¶ Itziar Hernandez
Clinical lecturer and practitioner at the Pruimboom Institute who works in direct clinical partnership with Leo Pruimboom. Primary lecturer for Module 6 (Organs Module: Digestive & Orofacial Systems) and Module 8 (Diagnostics), teaching the practical application of cPNI theory to patient assessment, the 5 plus 2 metamodel diagnostic framework, and the critical oral-gut-systemic axis in chronic disease.
Think of Itziar as the translator between cPNI theory and bedside reality—the person who takes Leo's evolutionary immunology frameworks and turns them into Tuesday morning patient protocols. She's like a bridge engineer who not only understands the physics of suspension cables (the theory) but has actually built bridges in hurricanes (clinical practice). When she teaches Module 6, she's showing you the digestive system not as an anatomy textbook but as a crime scene investigation: where did the barrier break? What's the bacterial fingerprint? How do we trace leaky gut back to periodontal disease and forward to autoimmunity? In Module 8, she's teaching diagnostic triage—the 5+2 metamodel is her flowchart for clinical decision-making under uncertainty. Having worked alongside Leo for ~2 years in clinic, she brings case studies, failure stories, and the messy reality of patients who don't fit textbook categories. She's not just teaching what to think; she's teaching how to think when the patient in front of you has contradictory lab values and three competing diagnoses.
graph TD
A["cPNI Evolutionary Theory<br/>Leo Pruimboom"] --> B["Clinical Translation<br/>Itziar Hernandez"]
B --> C["Module 6: Organ Systems"]
B --> D["Module 8: Diagnostics"]
C --> E[Oral-Gut Axis]
C --> F[Digestive Pathophysiology]
C --> G[Orofacial-Systemic Connection]
D --> H["5+2 Metamodel Framework"]
D --> I[Patient Anamnesis]
D --> J[Intervention Hierarchy]
E --> K[Clinical Case Studies]
F --> K
G --> K
H --> K
I --> K
J --> K
K --> L[Patient Outcomes]
L --> M["Refinement Loop<br/>back to practice"]
¶ Core Teaching Domains
Module 6 Focus: Organ System Pathology
Module 8 Focus: Diagnostic Framework
- Patient presentation → comprehensive history (diet, stress, sleep, movement, trauma, infections)
- Metamodel 0 assessment → identify which of the five systems (immune, neuro, endocrine, gut, metabolism) is primary dysregulator
- Cross-system mapping → trace connections (e.g., oral dysbiosis → gut dysbiosis → LGI → insulin resistance)
- Intervention prioritization → barrier restoration first (gut, oral, blood-brain), then immune resolution, then metabolic repair
- Protocol implementation → 5 plus 2 Metamodel Protocol with emphasis on evolutionary alignment (Intermittent Living, Exercise, sleep optimization)
Itziar's teaching is clinically significant because she bridges the gap between cPNI's complex evolutionary immunology theory and the practical reality of patient care. Her work alongside Leo gives her direct access to the iterative refinement of cPNI protocols in real clinical settings.
- Selfish Brain and Selfish Immune System conflicts: Itziar teaches diagnostic recognition of which system is "winning" the resource competition—guides intervention hierarchy
- Evolutionary mismatch: oral health protocols based on ancestral dietary patterns; addresses mouth breathing as modern pathology
- AMP Metamodel: teaches students to identify which AMP categories (pathogen, damage, emotional, digital) are driving patient's inflammatory state
- H. pylori eradication protocols: antibiotic alternatives using Manuka Honey, mastic gum, high-dose Vitamin C, zinc carnosine
- SIBO assessment and treatment: breath testing interpretation, Low-FODMAP diet phasing, Herbal antimicrobials protocols
- Leaky gut repair: L-glutamine, zinc, Vitamin D, Omega-3 fatty acids, collagen supplementation sequencing
- Periodontal disease intervention: oil pulling, antimicrobial mouth rinses, probiotic lozenges, surgical referral criteria
- Food sensitivities elimination: IgG testing interpretation, elimination-rechallenge protocols, oral tolerance restoration strategies
- CRP >3.0 mg/L indicates LGI requiring immediate barrier assessment
- Ferritin <30 ng/mL or >200 ng/mL (in absence of infection) suggests iron dysregulation requiring gut investigation
- HbA1c >5.7% warrants metabolic flexibility assessment regardless of diabetes diagnosis
- Vitamin D <30 ng/mL requires supplementation; >50 ng/mL target for immune optimization
- TSH >2.5 mIU/L with symptoms warrants thyroid investigation even if "within normal range"
- Works clinically with Leo Pruimboom at the Pruimboom Institute; has ~2 years of direct mentorship experience (as of Module 8 delivery)
- Primary lecturer for Module 6 (Organs I: Digestive & Orofacial Systems) covering mouth, esophagus, stomach, small intestine, large intestine, pancreas, liver, gallbladder
- Primary lecturer for Module 8 (Diagnosis) teaching the 5 plus 2 metamodel framework for clinical assessment and intervention prioritization
- Leads all Q&A sessions for Modules 6 and 8, providing case-based discussion and troubleshooting clinical scenarios
- Emphasizes the oral cavity as the first barrier in immune system education and pathogen exposure; teaches that 90% of systemic disease has oral component
- Teaches that periodontal disease affects 47% of adults over 30 and is linked to CVD, Alzheimer's Disease, rheumatoid arthritis, and Type 2 Diabetes
- Instructs on the bidirectional oral-gut axis: oral pathogens (especially Porphyromonas gingivalis) colonize gut and vice versa; shared microbiome between mouth and colon
- Teaches practical betaine HCl protocol: start 1 capsule mid-meal, increase by 1 each meal until warmth sensation, then reduce by 1 capsule—that's optimal dose
- Emphasizes anamnesis as intervention: thorough patient history-taking itself is therapeutic through validation, coherence-building, and patient education
- Teaches the "Pruimboom Principle": never suppress a symptom without understanding its evolutionary purpose—symptoms are adaptive responses to mismatch
- Leo Pruimboom — clinical mentor and collaborator; translates his evolutionary immunology frameworks into bedside protocols
- 5 plus 2 metamodel — core diagnostic framework taught in Module 8; systematic approach to patient assessment across five physiological systems
- Clinical PNI — embodies the practical application of psychoneuroimmunology theory in patient care
- Organs Module — primary lecturer for Module 6 covering digestive and orofacial pathophysiology
- Diagnostics — teaches comprehensive patient assessment, biomarker interpretation, and intervention hierarchy
- Periodontal disease — teaches as primary systemic inflammation driver; emphasizes oral-gut-systemic connections
- Oral dysbiosis — lectures on oral microbiome assessment, pathogenic species, and systemic translocation mechanisms
- Leaky gut — teaches barrier restoration protocols; emphasizes as central mechanism in chronic disease
- Gut microbiome — instructs on microbiome assessment (stool testing, clinical markers), probiotic selection, and prebiotic strategies
- SIBO — teaches breath test interpretation, herbal antimicrobial protocols, and underlying cause identification
- H. pylori — covers diagnostic testing, natural eradication protocols, and post-eradication barrier repair
- Food sensitivities — teaches IgG vs. IgE distinction, elimination protocols, and oral tolerance restoration
- Patient-Provider Relationship — emphasizes therapeutic alliance building, active listening, trauma-informed care
- Metaflammation — teaches as downstream consequence of barrier dysfunction; central concept in metabolic disease
- Molecular Mimicry — teaches mechanism linking oral/gut pathogens to autoimmune tissue targeting
- Intestinal permeability — core teaching focus; barrier restoration as primary intervention in chronic disease
- Bacterial translocation — teaches mechanism and clinical consequences; links to endotoxemia and systemic inflammation
- Tight junctions — teaches molecular structure and regulation; Zonulin as biomarker
- Betaine HCl protocol — practical teaching on gastric acid optimization for digestion and barrier function
- Pruimboom Institute — primary institution where she teaches and practices; center for cPNI education and clinical application
- Module 6 (Organs I: Digestive & Orofacial Systems)
- Module 8 (Diagnosis)