management strategies for Low Testosterone (Male Hypogonadism), and other andropause/perimenopause-related hormonal shifts impacting energy, mood, and cognition.

• Metabolic Disorders – Mastering Your Body's Fuel Systems:

  • Diabetes Mellitus (Type 1, Type 2, LADA, MODY): Intensive glycemic management (including metformin, advanced insulin regimens, GLP-1 agonists, SGLT2 inhibitors), proactive prevention of microvascular (retinopathy, nephropathy, neuropathy) and macrovascular complications, and specific strategies for maintaining cognitive function and stable energy levels critical for executive function.
  • Hyperlipidemia (Dyslipidemia): Advanced lipid panel interpretation (including LDL particle size, ApoB, Lp(a)), cardiovascular risk stratification using tools like SCORE2/ASCVD, targeted lifestyle interventions (dietary, exercise), and modern pharmacological management (statins, ezetimibe, PCSK9 inhibitors when indicated).
  • Obesity & Advanced Weight Management: Comprehensive assessment of contributing factors (genetic, metabolic, lifestyle, psychological), development of multi-modal plans incorporating ketogenic/low-carbohydrate dietary interventions, intermittent fasting protocols, personalized exercise physiology, behavioral strategies for emotional eating and habit change, and consideration for anti-obesity pharmacotherapy (e.g., GLP-1 agonists) to enhance metabolic health, reduce systemic inflammation, and optimize body composition for peak physical and mental performance.
  • Insulin Resistance & Metabolic Syndrome: Early diagnosis through HOMA-IR, fasting insulin, and clinical markers. Intensive lifestyle interventions (precision nutrition, targeted exercise protocols) to reverse or manage, thereby significantly enhancing energy, cognitive function, and mitigating long-term risks of diabetes, cardiovascular disease, and neurodegenerative conditions.
  • Gout & Hyperuricemia: Management to prevent acute attacks and long-term joint/kidney damage.
• •
  Thyroid Disorders – Regulating Your Internal Thermostat & Metabolism: Including Hypothyroidism (primary, central), Hyperthyroidism, and specialized management of Autoimmune Thyroid Disease (AITD) such as Hashimoto's Thyroiditis and Graves' Disease. This involves precise diagnosis (including full antibody panels), meticulous management of thyroid dysfunction, optimization of TSH/fT4/fT3 levels, and monitoring for systemic impact on energy, mood, weight, and cognition.
• •
  Adrenal Health & HPA Axis Regulation – Your Stress Response System: Assessment for conditions like Cushing's syndrome (including Dexamethasone suppression testing), Addison's disease (primary adrenal insufficiency), and evaluation of stress-induced HPA axis dysregulation ("adrenal fatigue" or atypical cortisol rhythms like "stiff cortisols"), offering strategies for adrenal support, stress adaptation, and resilience building.
• •
  Hyperprolactinemia: Thorough investigation of underlying causes (e.g., pituitary adenomas, medication-induced, stress) and appropriate management or referral.
• •
  Other Endocrine Conditions: Including Polycystic Ovary Syndrome (PCOS) assessment, parathyroid disorders, and pituitary dysfunctions.

Gastrointestinal Health & Gut-Brain Axis Optimization – The Second Brain's Impact:

• •
  Expertise in managing common GI issues such as Gastritis (acute, chronic, H. pylori-associated), Peptic Ulcer Disease (gastric, duodenal, including H. pylori eradication regimens), Gastroesophageal Reflux Disease (GERD) and Laryngopharyngeal Reflux (LPR), Functional Dyspepsia, Small Intestinal Bacterial Overgrowth (SIBO), and Irritable Bowel Syndrome (IBS) (all subtypes), with a focus on minimizing symptoms, restoring gut barrier integrity, optimizing microbiome health, and leveraging the gut-brain axis for improved mood, cognitive function, and reduced systemic inflammation.

• Specialized, comprehensive management of Inflammatory Bowel Disease (IBD) - Crohn's Disease & Ulcerative Colitis:

  • Thorough diagnostic workup (clinical assessment, inflammatory markers like CRP/ESR, fecal calprotectin, serological markers, coordination of colonoscopy/gastroscopy with biopsies, MRI/CT enterography).
  • Management of acute flares and induction of remission (5-aminosalicylic acid compounds, oral/rectal corticosteroids with careful tapering, nutritional therapy).
  • Initiation, monitoring, and co-management of immunomodulators (e.g., azathioprine, 6-mercaptopurine, methotrexate) and biologic therapies (e.g., anti-TNF agents like infliximab/adalimumab, vedolizumab, ustekinumab, JAK inhibitors), including therapeutic drug monitoring.
  • Development and implementation of long-term maintenance strategies to prevent relapse and improve quality of life.
  • Targeted nutritional counseling (e.g., specific carbohydrate diet (SCD) elements, low-FODMAP for symptom control, exclusive/partial enteral nutrition, micronutrient deficiency correction – iron, B12, Vit D, zinc).
  • Proactive monitoring and management of IBD-related complications (e.g., anemia, osteoporosis, malnutrition, extraintestinal manifestations like arthritis/uveitis/skin lesions, fistulas, strictures, abscesses).
  • Implementation of colorectal cancer surveillance protocols in long-standing colitis.
  • Assessment and utilization of medical cannabis for symptomatic relief (e.g., abdominal pain, cramping, nausea, appetite stimulation, sleep disturbances) in selected IBD patients, as part of a multimodal approach.
• •
  Celiac Disease & Non-Celiac Gluten Sensitivity: Diagnosis and management.
• •
  Chronic Liver Conditions: Initial assessment of conditions like NAFLD/MAFLD, viral hepatitis.

Neurological Health, Cognitive Preservation & Mental Acuity:

• •
  Managing common neurological issues such as Tension Headaches, Migraines (prophylactic and acute treatments), Cluster Headaches, Trigeminal Neuralgia, Peripheral Neuropathies (e.g., diabetic, idiopathic), Dizziness/Vertigo (e.g., BPPV, vestibular neuritis), Bell's Palsy, and Restless Legs Syndrome, focusing on minimizing their impact on daily performance, concentration, and quality of life.
• •
  Dedicated focus on early detection, diagnostic support, symptomatic management, and strategies to preserve cognitive function and independence in neurodegenerative conditions like Alzheimer's Disease, Parkinson's Disease, Lewy Body Dementia, and Frontotemporal Dementia.
• •
  This includes managing Behavioral and Psychological Symptoms of Dementia (BPSD) through non-pharmacological approaches first (environmental modification, behavioral strategies, caregiver education), careful and judicious medication titration for agitation/aggression/psychosis, exploration of ketogenic dietary interventions for potential neuroprotective and cognitive benefits, and assessment for medical cannabis for specific symptoms (agitation, pain, sleep disturbances, appetite stimulation).
• •
  Multiple Sclerosis (MS): Co-management of symptoms and support.
• •
  Epilepsy & Seizure Disorders: Initial assessment and co-management.