Hard Case? Start Here. Functional Immunology for Complex Cases with Dr. Sam Yanuck

In this episode, Dr. Kate Kresge talks with functional immunology educator Dr. Samuel Yanuck about the immune signals hiding in plain sight in complex, chronic cases. Dr. Yanuck makes the case that "there's immunology in every case," from neuropathy and migraine to heart disease, depression, and anxiety. He explains how Th1/Th2 balance, inflammasome activity, and mast cell loops can drive symptoms in patients whose standard labs look fine, then walks through a "wide net" workup, how to read Epstein-Barr virus panels, and natural immune modulators clinicians are using. (Yanuck 2020) If you have a patient who has seen a dozen providers without answers, start here.

3 Key Takeaways

Inflammation and mood can feed each other. Inflammatory cytokines can reach the brain and affect neurotransmitter metabolism, neuroendocrine function, and neural plasticity in major depression. (Miller 2009)

Sleep is an immune intervention. Disturbed sleep is linked to dysregulated inflammatory and antiviral responses, while healthy sleep supports host defense. (Irwin 2019)

Cast a wide enough net to be surprised. Dr. Yanuck pairs a detailed history with labs beyond the standard CBC and metabolic panel, including hs-CRP, iron studies, thyroid antibodies, oxidative stress markers, VIP, and viral panels.

Guest: Dr. Samuel Yanuck is a functional medicine clinician and educator who created Cogence Immunology, a training program that has reached more than 9,000 clinicians in over 60 countries. He is co-founder of the Yanuck Center for Life and Health in Chapel Hill, North Carolina, where he sees patients with complex immune-driven illness.

Clinical FAQ

What are PANS and PANDAS?

PANDAS describes children whose OCD and/or tic symptoms appear to be triggered by group A strep infection, first characterized in a series of 50 cases at NIMH. (Swedo 1998) Dr. Yanuck explains how cross-reactive antibodies may affect dopamine receptors in the brain. (Cunningham 2019)

How does Dr. Yanuck read an EBV panel?

He uses VCA IgG and EBNA to gauge antibody burden, considering chronic infection as values climb well above the top of the range, and uses early antigen as a marker of active viral replication. (CDC 2024)

Which natural immune modulators came up?

He discusses astragalus, andrographis, reishi, berberine, baicalin from Chinese skullcap, and sulforaphane for Th1 support, plus quercetin and cofactors for histamine clearance. (Yanuck 2020)

Timestamps

00:00 – Meet Dr. Sam Yanuck

04:16 – Immunology in every case

07:33 – What's missing in traditional training

21:13 – PANS, PANDAS, and autoimmune encephalitis

27:37 – How depression, anxiety, and inflammation feed each other

36:00 – The labs you're probably not running

41:16 – Genetics, IL-6, histamine, and acetylcholine

55:36 – Screening for chronic viral infections

59:15 – IgG patterns and EBV early antigen

01:06:12 – Nutrition, herbs, and Th1 support

01:09:39 – Histamine, aldehydes, and mast cells

01:12:46 – Where to find Dr. Yanuck and Cogence Immunology

Ready to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript helps clinicians bring supplement dispensing, lab ordering, and patient education into one centralized workflow. For more practitioner education on supplements, nutrition, and evidence-informed clinical care, visit Fullscript Academy at academy.fullscript.com.

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.