What I brought home from IFM 2026
June 19, 2026I just got back from the Institute for Functional Medicine’s annual conference in San Diego, and I wanted to send you a quick dispatch. One caveat up front: what follows is what faculty argued from the stage — emerging thinking, not settled science, and no substitute for psychiatric care. But two of the mental-health threads were striking enough that I’ve been turning them over ever since.
Inflammation as a shared thread.
A recurring argument across several talks: that inflammation may sit underneath a lot of psychiatric diagnoses at once. Presenters kept pointing to the same two inflammatory signals — the cytokines IL-6 and TNF-α — turning up again and again across depression, bipolar, anxiety, OCD, PTSD, even schizophrenia and autism. One described the mechanism vividly: chronic inflammation appears to flip the brain’s resident immune cells, the microglia, out of a quiet resting state into an activated, inflammatory one.
If that picture holds, it reframes what “treatment-resistant” means. A case that won’t move with one more medication change might be responding to an inflammatory driver nobody has measured yet. That’s the whole premise behind “undertested” — the answer is often sitting in a system no one thought to look at.
Hormones the brain makes itself.
The second thread was neurosteroids — hormones the brain produces on its own. One presenter laid out how DHEA appears to act directly on the same receptor systems many of our medications target (the NMDA and GABA-A systems), and described pregnenolone as a kind of “memory hormone.” He also flagged unusually low prolactin as a possibly overlooked signal in stubborn anxiety — exactly the sort of marker that rarely makes it onto a standard workup.
What I keep coming back to is how concrete this is. These aren’t abstractions; they’re measurable. If your own biochemistry is helping shape how you feel, that’s something you can actually test rather than guess at.
And one more, just emerging: a large 2025 analysis (Xie and Al-Aly) linked GLP-1 medications to lower rates of depression, substance-use disorders, and even dementia — more evidence that these drugs are doing something in the brain, not just the gut. More on that another time.
None of this replaces good psychiatric care; it widens the investigation around it. If you’ve been told you’re treatment-resistant and have quietly wondered what hasn’t been looked at, that’s exactly what a discovery call is for — free, about 15 minutes, no pressure. Just a chance to think through what a comprehensive workup might actually turn up.
One more thing worth mentioning: I’ve recently simplified the program and lowered the upfront commitment to make it easier to get started.
| Book a free 15-minute discovery call → |
Warmly,
David Wiss, PhD, RDN, FMCP
Founder, FxMed Mental Health
P.S. — Everything here is one set of conference perspectives, shared because I found them genuinely interesting — not medical advice. The science is still emerging, and I’ll keep separating what’s promising from what’s proven.