The Root Cause Medicine Podcast
Metabolic Flexibility: A Fullscript Forward Preview
October 9, 2025
True longevity requires metabolic flexibility, but how can we help our clients get there? This episode previews personalized metabolic health and longevity strategies from Dr. Rob Downey and Monique Class, presenters at Fullscript Forward 2025. Dr. Downey discusses how metabolic phenotyping, stress/HRV context, and GI patterns can inform evaluation, while Monique describes low-dose (microdosed) GLP-1 approaches, titration by response, and gradual tapering within lifestyle-first care model help them achieve impactful results for their clients. The conversation explores objective monitoring (labs, body composition), muscle-preserving movement, and structured workflows that may help patients sustain progress after medication changes. This episode is for informational and educational purposes only.

If metabolic flexibility is the key to longevity, are we missing critical opportunities to help our patients achieve it?

In this episode of The Root Cause Medicine Podcast, we sit down with Dr. Rob Downey and Monique Class, two respected functional medicine clinicians presenting at Fullscript Forward 2025, to explore how precision approaches to metabolic health are reshaping longevity care. Dr. Downey reveals how metabolic phenotyping, stress and HRV mapping, and gut function insights can inform individualized care strategies, while Monique shares her thoughtful approach to microdosed GLP-1 protocols, titration by response, and slow tapering models designed to complement lifestyle-first interventions. Together, they unpack the art and science of whole-person metabolic medicine—covering body composition tracking, lab-based decision-making, and muscle-preserving movement routines that clinicians can integrate into real-world workflows.

If you’re ready to help your clients achieve true metabolic transformation, this episode offers the frameworks, data points, and clinical pearls you won’t want to miss.

Clinical Takeaways from This Episode 

Guest Bios

Dr. Rob Downey, MD, IFMCP — Functional medicine physician at Seaworthy Medicine (AK); discussed phenotyping, HRV/stress context, and gut-metabolic foundations in complex cases.

Monique Class, FNP, IFMCP — Family nurse practitioner with 35+ years in functional medicine; discussed GLP-1 microdosing, tapering/off-ramps, and whole-person frameworks for weight management, inflammation, and longevity.

Labs Mentioned (Monitoring & Context)


Ingredients & Therapeutic Nutrition Mentioned 

Diet patterns referenced: Protein at meals, fermented foods, colorful produce, structured meal timing, mindful alcohol intake

Fullscript Forward Details

Timestamps

00:00 Intro & Fullscript Forward overview
01:54 Guest intros
03:15 Downey’s journey: autoimmunity → metabolic health focus
10:20 Phenotype & hormonal pattern assessment
13:18 Sequencing foundational interventions before advanced steps
15:39 Labs for assessing metabolism
19:22 GLP-1 tapering and off-ramp planning
22:26 Small-dose GLP-1 protocols & titration discussion
30:31 Metabolic rebound: drivers & mitigation approaches
43:03 Whole-person care & healthspan goals


Frequently Asked Questions
Q: What makes this episode different from other GLP-1 discussions?
Most conversations stop at dosing. This one goes further—into phenotyping, nutrient status, and tapering protocols that integrate lifestyle medicine. It’s about how to use GLP-1s thoughtfully within a personalized, long-term metabolic framework.

Q: What is “metabolic phenotyping,” and why does it matter?
Dr. Downey explains how identifying phenotype patterns—such as stress physiology, body composition, and gut-driven inflammation—can help clinicians prioritize interventions and understand why certain patients plateau despite doing “everything right.”

Q: What key labs and metrics do the guests discuss?
They review labs that provide insight into insulin sensitivity, thyroid health, inflammation, and micronutrient status, as well as body composition measures (like visceral fat and phase angle) that reveal metabolic trends beyond weight alone.

Q: What can providers take away from this conversation?
A clearer view of how to connect physiology, psychology, and behavior change in metabolic medicine—plus practical insight into tapering, monitoring, and optimizing care over time.

Q: Who should listen to this episode?
Healthcare professionals interested in functional and lifestyle medicine, longevity, or integrative metabolic care—particularly those seeking to bridge the gap between pharmacology and personalized nutrition.


Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.