Podcasts about crp

In this episode, David Watumull breaks down the science behind astaxanthin — a powerful carotenoid antioxidant backed by over 4,000 peer-reviewed papers and 100+ human clinical trials — and explains why it may be one of the most underappreciated longevity compounds available today. The conversation explores how astaxanthin anchors across cellular membranes to protect mitochondria from oxidative stress, reduce chronic inflammation ("inflammaging"), support cardiovascular health by lowering oxidized LDL and CRP, and cross the blood-brain barrier to enhance cognitive function and neuroprotection. They also discuss its role in energy production, endurance performance, healthy aging, and a landmark NIH lifespan study showing a 12% extension in mammals. Ultimately, the episode reframes longevity not as chasing stimulants or shortcuts, but as protecting cellular integrity so the body can function the way it was designed to — for longer and at a higher level. ----- 00:00 – The Longevity Molecule You've Never Heard Of 02:45 – What Is Astaxanthin? 07:30 – How It Protects Your Cell Membranes 13:40 – Free Radicals & Oxidative Stress Explained 25:50 – Brain Health, Neuroplasticity & Mitochondria 29:40 – Cardiovascular Disease & Oxidized LDL 34:05 – Alzheimer's, MCI & Neuroprotection 43:00 – Energy Production & Mitochondrial Function 58:40 – Inflammaging & Longevity Pathways 1:03:40 – NIH Study: 12% Lifespan Extension 1:09:00 – Athletic Performance & Endurance 1:15:00 – Dosing, Absorption & Bioavailability 1:26:00 – Can Antioxidants Become Harmful? 1:30:00 – Why Isn't This Mainstream? 1:37:30 – Living Ever Forward ----- Episode resources: Save 20% with checkout code EVERFORWARD at https://www.AX3.Life.com Watch and subscribe on YouTube Learn more at https://ax3.life/pages/science 

„Blutwerte sind nur Zahlen - Bedeutung bekommen sie erst im Kontext.“ Blut liefert viele Informationen über unseren Körper. In wenigen Millilitern stecken Hinweise auf Entzündungen, Stoffwechsel, Nährstoffversorgung und mögliche Erkrankungen. Trotzdem wird das sogenannte „große Blutbild“ oft überschätzt. Es untersucht nur die Blutzellen - also rote und weiße Blutkörperchen sowie Blutplättchen. Stoffwechselwerte, Hormone oder Vitamine gehören nicht automatisch dazu. In dieser Episode von HEALTH NERDS erklären Podcast-Host Felix Moese und Gesundheitswissenschaftler Matthias Baum, was ein kleines und ein großes Blutbild wirklich aussagen und welche Werte zusätzlich sinnvoll sein können. Dazu gehören zum Beispiel der Langzeitblutzucker HbA1c, der Eisen-Speicherwert Ferritin, das hochsensitive CRP als Entzündungsmarker oder genauere Cholesterinwerte. Entscheidend ist dabei nicht nur der einzelne Wert, sondern wie er eingeordnet wird. Ein HbA1c-Wert zeigt, wie sich der Blutzucker in den letzten Wochen entwickelt hat. Ferritin gibt Auskunft über die Eisenspeicher. Das hsCRP kann auf stille Entzündungen hinweisen. Doch all diese Werte müssen gezielt bestimmt werden - sie sind kein fester Bestandteil eines normalen Blutbilds. Wichtig ist außerdem: „Im Referenzbereich“ bedeutet nicht automatisch „optimal“. Referenzwerte orientieren sich an Durchschnittswerten der Bevölkerung. Ob ein Wert wirklich gut zum eigenen Körper passt, hängt von vielen Faktoren ab - etwa Ernährung, Stress, Bewegung oder dem Zeitpunkt der Blutabnahme. Ein einzelner Laborwert ohne Zusammenhang sagt daher oft weniger aus, als man denkt. Was zeigt ein großes Blutbild wirklich? Welche zusätzlichen Werte sind sinnvoll? Wann ist ein Wert zwar normal, aber trotzdem nicht ideal? Und wann lohnt sich ein Bluttest überhaupt? HEALTH NERDS. Mensch, einfach erklärt. Spare 15% auf Deine erste Bestellung auf https://artgerecht.com mit dem Code: HEALTHNERDS15 (im Warenkorb eingeben) Ein ALL EARS ON YOU Original Podcast.

Hidden fat stored deep inside organs, especially the pancreas and abdomen, links to brain shrinkage, cognitive decline, and a higher risk of neurologic disease even when your weight looks normal An MRI-based study of 25,997 adults found that fat distribution patterns inside the body predict brain aging and cognitive outcomes more strongly than body mass index (BMI) alone People with high pancreatic fat showed around 30% fat concentration in the pancreas, which was up to six times higher than lean individuals and tied to extensive gray matter loss The "skinny fat" profile involved high internal abdominal fat despite only moderate BMI, with men showing the steepest decline in brain volume and slower thinking speed Simple metabolic assessments like fasting insulin, HOMA-IR, CRP, lipid profiles, and waist-based ratios offer practical ways to detect hidden risks early, before obvious symptoms appear

Welcome back to our weekend Cabral HouseCall shows!   This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track!   Check out today's questions:    Michael: Hi Dr. Cabral. I'm an IHP Level 1 and have been following you for over 2 years. I'm grateful for all you do. I'm a 61 year old male and take no medication. I've always had elevated cholesterol but it's come down a lot over the last 2 years. I now have LDL of 108. My CRP is in the normal range at 0.41. My homocysteine is also in the normal range at 8.9. My coronary calcium score from almost 3 years ago is 129. I want to make sure my heart stays healthy and want to be smart about what supplements to take apart from the foundational ones like the DNS and Omega 3. If I take all the supplements that promote a healthy heart, it gets a bit expensive and I was wondering if you thought about formulating one supplement to combine some of them. I'm currently taking D3+K2, Red Yeast Rice, Berberine and Inflamma Soothe, and I'm considering adding in Proteolytic Enzymes. What are your thoughts on which ones to prioritize?      Lily: Hi Doc, I am taking the foundational supplements and magnesium. I know that everyone is different and the personal approach is best (I just ordered your new book). But, if you had to say, beyond the foundational supplements, what are your next 4 favorite supplements?      Tommy: Hi Dr C, I'm An IHP 2. I've come a long way with my health and career thanks to you. I've had many issues in life similar to you. In the last 2 years I feel like I've become very prone to gut issues. I've done 2 para and 1 CBO in the last year. I seem to get bouts of dhiarrea like I've picked up a bacteria. I have wondered if my stomach acid is low, being an online presence is stressful, but I'm working on my stress more than ever. What else could cause me to have a 'weak stomHawkins: ach'? I still get anal itching too, sometimes during the day, I know you've mentioned this could also be histamines and not just parasites. I've had so much trauma, antibiotics, and 14 years of steroid creams. I've had low cortisol too which I believe is much better now.      Scott: Hi Stephen. (Scott UK) . My wife had a routine operation (9 operations in total) and ended up with stomach problems diagnosed with gastroparesis, well that's what they said, she ended up with a feeding tube and an ileostomy, in the last couple of years she's really turn thing around she's back to solid food and she hasn't fed on her feeding tube for 9 to 10 months now, she's gaining weight and looking really healthy, she's 53 and going through menopause, she's been diagnosed with carpal tunnel and trigger finger in both hands, and both thumbs are now stuck straight, she takes half of a scoop of DNS and greens powder, D3k2. magnesium, zinc, omega 3, infrared sauna, red light, 7000 steps, they want to operate on both hands,which I'd like to avoid, any suggestions would be very helpful.      Stephanie: Hi! I had a full work up done and it showed my prolactin level is 95. CRP also elevated, but everything else within range. I am willing to go see an endocrinologist, but I am hesistant to take the cabergoline (I've read that's likely how they will proceed). Is there anything else I can do? I started taking Vitex Berry when I got the results.      Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!      - - - Show Notes and Resources: StephenCabral.com/3669 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

This is a major episode of Talk Dirt To Me, covering some of the biggest stories currently impacting American agriculture, rural landowners, and national farm policy. We begin with the story of Gregory Family Farm in Sumner County, Tennessee, and their ongoing battle with the Tennessee Valley Authority (TVA) over eminent domain. This situation raises serious questions about private property rights, government authority, and what happens when multi-generation farmland stands in the path of federal infrastructure projects. We explain what is happening, why it matters beyond Tennessee, and what this case could mean for farmers and landowners across the country. Next, we break down President Trump's executive action protecting Glyphosate and Phosphorus and discuss why the decision is tied not only to agriculture but also to food security and national security. We examine how crop protection tools affect American production capacity, global competitiveness, and the stability of the U.S. food supply. The conversation then turns to an in-depth look at Farm Bill 2.0. This episode serves as our first comprehensive breakdown of the new legislation and what it includes for farmers and rural communities. Topics covered include strengthened farm safety nets, conservation funding through EQIP and CRP programs, efforts to improve export competitiveness, pesticide liability protections, increased farm loan limits, and provisions aimed at limiting the nationwide impact of California's Proposition 12. We also discuss potential concerns and areas that may change as amendments continue to shape the bill. We will continue updating listeners as new developments occur. Along the way, the episode includes classic Talk Dirt To Me conversation, including Memphis rap nostalgia, Logan's story about an interview with a legacy media outlet that will likely never air, and a recap of our experience at the National Farm Machinery Show in Louisville. Made in USA Product of the Week: the suppressor cover from T and K Hunting Gear, built for durability and performance in the field. If you want real discussions about farming, policy, rural America, and the culture surrounding agriculture, this episode delivers an in-depth and honest conversation you will not hear anywhere else. Go check out Agzaga! It is the ultimate online farm store. American owned and operated. Go check out their site and get what you need. Be sure to use the code TalkDirt20 to get $20 off your order of $50 or more! Visit them at: https://agzaga.com 

Understanding and Managing Heart Health: In this Heart Health Month episode of the Intelligent Medicine Podcast, nutritionist Leyla Muedin addresses a listener's question about elevated cholesterol levels and calcium scores. Drawing on an article written by Dr. Hoffman, she emphasizes the importance of discussing statin use with a doctor, considering individual risk factors, and getting additional tests like VAPs, NMR, homocysteine, and lipoprotein levels. The episode explores the importance of vitamins K2 and folate in cardiovascular health, addressing nutritional deficiencies, and the impact of dietary choices on heart health.

Dr. Karen Vanderhoff joins us to discuss what she is seeing in the health crisis of Midwest farmers. The suicide rates are very high compared to other occupations, and we want to know why and what we can do about it.   hokseynativeseeds.com (for CRP mixes, hunting habitat mixes, and backyard pollinator mixes)

In this episode of the *Innovations and Clinical Implementation* podcast recorded at LongevityFest, hosts Tom Blue and Chris D'Adamo discuss the rapid evolution of epigenetic testing with Ryan Smith. Ryan Smith is the founder and global head of research and development at TruDiagnostic, a CLIA-certified lab and health data company that has built one of the world's largest private epigenetic databases to advance the measurement of biological aging. The discussion traces the 140% year-over-year growth in consumer interest regarding biological age and explores how TruDiagnostic utilizes AI to interpret over 1.3 million DNA methylation sites to validate longevity interventions in clinical trials. Smith previews the upcoming release of "methylation risk scores" that can predict the onset of diseases like COPD and Lyme disease, and details the development of "Epigenetic Biomarker Proxies" (EBPs) intended to eventually replace traditional labs by deriving thousands of metrics—such as HbA1c, CRP, and environmental toxins—from a single finger stick.   For access to episode resources, click HERE.

Independent filmmaker Christina Shaver discusses two projects in Aledo. One involves the film "Everything Fun You Could Possibly Do in Aledo, Illinois" and the other involves a documentary film on late Aledo artist Gertrude Abercrombie.  Bill Graff, State Executive Director USDA-FSA and Shelley Sweatman, Illinois Conservation Division Chief USDA-FSA, talk CRP sign-up.  DTN ag meteorologist John Baranick discusses the possibility for severe weather on Thursday.  

Laura Walter, of the Tall Grass Prairie Center, joins us to discuss the new species she is trying to grow at her facility. Also, which species is no one else growing that she has available for new growers. We also talk about hemiparasites and more.   hokseynativeseeds.com (for backyard pollinator mixes, CRP mixes, hunting mixes, and more!)

This week, Tony shares a morning report physiology pearl: Why do patients with active lupus have a low CRP? Click here to obtain AMA PRA Category 1 Credits™ (0.5 hours), Non-Physician Attendance (0.5 hours), or ABIM MOC Part 2 (0.5 hours). Audio edited by Clair Morgan of Nodderly.com. Resident Giancarlo Buonomo and medical student Millennium Manna are our producers.

You've heard of burnout. But what if the real crisis starts long before the breaking point? In this short opener, host Stacie introduces allostatic load — the scientific term for the cumulative "wear and tear" the body accumulates under chronic, unresolved stress. It's not a bad week. It's what happens when the body never fully recovers, and the nervous system learns to treat survival mode as its new normal. Research shows women carry a disproportionate allostatic burden — driven not just by biology, but by the invisible labor, emotional weight, and systemic pressures that don't clock out at 5pm. And for leaders and HR professionals, this matters: what often looks like a performance problem in your workforce may actually be a health signal hiding in plain sight. This episode opens a series that follows allostatic load where it leads — into autoimmune disease, hormonal disruption, ADHD, and what it truly costs women, leaders, and organizations when we keep misreading the signal. Under 5 minutes. But it might change how you see everything else. Stacie Origins of the Term The concept of allostasis — meaning "stability through change" — was first introduced by neurobiologist Peter Sterling and epidemiologist Joseph Eyer in 1988 to describe how the brain dynamically recalibrates internal physiological systems in anticipation of environmental demands, rather than simply reacting to them. Building on this foundation, neuroscientist Bruce McEwen and physiologist Eliot Stellar coined the term allostatic load in 1993, defining it as the cumulative physiological "wear and tear" the body experiences when allostatic systems are chronically activated, fail to shut off, or never perform normally. McEwen later described this as "the price of adaptation" — the physiological cost the body pays for sustained attempts to manage chronic stress. The Biological Cascade: What Happens in the Body When the brain perceives a stressor — real or anticipated — it activates two primary physiological systems: the sympathetic-adrenal-medullary (SAM) axis, which releases catecholamines (adrenaline, noradrenaline), and the hypothalamic-pituitary-adrenal (HPA) axis, which releases glucocorticoids, primarily cortisol. In the short term, these responses are adaptive and protective. However, under conditions of chronic, unresolved stress, this cascade remains activated. Over time, the brain and organ systems undergo measurable physiological changes: ↑  Elevated cortisol, epinephrine, and norepinephrine (neuroendocrine markers) ↑  Elevated inflammatory markers: C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen ↑  Dysregulated blood pressure, lipid levels, glycated hemoglobin (metabolic markers) ↓  DHEA (dehydroepiandrosterone) — the protective counterpart to cortisol A 2001 landmark study using the MacArthur Studies of Successful Aging demonstrated that higher allostatic load scores at baseline were significantly associated with increased 7-year mortality risk and declines in both cognitive and physical functioning. A comprehensive 2020 systematic review of 267 studies confirmed that allostatic load and allostatic overload are robustly associated with poorer physical and mental health outcomes across a wide range of conditions.

There was a push at the Iowa Capitol to put the Buffer Strip Pollinator Program into a bigger setting for farmers to put onto their land. But it was killed in subcommittee. Why? We're trying to find out. Check out another riveting episode of Coffee Time Wednesday on The Prairie Farm Podcast. hokseynativeseeds.com (for buffer strip pollinator mixes, backyard prairie mixes, CRP mixes, and a lot more!)

30-Day Anti-Inflammatory Challenge PodcastFIVE PRIMARY POINTS of the PODCASTPurpose and closeness are biologically linked drivers of vitality.Research involving over 8,000 people shows that a strong sense of purpose explains much of the relationship between loneliness and mortality, reinforcing that vitality cannot be optimized in isolation.Loneliness is a serious health risk—not just an emotional state.It is associated with cardiovascular disease, dementia, suicide, increased inflammation (including higher CRP levels), reduced resilience, and cognitive decline, demonstrating that social connection is fundamental to long-term health.Closeness must be intentionally cultivated.High-quality relationships may matter more than traditional risks like smoking or obesity. Practical strategies include practicing forgiveness, building a “vitality squad” of about four trusted friends, actively listening, and scheduling regular in-person connection.Purpose functions as a longevity enhancer and performance differentiator.A study of more than 13,000 people found that those with a high sense of purpose had less than half the mortality risk of those with low purpose. Purpose guides how we invest time and energy and acts as a powerful motivational engine.Identifying purpose requires reflection, experimentation, and service to others.Key steps include clarifying values, recognizing strengths, stepping outside comfort zones, seeking guidance, and refining a concise purpose statement. Ultimately, meaningful actions sustained over time—and focusing on improving others' lives—lead to a meaningful life.Copyright, VyVerse, LLC. All Rights Reserved. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit vitalityexplorers.substack.com/subscribe

This episode of EM Pulse dives into one of the most stressful scenarios in the ED: the febrile infant in the first month of life. Traditionally, a fever in this age group has meant an automatic “full septic workup,” including the dreaded lumbar puncture (LP). But times are changing. We sit down with experts Dr. Nate Kuppermann and Dr. Brett Burstein to discuss a landmark JAMA study that suggests we might finally be able to safely skip the LP in many of our tiniest patients. The Study: A Game Changer for Neonates Our discussion centers on a massive international pooled study evaluating the PECARN Febrile Infant Rule specifically in infants aged 0–28 days. While previous guidelines were conservative due to a lack of data for this specific age bracket, this study provides the evidence we've been waiting for. The Cohort: A large pool of infants across multiple countries. The Findings: The PECARN rule demonstrated an exceptionally high negative predictive value for invasive bacterial infections. The Big Win: The rule missed zero cases of bacterial meningitis. Defining the Danger: SBI vs. IBI The experts break down why we are shifting our terminology and our clinical focus. Serious Bacterial Infection (SBI)  Historically, this was a “catch-all” term including Urinary Tract Infections (UTIs), bacteremia, and meningitis. However, UTIs are generally more common, easily identified via urinalysis, and typically less life-threatening than the other two. Invasive Bacterial Infection (IBI)  This term refers specifically to bacteremia and bacterial meningitis. These are the “high-stakes” infections the PECARN rule is designed to rule out. Dr. Kuppermann notes that we should ideally view bacteremia and meningitis as distinct entities, as the clinical implications of a missed meningitis case are far more severe. The HSV Elephant in the Room One of the primary reasons clinicians hesitate to skip an LP in a neonate is the fear of missing Herpes Simplex Virus (HSV) infection. Low Baseline Risk: While the overall risk of HSV in a febrile infant is low, the risk of “isolated” HSV (meningitis without other signs or symptoms) is even rarer. Screening Tools: Most infants with HSV appear clinically ill. Clinicians can also use ALT (liver function) testing as a secondary screen – transaminase elevation is a common marker for systemic HSV. Clinical Judgment: If the baby is well-appearing, has no maternal history of HSV, no vesicles, and no seizures, the risk of missing HSV by skipping the LP is exceptionally low. Practical Application: Shared Decision-Making This isn’t just about the numbers—it’s about the parents. “Families don’t mind their babies being admitted… They do not want the lumbar puncture. It is the single most anxiety-provoking aspect of care.” — Dr. Brett Burstein The PECARN “Low-Risk” Criteria:  (Remember, this rule applies only to infants who are not ill-appearing.) Urinalysis: Negative Absolute Neutrophil Count (ANC): ≤ 4,000/mm³ Procalcitonin (PCT): ≤ 0.5 ng/mL The Bottom Line: If an infant is well-appearing and meets these criteria, physicians can have a nuanced conversation with parents about the risks and benefits of forgoing the LP, while still admitting the child for observation (often without empiric antibiotics) while cultures brew. Key Takeaways The “Well-Appearing” Filter: If an infant looks ill, the rule does not apply. These patients require a full workup, including an LP, regardless of lab results. Meticulous Physical Exam: Assess for a strong suck, normal muscle tone, brisk capillary refill, and any rashes or vesicles. History is Key: Always ask about maternal GBS/HSV status, pregnancy or birth complications, prematurity, sick contacts, and any changes in feeding, stooling or activity. Procalcitonin: PCT is the superior inflammatory marker for this rule. If your facility only offers traditional markers like CRP, the PECARN negative predictive value cannot be strictly applied. In the words of Dr. Kuppermann: “If you don’t have it, for God’s sakes, just get it! ALT to Screen for HSV: While not part of the official PECARN rule, our experts suggest that significantly elevated liver enzymes should raise suspicion for systemic HSV. Observe, Don’t Discharge: Being “low risk” does not mean the infant goes home. All infants ≤ 28 days still require admission for 24-hour observation and blood/urine cultures. We want to hear from you! Does this change how you approach febrile neonates in the ED? How do you handle shared decision-making with parents? Connect with us on social media @empulsepodcast or on our website ucdavisem.com. Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Dr. Nate Kuppermann, Executive Vice President and Chief Academic Officer; Director, Children’s National Research Institute; Department Chair, Pediatrics, George Washington University School of Medicine and Health Sciences Dr. Brett Burstein, Clinician-Scientist and Pediatric Emergency Medicine Physician at Montreal Children’s Hospital, McGill University Resources: Burstein B, Waterfield T, Umana E, Xie J, Kuppermann N. Prediction of Bacteremia and Bacterial Meningitis Among Febrile Infants Aged 28 Days or Younger. JAMA. 2026 Feb 3;335(5):425-433. doi: 10.1001/jama.2025.21454. PMID: 41359314; PMCID: PMC12687207“Hot” Off the Press: Infant Fever Rule “Hot” Off the Press: Infant Fever Rule Do I really need to LP a febrile infant with a UTI? PECARN Infant Fever Update: 61-90 Days Kuppermann N, Dayan PS, Levine DA, Vitale M, Tzimenatos L, Tunik MG, Saunders M, Ruddy RM, Roosevelt G, Rogers AJ, Powell EC, Nigrovic LE, Muenzer J, Linakis JG, Grisanti K, Jaffe DM, Hoyle JD Jr, Greenberg R, Gattu R, Cruz AT, Crain EF, Cohen DM, Brayer A, Borgialli D, Bonsu B, Browne L, Blumberg S, Bennett JE, Atabaki SM, Anders J, Alpern ER, Miller B, Casper TC, Dean JM, Ramilo O, Mahajan P; Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN). A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Pediatr. 2019 Apr 1;173(4):342-351. doi: 10.1001/jamapediatrics.2018.5501. PMID: 30776077; PMCID: PMC6450281. Pantell RH, Roberts KB, Adams WG, Dreyer BP, Kuppermann N, O’Leary ST, Okechukwu K, Woods CR Jr; SUBCOMMITTEE ON FEBRILE INFANTS. Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old. Pediatrics. 2021 Aug;148(2):e2021052228. doi: 10.1542/peds.2021-052228. Epub 2021 Jul 19. Erratum in: Pediatrics. 2021 Nov;148(5):e2021054063. doi: 10.1542/peds.2021-054063. PMID: 34281996. ****Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.  

Midlife health is about far more than a single lab value. In this episode, we talked about how hormones, muscle mass, cholesterol, and inflammation influence long term heart and metabolic health. If you've ever felt overwhelmed or confused by what to focus on, we're bringing the clarity and direction to make it easier on you!Timestamps:[1:50] Welcome[11:52] I saw a post that said muscles in our legs help us have longevity and our calf muscles are like the second heart in the body. I'm assuming there's some truth, but does that just mean to continue to strike train and to walk?[24:56] How do you know if you're in peri-menopause? I feel like everything is a symptom.[37:24] What are the pros and cons of muscle splits vs. whole body workouts?[45:25] What dietary guidance do you have for lowering high total cholesterol? Episode Links:Kicking Back Cognitive Aging: Leg Power Predicts Cognitive Aging after 10 Years in Older Female TwinsSeeking Health DAO enzymeSeeking Health Histamine ProbioticThyroid Markers to check: TSH, Free T4, Free T3, Thyroid peroxidase antibodies (TPO), Thyroglobulin antibodies (TGAb)Additional cholesterol markers to check: ApoB, LDL-P, hs-CRP, fasting insulinSponsors:Go to boncharge.com/WELLFED and use coupon code WELLFED to save 15% off any order.Go to getkion.com/wellfed to get 20% off your order. Go to http://mdlogichealth.com/wfcolostrum , and use coupon code WFC15 for 15% off. You can also use code WELLFED for 10% off site wide on all MD Logic Products. Go to wellminerals.us/vitaminc and use code WELLFED to get 10% off your order.

Weight frustration in perimenopause isn't just about vanity—it's about a physiological shift that changes how our bodies handle fuel. In this episode, Dr. Rachel Pope sits down with midlife health expert Ann Konkoly to demystify GLP-1 medications (like Ozempic and Zepbound), the hidden dangers of visceral fat, and why the scale is often a "shitty measurement" for your actual health.In this episode, we discuss: The "Middle" Mystery: Why the "eat less, move more" mantra fails women in perimenopause and how this transition impacts weight maintenance. GLP-1s Beyond Weight Loss: Ann explains the metabolic benefits of these medications, including reducing neuroinflammation and protecting the heart and kidneys. The Hidden Danger of Visceral Fat: Why a "normal BMI" can be misleading and how internal fat affects your risk for chronic disease. Synergy with MHT: How optimizing cardiovascular health can create a safer "on-ramp" for starting hormone replacement therapy. Preserving Lean Muscle: Strategies for "muscle-centric medicine" to ensure weight loss doesn't come at the expense of your strength and bone density. The HOMA-IR Hack: A simple way to use fasting glucose and insulin levels to see if insulin resistance is your primary roadblock. Planning for your later years: Why the choices you make in your 40s and 50s determine your mobility and independence in your 80s and 90s.The "Proactive Midlife" Lab ChecklistAnn suggests asking your provider for these specific markers to get a true picture of your metabolic health: Fasting Insulin & Fasting Glucose (to calculate your HOMA-IR score). Lipid Panel (focusing on Triglycerides). Lipoprotein(a) & hs-CRP (markers of inflammation and genetic heart risk). Body Composition Analysis (to track muscle mass vs. visceral fat).About Ann:Ann Konkoly is a board-certified Nurse Practitioner, Certified Nurse Midwife, and Menopause Society Certified Practitioner. She is the founder and CEO of Kultivate Women's Health in Beachwood, Ohio, where she specializes in evidence-based hormone therapy, metabolic health, and medical weight management.Connect with Ann: Website: www.kultivatewomenshealth.com/about Instagram: www.instagram.com/annkonkoly.npConnect with Dr. Rachel Pope: Website: ourwomanity.comSocial Media: @drrachelpope

🧭 REBEL Rundown 🗝️ Key Points 💉 Hydrocortisone Saves Lives:The 2023 Cape Cod Trial (NEJM) showed a clear mortality benefit and reduced need for intubation in severe CAP patients treated with hydrocortisone.📊 Guidelines Are Catching Up:The SCCM (2024) and ERS now recommend steroids for severe CAP, while ATS/IDSA updates are still pending.🔥 Redefining “Severe”:Patients requiring high FiO₂ (>50%), noninvasive or mechanical ventilation, or PSI >130 meet criteria for steroid therapy — even outside the ICU.🍬 Main Risk = Hyperglycemia:Elevated glucose was the most consistent adverse effect, but rates of GI bleed and secondary infection were not increased.🧭 Early, Targeted Use Matters:Start hydrocortisone within 24 hours of identifying severity — especially in patients with high CRP (>150) or strong inflammatory response. Click here for Direct Download of the Podcast. 📝 Introduction Corticosteroids have long sparked debate in the treatment of bacterial pneumonia — once viewed with skepticism, now increasingly supported by high-quality evidence. In this episode, Dr. Alex Chapa joins the REBEL Core Cast team to explore how the 2023 Cape Cod Trial (NEJM) reshaped practice and guideline recommendations for severe community-acquired pneumonia (CAP). 📖 Historical Context & Long-Standing Skepticism For decades, the use of steroids in pneumonia was controversial.Early Use: Steroids entered practice in the 1940s and 50s for autoimmune inflammation, but there was immediate hesitation regarding secondary superinfections.Mixed Data: From the 1980s to the 2000s, small studies emerged on severe pneumonia and ARDS, but the data was inconsistent. Different trials used varying definitions of “severe” pneumonia and different C-reactive protein (CRP) cutoffs, making the data “spread” and easy to “cherry pick” to support or deny a benefit.Past Guidelines: This uncertainty was reflected in official guidelines:2007 (ATS/IDSA): The American Thoracic Society and the Infectious Diseases Society of America did not address the topic due to insufficient data.2019 (ATS/IDSA): Pre-COVID, the guidelines recommended against using corticosteroids in severe CAP. They acknowledged no benefit for non-severe pneumonia, but the data for severe pneumonia was considered too weak to endorse.Pre-Trial Consensus: Prior to 2023, the consensus was to avoid steroids in non-severe pneumonia, while severe pneumonia remained a “gray area” with no treatment showing a clear mortality difference. 📜 The Landmark Cape Cod Trial (NEJM 2023) The Cape Cod trial, published in the New England Journal of Medicine in 2023, reignited the discussion by providing robust, positive data.Trial Design: Phase 3, multi-center, double-blind, randomized, controlled trial.Intervention: 800 patients randomized to two groups, Hydrocortisone as a continuous infusion (200mg/day) versus a placebo infusion.Taper: On day 4, clinicians would decide whether to continue the infusion or begin a taper based on clinical response.Population: Patients with severe CAP, defined by meeting at least one of the following criteria:Pneumonia Severity Index (PSI) > 130.O2 by FiO2 ratio < 300.Need for mechanical or non-invasive ventilation (with PEEP ≥ 5).Need for high FiO2 (>50%) via non-rebreather or heated high flow.Primary Outcomes: Death for any cause 6.2% (hydrocortisone) vs 11.9% (placebo)Secondary outcomes:Death from any cause at 90 days 9.3% (hydrocortisone) vs 14.7% (placebo)Endotracheal intubation 18% (hydrocortisone) vs 29% (placebo)Hospital-acquired infections 9.8% (hydrocortisone) vs 11.1% (placebo)Gastrointestinal bleeding 2.3% (hydrocortisone) vs 3.3% (placebo)Vasopressor initiation by day 28 15.3% (hydrocortisone) vs 25.0% (placebo)Key Findings: The trial demonstrated superiority for hydrocortisone 📋 Updated Guidelines & Current Practice The Cape Cod trial, along with subsequent meta-analyses, has begun to change official recommendations.Society of Critical Care Medicine (SCCM): In 2024, an SCCM expert panel, reviewing the Cape Cod trial and 18 others, strongly recommended corticosteroids for severe CAP. They concluded that steroids reduce mortality and the need for mechanical ventilation.Meta-Analysis (Smit et al.): A 2024 meta-analysis in Lancet Respiratory confirmed the 30-day mortality benefit.European Respiratory Society (ERS): The ERS has issued a recommendation to use steroids for severe pneumonia but still urges caution regarding side effects.ATS/IDSA: As of the podcast recording, the ATS/IDSA had not yet updated their 2019 guidelines. 🛠️ Practical Application for Clinicians Defining “Severe” CAP: The key is to identify patients who qualify as “severe”. This can be done using:Scoring Tools: The PSI is the best validated tool for mortality but is cumbersome. Simpler tools like CURB-65 or SMART-COP are practical and acceptable for defining severity. 2023 meta-analysis from by Zaki et al showed both work well, but CURB-65 has better mortality prediction early on.Cape Cod Criteria: Any patient meeting the trial’s inclusion criteria (e.g., high-flow O2, non-invasive ventilation) qualifies, regardless of location (ED, floor, or ICU).Biomarkers: While not required, a CRP level was used in many studies. A CRP > 150 (Cape Cod) or > 204 (Smit meta-analysis) strongly indicates severe inflammation that would benefit from steroids.Clinical Judgment: A patient who looks “sick,” has “soft” blood pressure, or has dense infiltrates and high oxygen needs (e.g., >50% FiO2 on high flow) is a candidate.Adverse Effects:Hyperglycemia: This was the most significant risk identified, with rates between 6-12%. This is a primary concern, especially in patient populations with high BMI.GI Bleed & Secondary Infection: Fears of these side effects, which contributed to historical skepticism, were not borne out in the Cape Cod trial. The data does not support being overly concerned.Other Side Effects: Mood changes, delirium, insomnia, and agitation in the elderly are known side effects of steroids that were not specifically addressed in the trial but remain clinical concerns. 🔄 Clinical Pathway for Steroids in Severe CAP Unanswered Questions & Future Research Possible remaining questions:Biomarkers: Can we find a more precise CRP level to distinguish moderate from severe disease? Could other markers like ferritin or IL-6 be used? Dosing & Tapering: How much immunomodulation is needed, and when is it truly safe to taper?Gender Differences: Early data suggests females may respond better to steroids and experience fewer side effects. The question of female patients with severe CAP require less corticosteroids needs further exploration. 👉 Clinical Bottom Line The current literature, spearheaded by the Cape Cod trial, now supports the use of corticosteroids in severe community-acquired pneumonia. The best evidence currently points to hydrocortisone, started early (within 24 hours) after severity is identified using a validated tool. While hyperglycemia is a risk, the previous fears of GI bleeding and secondary infections were not substantiated in recent, rigorous trials. 📚 References Chapa-Rodriguez A, Abou-Elmagd T, O’Rear C, Narechania S. Do patients with severe community-acquired bacterial pneumonia benefit from systemic corticosteroids?. Cleve Clin J Med. 2025;92(10):600-604. PMID: 41033846Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in Severe Community-Acquired Pneumonia. N Engl J Med. 2023;388(21):1931-1941. PMID: 36942789Chaudhuri D, Nei AM, Rochwerg B, et al. 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia. Crit Care Med. 2024;52(5):e219-e233. PMID: 38240492 Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Show Notes Alex Chapa, MD PGY 5 Pulmonary Critical Care Fellow Cape Fear Valley Medical Center Fayetteville NC 🔎 Your Deep-Dive Starts Here REBEL Core Cast 149: Review of Corticosteroids in Community-Acquired Pneumonia Corticosteroids have long sparked debate in the treatment of bacterial ... Thoracic and Respiratory Read More The post REBEL Core Cast 149: Review of Corticosteroids in Community-Acquired Pneumonia appeared first on REBEL EM - Emergency Medicine Blog.

Exclusive! We venture inside the Beltway to analyze the Sen. Lee land-sale debacle, look back on the victories, defeats and delays in law-making and public policy with our friends Jeff Crane (Pres./CEO) and Taylor Schmitz (Sr. VP - policy) of the Congressional Sportsmen's Foundation. That organization roams the halls of congress and all the alphabet agencies that restrict, protect and frustrate us, advocating on our behalf with legislative staff, elected officials and bureaucrats who make the rules. We'll look ahead, too, at some critical policy and legal opportunities including the chance for a new Farm Bill - the catchall legislation that funds CRP, among other programs. We'll also learn how plain old sportsmen and women can get involved at every level to ensure our voices are heard - and heeded. Insider editions are brought to you by CableGangz tie-out systems and Heartland Lodge, where you'll get special freebies and gifts for every booking (learn more here). [Take 10% off your next order at CableGangz.com with the promo code CG10.]

MANUAL DESCARGAR: https://drive.google.com/file/d/18-eu...Me pueden encontrar tambien en Instagram:   / medhacker  TikTok: https://www.tiktok.com/Compartan si me quieren apoyar! Gracias! ¿Qué es la creatina?-Descubierta en 1832, incluso antes que el ATP.-Es un compuesto nitrogenado que el cuerpo produce en hígado y cerebro.-Se obtiene en pequeñas cantidades de carne y pescado, pero es casi inexistente en dietas vegetarianas o veganas.-Funciona como "el Robin de Batman (ATP)": ayuda a regenerar rápidamente energía para contracciones musculares.Efectos principales en el músculo-Mejora fuerza y rendimiento: más repeticiones, mejor recuperación entre series.-Aumento de masa magra: en promedio 700 g de músculo en 6 semanas.-Recuperación: acelera la reparación muscular y disminuye daño.-Efectos en aeróbicos: ayuda en hidratación y reduce inflamación tras maratones o ironman.-No es un esteroide.Propiedades antiinflamatorias-Reduce citocinas inflamatorias (IL-6, TNF-α, CRP).-Tiene potencial en condiciones donde la inflamación es clave: envejecimiento, sarcopenia, enfermedades neurológicas.-Puede proteger al cerebro en situaciones de estrés metabólico (falta de sueño, jet lag, trauma).Cerebro y cognición-Beneficios en memoria, atención, depresión, Alzheimer, Parkinson y conmociones cerebrales.-Mejora síntomas de privación de sueño y fatiga mental.-En Alzheimer: 20 g/día por 8 semanas mostró mejoría cognitiva.-En depresión: 5 g/día junto con terapia o medicación ayudó a reducir síntomas.Salud ósea-En mujeres postmenopáusicas: 8–12 g/día redujo pérdida de densidad mineral ósea en cadera.-Puede actuar como anti-resortivo, parecido a los bifosfonatos.-Potencial para disminuir riesgo de fracturas y fragilidad.Mujeres, embarazo y niños-Mujeres: suelen tener menores reservas, responden bien a suplementación.-Embarazo: estudios en animales muestran beneficios en placenta y desarrollo fetal; ensayos clínicos en humanos están en curso.-Niños y adolescentes: dosis seguras (0.1 g/kg). Evidencia positiva en deportes y en casos de conmoción cerebral.Dosis y formas de uso-Estándar: 3–5 g/día.-Carga rápida: 20 g/día (divididos) por 5–7 días, luego 3–5 g/día.-Enfocado en cerebro: más de 10 g/día, incluso hasta 20 g en patologías como Alzheimer.-Se puede tomar con comida (mejor absorción con proteínas o carbohidratos).-No importa la hora: lo clave es la consistencia.Mitos y realidades-Daño renal: falso (creatinina puede subir, pero es marcador falso).-Hipertensión: no aumenta la presión arterial.-Retención de líquidos peligrosa: la hidratación es intracelular y benéfica.-Pérdida de cabello: no hay evidencia.-Engorda: al contrario, puede favorecer leve pérdida de grasa.-Necesidad de ciclo: no es necesario suspender.Seguridad-Considerado por la FDA como “Generally Recognized as Safe (GRAS)”.-Más de 1000 estudios respaldan su seguridad y eficacia.-Puede usarse en jóvenes, adultos, mujeres y mayores.Futuras áreas de investigación-Uso en cáncer, tanto en prevención como adyuvante en tratamientos.-Embarazo y lactancia: estudios en humanos en curso.-Trastornos neurológicos y psiquiátricos: depresión, ansiedad, PTSD, ADHD.Recomendaciones prácticas-Base de salud: ejercicio + sueño + buena nutrición.-Creatina es “la cereza del pastel”: segura, económica y altamente estudiada.-Idealmente acompañada de entrenamiento de fuerza y suficiente ingesta proteica.-En pacientes que usan GLP-1 (semaglutide, tirzepatide): fundamental para evitar pérdida de músculo.

Beat Heart Disease Before It Starts — Insights from Dr. Howard Elkin with Dr. Ben Weitz. Dr. Elkin's website is Heartwise.com.  His main office is in Whittier, California and he has a concierge practice in Santa Monica, California and his office number is 562-945-3753. What You'll Hear In This Episode: 02:40    A Functional Medicine approach looks at why the body would lay down plaque as a rational response to coat the artery wall against inflammation or oxidation or glycation reactions. 06:08    I asked Dr. Elkin what his view is on cholesterol and he mentioned that half of patients who have heart attacks have normal cholesterol 08:09    Dr. Elkin discusses the benefits of the Boston Heart Lab and other advanced lipid profiles for better assessing true CVD risk 09:36    Howard explains how small, dense particles are more likely to be oxidized and incorporated into arterial plaques 10:50     I explained how larger HDL particles perform reverse cholesterol transport to remove potentially harmful LDL particles from the blood stream 11:02     I asked how Dr. Elkin treats patients who have small, dense LDL particles and he explained that he gets his patients to change their lifestyle and he uses certain nutritional supplements such as niacin before he puts them on medications.   13:10     I asked Howard what are some of the most important dietary factors to change to lower cardiovascular risk in such a patient?  He said it's not about cutting our eggs and saturated fat, like we used to think.  Howard's way of thinking is that sugar not fat is the main villian, since it is pro-inflammatory. 16:57    I asked Dr. Elkin about one of his recent blog articles where he wrote about the new PCSK-9 inhibitor medications for cholesterol. Dr. Elkin explained these may be effective, but they showed that they could bring LDL cholesterol levels down to 36 and this is actually not a good thing, since you need cholesterol for hormones, vitamin D production, and brain function.   Also, these drugs cost $14,000 per year. 20:30   Howard explained that when he does places patients on statins, he always puts them on CoQ10 to prevent muscle problems. He usually uses 100-200 mg to start with.  With patients who have heart failure he will use very high dosages, along with magnesium, L-Carnitine, and D-Ribose. 24:22   Dr. Elkin discusses what nutritional supplements he will use to raise HDL levels: 2 tablespoons daily of Extra Virgin Olive oil,  coconut oil, low carb diet, exercise, weight reduction, and niacin. 27:52    I asked Howard how to lower Lp(a). He said that this fragment of LDL is extremely atherogenic and is highly likely to get oxidized. Niacin, estrogen, and fish oil can help. I mentioned that I also found that berberine and tocotrienols were also helpful. 30:30   We discussed what to do about patients with elevated CRP (indicative of inflammation). Dr. Elkin mentioned that this test should be done routinely on all patients, but it is often not measured.  There is a link between obesity and CRP and also between oral cavity problems and sinusitis and even poor sleep. He likes fish oil, turmeric, ginger, and boswellia to reduce inflammation.

Get Busy Living PodcastFIVE PRIMARY POINTS of the PODCASTChronic Inflammation is a Powerful Predictor of Disease and DeathDr. Mishra explains that mounting evidence—including a major American College of Cardiology scientific statement—shows inflammation, measured by high-sensitivity C-reactive protein (hsCRP), predicts long-term cardiovascular risk and mortality more strongly than LDL cholesterol alone. Inflammation is no longer a theoretical concern; it is clinically actionable and central to aging, heart disease, cancer, and dementia risk.Excess Inflammation Accelerates Aging and DiseaseWhile inflammation is essential for healing and fighting infection, chronic or excessive inflammation damages tissues and increases mortality risk. Dr. Mishra emphasizes that inflammation may be one of the best biological markers of aging, making immune balance—not suppression—a critical goal for long-term vitality.30-Day Anti-Inflammatory Challenge Targets the Essentials that Matter MostThe episode introduces a simple, actionable “execute on the essentials” framework:cut 200 calories per day, move 20 more minutes daily, sleep 20 more minutes nightly, and strengthen one in-person social connection each week. These small, disciplined changes can meaningfully lower inflammation and reduce disease and death risk without medications.Four Lifestyle Levers—Diet, Exercise, Sleep, and Connection Work SynergisticallyEating less and less often reduces inflammatory burden; regular aerobic and resistance exercise lowers CRP, IL-6, and TNF-α; adequate sleep both reduces inflammation and improves metabolic control; and social connection directly alters immune-related gene activity. Together, these four levers form a powerful, low-cost “anti-inflammatory quartet”Peak Vitality Requires Identifying Your Personal “Free Solo”Inspired by Alex Honnold's rope-free climb of Taipei 101, Dr. Mishra challenges listeners to define their own “Free Solo”—a deeply personal pursuit that demands long-term discipline, courage, and preparation. Pairing biological vitality (low inflammation) with meaningful purpose unlocks the highest levels of performance and fulfillment. Copyright VyVerse, LLC. All Rights Reserved. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit vitalityexplorers.substack.com/subscribe

Show notes: (0:00) Intro (0:49) Dr. Shah's background and personal health crisis (4:55) The most important biomarkers: hs-CRP, A1C, ApoB (7:46) How to track inflammation and metabolic health (13:00) Home tools: bioimpedance scale, grip strength meter (21:09) Nutrition basics: just cut ultra-processed foods (27:09) Hidden toxins in your air, water, and skincare (34:37) Longevity circuit: sauna, cryotherapy, hyperbaric oxygen (38:11) Therapeutic plasma exchange and next-gen biohacking (40:01) Dr. Shah's top 3 health tips anyone can start today (41:18) Where to find Dr. Shah (42:11) Outro Who is Dr. Darshan Shah?   Darshan Shah, MD is a health and wellness specialist, well-known, board-certified surgeon, published author, tech entrepreneur, and founder and CEO of Beautologie and Next Health. As an expert on all body systems, he has performed over 10,000 surgical procedures, including trauma surgery, general surgery and plastic/reconstructive procedures. As a health and wellness specialist, he has advised thousands of patients on how to optimize their well-being and extend their lifespan, culminating in the creation of Next Health, the first health optimization and longevity center to offer life-extending and enhancing technology and treatments in a beautiful, welcoming environment.   Connect with Dr. Shah Website: https://www.drshah.com/ LinkedIn: https://www.linkedin.com/in/darshanshahmd IG: https://www.instagram.com/darshanshahmd/   Grab your free Biomarker guide: https://www.drshah.com/biomarkers   Tune in: https://www.drshah.com/extend Links and Resources: Peak Performance Life Peak Performance on Facebook Peak Performance on Instagram

In this episode, James and Mark are joined by Matt Chouinard, Waterfowl Programs Director for Delta Waterfowl, for an in-depth discussion on current prairie wetland and grassland conditions. They explore how recent weather patterns and agricultural pressures are shaping duck nesting success across the Prairie Pothole Region.   Matt shares insights on the critical role of habitat for both nesting and brood-rearing, the value of conservation programs like CRP, and the importance of additional management strategies—including Delta's innovative Hen House program. The conversation also dives into the psychology of duck hunters, public perceptions of population trends, and the data-driven science behind conservation decisions. From habitat loss to hunter memories, this episode unpacks the complex relationships among agriculture, wetlands, waterfowl populations, and hunting success—highlighting why sustaining prairie ecosystems is essential for the future of waterfowl conservation.

Watch the FULL podcast here: https://youtu.be/qHFymGgsYyEWorried about Alzheimer's and what you can do now? You'll hear practical, testable steps to lower risk by targeting metabolism, inflammation and toxins, plus daily habits for brain rest and sleep. This clip explores the idea that Alzheimer's can have different drivers, the importance of early testing (continuous glucose monitors, hs-CRP, urine toxin tests), and simple changes like meditation, less phone time, better sleep, air purifiers, filtered water, non-toxic skin products, and eating organic while avoiding ultra-processed foods.***This episode is sponsored by: NOWATCH: Health tracking reimaginedKnow your body, trust yourself.15% off with code LWBW15 at nowatch.com***The Great British Veg OutHow to support your gut, energy, and hormones by eating more — not less.

Join Our Online Education Community "The School of Doza" Here: https://community.schoolofdoza.com/ In this podcast episode, Nurse Doza discusses the common complaint of fatigue and offers insights into its possible causes. He emphasizes the importance of addressing fatigue, as it should not be a daily occurrence. He also recommends getting blood tests, particularly one for DHEAS, to assess adrenal function and the body's response to stress. He mentions that chronic stress, lack of sleep, and unhealthy lifestyle habits can contribute to fatigue. Nurse Doza encourages listeners to prioritize self-care, including good sleep and stress management, to improve their energy levels and overall health.   TIMESTAMPS: 00:00 START 05:50 Adrenal issues can cause fatigue. 11:46 Inflammation and fatigue are connected. 16:34 Address underlying causes of fatigue. 22:08 Check homocysteine levels for fatigue. 27:43 Sugar and inflammation decrease ATP. 32:15 Adrenal support supplement is recommended.     Looking for a boost in energy and mood? Discover Zen, MSW's premium adrenal support supplement. Packed with natural ingredients, it aids in balancing your hormones and combating fatigue. Elevate your health and regain that lost zest for life.  Click here

In this special Metabolic Mailbag episode, cardiologist Dr. Bret Scher steps into the hot seat to answer your most pressing questions about ketogenic therapy, heart health, and metabolic markers. Drawing directly from listener questions, this conversation tackles the confusion and concern many people face when lab results change after starting a ketogenic diet.

Com o começo do BBB está liberado diagnosticar as pessoas? Assumimos o papel de psicólogos de método pra analisar casos reais.É autoestima ou narcisismo? Ciúmes ou falta de elogio do pai? Já se autodiagnosticou no TikTok hoje? Vem tirar o seu CRP, porque aqui o diagnóstico é tirado do grupo!

In this episode of the Metabolic Freedom Podcast, Ben Azadi explains why turmeric is one of the most misunderstood anti-inflammatory tools and why most people never feel its benefits. Ben breaks down the science behind curcumin, the active compound in turmeric, and how it works with the body's natural intelligence to lower inflammation instead of masking pain like medications. You'll learn: Why over 90% of turmeric supplements fail due to poor absorption How curcumin lowers key inflammatory markers like CRP, TNF-alpha, and IL-6 What actually happens inside your body over a full 30-day turmeric protocol The biggest mistakes people make when taking turmeric How to choose the right turmeric supplement for real results The best timing and dosage to maximize absorption Why turmeric can support joint health, gut health, metabolic health, and recovery Ben also shares his personal story of overcoming chronic inflammation and joint pain, plus how turmeric has helped even his senior dog with arthritis. This episode is a must-listen if you're dealing with joint pain, stubborn inflammation, slow recovery, or want a natural way to support long-term metabolic health.

Most people assume they're being proactive about their health because they get an annual physical and a standard blood panel. A few numbers come back "normal," the doctor gives a thumbs-up, and that's the end of the conversation.  The problem is that those labs are often incomplete and disconnected from how people actually live, train, eat and recover. Many of the markers that matter most for long-term metabolic health and inflammation — like fasting insulin and high-sensitivity CRP — are routinely excluded. So what you're left with are numbers that often only flag problems once things are already far off track.  On top of that, testing once a year gives you no meaningful sense of trends, context, or direction. This episode looks at a more practical approach: identifying the biomarkers that actually reflect metabolic health, inflammation, hormonal balance and recovery, and finding ways to test them regularly without relying on one-off lab work.  It also addresses why timing, training load, and recent stress matter when you get blood drawn — and how ignoring those variables can lead to misleading results and unnecessary concern. The broader point is simple: meaningful blood work isn't just about collecting more data. It's about measuring the right things, testing often enough to see patterns, and interpreting results in the context of your lifestyle.  When you do that, blood work becomes a useful feedback tool instead of a once-a-year formality that tells you very little about where your health is actually headed. Learn more: What It Means to Be Metabolically Healthy [Blog Post]: https://michaelkummer.com/metabolic-health/ Affordable At-Home Blood Testing with SiPhox Health [Video]: https://youtu.be/R7qRLzBcp94  63: HbA1c Levels Explained: Why They May Be High Without High Blood Sugar: https://www.primalshiftpodcast.com/63-hba1c-levels-explained-why-they-may-be-high-without-high-blood-sugar/  Thank you to this episode's sponsor, OneSkin! What sold me was seeing real results. My wife started using OneSkin, and the improvement in her skin was obvious — not subtle, not hype. OneSkin products are built around their patented OS-01 peptide, developed from longevity research and tested for sensitive skin. Full review here: https://michaelkummer.com/health/oneskin-review/ For a limited time, get up to 30% off your first three subscription orders — no code required: https://oneskin.pxf.io/c/1289595/3445782/31050 In this episode: 00:00 Intro 02:19 The importance of comprehensive blood panels 05:36 Key biomarkers to monitor 09:43 Affordable and convenient blood testing options 18:03 Final thoughts Find me on social media for more health and wellness content: Website: https://michaelkummer.com/ YouTube: https://www.youtube.com/@MichaelKummer Instagram: https://www.instagram.com/primalshiftpodcast/ Pinterest: https://www.pinterest.com/michaelkummer/ Twitter/X: https://twitter.com/mkummer82 Facebook: https://www.facebook.com/realmichaelkummer/ [Medical Disclaimer] The information shared on this video is for educational purposes only, is not a substitute for the advice of medical doctors or registered dietitians (which I am not) and should not be used to prevent, diagnose, or treat any condition. Consult with a physician before starting a fitness regimen, adding supplements to your diet, or making other changes that may affect your medications, treatment plan, or overall health. [Affiliate Disclaimer] I earn affiliate commissions from some of the brands and products I review on this channel. While that doesn't change my editorial integrity, it helps make this channel happen. If you'd like to support me, please use my affiliate links or discount code.  

-Football Friday PLAYOFF EDITION with The Drive! Texans. Steelers-LFG Y'all! -Texans DT Tommy Togiai Joins LIVE on The Drive's Football Friday! -Those VERY Key Matchups YOU Should Be Watching; Texans/Steelers Mon. Night! -Texans OC Nick Caley LIVE from NRG Ahead of Monday Night vs Steelers! -Indiana OR Oregon?! PEACH BOWL TONIGHT -WILD CARD Weekend EVE H-Town! AND-the Houston Rodeo Artists ya MUST See!! -Steelers' Aaron Rodgers? Does NOT Sound Thrilled About Facing Texan Defense -T-Mil's BEST BET$ for the NFL Wild Card Weekend!$!$

She looked perfect on paper. Impeccable diet. Physically fit. Emotionally stable. Then she walked into my office and said, "I can't stop crying. I can't think. Something is wrong, and I don't know what it is." Her labs told part of the story: CRP at 87, neutrophils through the roof, lymphocytes bottomed out. But there was no fever. No illness. No obvious source. Until she dropped one sentence that changed everything. This is the first episode of my new Clinical Thinking series where I walk you through real patient cases, step by step, so you can see how I actually think through complex presentations. In this episode, you'll learn why the obvious answer is rarely the right one, how the 30/30/30 rule can keep you from tunnel vision, and what a cracked tooth taught me about dental history and emotional symptoms. I also share the exact protocol I used, and why I intentionally kept it simple instead of ordering more tests. If you want the framework behind how I approach every case, download The 6 Principles of Clinical Thinking. And if you're ready to develop this kind of thinking, not just follow protocols, join me inside Clinical Academy.  

What if the most powerful health checkup you ever had happened at your kitchen table, not a clinic? We sit down with Dr. Natasha Milinkovic, a UK physician who moved from the front lines of vascular surgery and emergency medicine to the leading edge of preventive care, to explore how lab‑grade at‑home blood testing and intelligent coaching can change outcomes before a crisis hits.We start with the problem he saw repeatedly: people arriving late with preventable chronic disease. That urgency drives a practical roadmap for what to measure and why. You'll hear a clear breakdown of high‑value biomarkers—HbA1c for glucose trends, ApoB and the ApoB to ApoA1 ratio for cardiovascular risk, and thyroid markers for therapy tuning—and why total cholesterol alone often misleads. Tosh explains how accuracy is maintained through CLIA‑accredited labs and transparent methods, addressing trust in a post‑Theranos world. We also dig into biological age: how markers like hs‑CRP, HbA1c, and sex hormones push it up or down, and the specific lifestyle levers that can nudge it younger over the next 90 days.Then we open the hood on Sai, an AI longevity expert trained on a clinician‑curated knowledge base. Instead of scraping the noisy web, Sai reads your longitudinal labs, medications, and context to deliver personalized, evidence‑based guidance. Think trend detection for creeping glucose, stubborn ApoB, or hidden inflammation—and concrete next steps that you can take today. Looking ahead, Tosh shares what's next: home hardware that brings instant panels into your routine and a vision of predictive health where alerts trigger action long before symptoms do.If you want to cut through hype, track the markers that matter, and pair credible data with smart coaching, this conversation will give you the playbook. Subscribe, share with a friend who's optimizing their health, and leave a review with the one biomarker you plan to track this year.Note: I am an advisor to Siphox but I only advise those companies whose products I would use for myself and family.https://siphoxhealth.com/lufkinFASTING CHALLENGE: https://robert-lufkin.mykajabi.com/fast?ref=RLLies I Taught In Medical School : Free sample chapter- https://www.robertlufkinmd.com/lies/Complete Metabolic Heart Scan (LUFKIN20 for 20% off) https://www.innerscopic.com/Fasting Mimicking Diet (20% off) https://prolonlife.com/Lufkin At home blood testing (20% off) https://siphoxhealth.com/lufkin Web: https://robertlufkinmd.com/X: https://x.com/robertlufkinmdYoutube: https://www.youtube.com/robertLufkinmdSubstack: https://robertlufkinmd.substack.com Instagram: https://www.instagram.com/robertlufkinmd/LinkedIn: https://www.linkedin.com/in/robertlufkinmd/TikTok: https://www.tiktok.com/@robertlufkinThreads: https://www.threads.net/@robertlufkinmdFacebook: ...

There's no better time than now to set some new year's resolutions. In this episode, we are going to learn about how you,me, and really anyone can get involved in conservation. We'll learn about the Farm Bill and how it effects wildlife, wild habitat, and even hunting quality. We'll learn about conservation incentive programs like CRP and EQIP. Most importantly, we will learn how all of us can get involved and get some actual, tangible conservation in motion. Connect with Lake Pickle and MeatEater Lake Pickle on Instagram MeatEater on Instagram, Facebook, Twitter, YouTube, and YouTube Clips MeatEater Podcast Network on YouTubeSee omnystudio.com/listener for privacy information.

Modern anxiety isn't just emotional. It's chemical — and it's being triggered and sustained by the way we're living, consuming, and overstimulating ourselves every single day. In this powerful, personal episode, Elizabeth pulls back the curtain on what's really happening when we feel anxious for "no reason" — and shares the neurochemical truth about dopamine, oxytocin, cortisol, and inflammation. If you're constantly in your head, overwhelmed, overstimulated, or one step away from panic — this conversation will shift everything. You'll also hear the exact strategy Elizabeth is using to reclaim peace and presence in her everyday life — without deleting her business, becoming a monk, or pretending life isn't loud and full.

What if the gap between your age and your energy is wider than you think—and fixable? That's the wager we make as we sit down with longevity strategist Bob Gilpatrick to unpack why most people lose health, not just time, in their final decade and how to reverse that trend with measurable steps. We trace his journey from a near-fatal crash at 17 to a career spanning plant science roots, healthcare leadership, and breakthroughs that blend targeted nutrition with mind-body mastery.We get practical fast: CRP as a “burn rate” for your body, why keeping it below 0.5 changes everything, and how a complete nutrient strategy powers real mitochondrial energy instead of caffeine jitters. Bob explains epigenetic reprogramming—plant-derived, purified molecules that nudge gene sets for muscle, energy, NAD, and BDNF—plus why they can outperform complex peptide stacks at a fraction of the cost. He pairs these advances with essential building blocks: amino acids, enzymes, and minerals that allow your body to build what your genes request. The result? Faster strength gains, better motivation, and noticeable changes many feel within days.We also go beyond biology to the beliefs that block action. You'll hear how EFT tapping and havening calm the nervous system, reduce cravings, and resolve grief or fear by changing brain states in real time. From cartilage support that challenges “once it's gone, it's gone” to sustainable weight loss that protects muscle, this episode is a blueprint for adding strong, clear years—healthspan—to your life. If you're ready to test, adjust, and prove it in your own bloodwork and daily energy, this conversation gives you the steps and the science.Subscribe, share with a friend who needs a push, and leave a review telling us the one change you'll make this week. Then visit boomerboost.com for details and use promo code Omar at checkout.Join the What if it Did Work movement on FacebookGet the Book!www.omarmedrano.comwww.calendly.com/omarmedrano/15min

In this episode, Ben Azadi reveals the real reason arteries clog and it's not age, genetics, or cholesterol. The true driver of heart disease is chronic inflammation and metabolic dysfunction. Ben breaks down five science-backed drinks proven in human studies to reduce arterial plaque, lower inflammation, improve insulin sensitivity, boost nitric oxide, and support long-term cardiovascular health. You'll learn how simple ingredients like pomegranate juice, high-quality coffee, raw cacao, apple cider vinegar, and turmeric can dramatically improve markers like ApoB, CRP, triglycerides, fasting insulin, and blood pressure. Ben also explains how to rotate these drinks for maximum benefit, which options are best for keto or diabetes, and how quickly you can expect to see results in your lab work. This episode empowers you with practical, natural tools your doctor likely never mentioned, helping you take control of your metabolic and heart health starting today. FREE GUIDE: 5 Vegetables You Must Avoid To Lose Weight & Belly Fat   - https://bit.ly/3L6xMo0 

If you've been told your bloodwork is “normal” but you still feel exhausted, foggy, inflamed, anxious, or stuck in your weight… this episode will be a game changer.In Episode 374 of The Period Whisperer Podcast, we break down the exact blood chemistry markers women in perimenopause should request, why they matter, and what they reveal that most doctors completely overlook.You'll learn:✨ The truth about thyroid testing — and why TSH alone is NOT enough ✨ How to interpret a full iron panel in the context of fatigue + hair loss ✨ Why liver markers like ALT, AST, and GGT matter for estrogen detox ✨ The role of fasting insulin, glucose, and A1c in midlife weight gain ✨ How inflammation markers like hs-CRP influence perimenopause symptoms ✨ What free testosterone + SHBG reveal about libido and energy ✨ The key nutrient markers (D, B12, zinc, magnesium, selenium, iodine) every woman should track ✨ How to confidently advocate for these tests with your primary care providerIf you want a clear roadmap for understanding your body in perimenopause — not just being dismissed with “everything looks fine” — this episode is your toolkit.

If you have been feeling inflamed, fatigued, overly stressed, or unsure why your body is not responding the way it used to, this episode will help you understand what your physiology is trying to communicate.  In today's episode, I sat down with Dr. Ara Suppiah, a functional sports medicine physician who makes complex biomarker data feel simple, practical, and grounded. We explore why health is shaped by patterns and trends rather than isolated numbers and how markers like the Omega-3 index, hs-CRP, cortisol, and the neutrophil-to-lymphocyte ratio reveal what is happening beneath the surface.  We also discuss oral health as an early inflammation signal, the connection between movement and longevity, and the small daily habits that strengthen resilience. Dr. Ara Suppiah is a functional sports medicine physician known for translating complex physiology into guidance people can apply right away. What's Discussed: (00:00) Why your labs look “normal” even when your body doesn't (04:18) The biomarkers that quietly predict resilience or burnout (09:52) What Omega-3, hs-CRP, and NLR reveal about hidden stress (15:10) How your gums expose inflammation before symptoms begin (21:44) The link between movement, recovery, and long-term vitality (28:30) What natural movement teaches us about microbiome health (36:12) How overtraining disrupts hormones and drains energy (42:58) When tools and medications support longevity goals (51:05) How to build a physiology that ages slowly and feels grounded Thank You to Our Sponsors: IM8: I'm always searching for wellness that's simple, effective, and rooted in science. That's why I love IM8, a daily drink with 92 nutrients designed to support energy, gut health, and longevity.Use code MONASHARMA10 for 10% off at im8health.com. Learn more about Mona Sharma: Download Your FREE Guide - 12 Wellness Tips to Unlock Your Best Health Now: Ready to reclaim your vitality? Download Mona's 12 Wellness Tips and take actionable steps to transform your health, energy, and mindset. Get started now at https://monasharma.com/12tips.  Visit Mona's website: https://monasharma.com – Unlock powerful tools and wisdom rooted in wellness to elevate your health, energy, and clarity. Mona blends ancient healing practices with modern science to help you achieve lasting transformation. Follow Mona on Instagram: Stay connected with Mona for daily inspiration, holistic health tips, and personal growth. Join the conversation on Instagram at https://instagram.com/monasharma. Learn more about Dr. Ara Suppiah : Website: http://www.draraoncall.com  Instagram: @draraoncall

In this article, Kyle Hedges shares strategies for finding and connecting on educated roosters on public lands, including walk-in access areas and CRP fields.For high-quality hearing protection, check out alclair.com.Read more at projectupland.com.

University of Georgia's David Dickens and National Land Realty forester-agent Steve Chapman break down how pine straw turns timberland into a cash-flowing asset before the first thinning. For longleaf stands, raking can often start around age 12–15 and run 5–10 seasons, commonly paying about $150–$250 per acre on cutover sites and $250–$400 per acre on old-field sites, with first-year old-field rakes sometimes higher. At 100 acres and $300 per acre, that is roughly $30,000 a year and up to $300,000 before a first cut. They cover species fit (longleaf leads, slash limited, loblolly has no straw value), contract traps to avoid, CRP limits, and how herbicide, spacing, and canopy closure drive straw yield. Episode takeaways: Longleaf pine is the primary straw species; raking usually begins at age 12–15 once canopy closure suppresses understory, then repeats annually for 5–10 years. Typical annual payments: about $150–$250 per acre on cutover sites and $250–$400 per acre on old-field sites; an example 100-acre tract at $300 per acre yields about $30,000 per year pre-thinning. Sell straw by the acre, not by the bale; define terms if you must do bale pricing and expect year-to-year yield swings. Manage for clean floors and tree health: foliar-only herbicide every few years, avoid excessive raking in arid areas, watch nutrient export and moisture loss that can invite beetles on marginal sands. Thinning resets raking in Georgia; most contractors prefer thinned stands, so plan to harvest straw before the first thinning window. CRP wildlife contracts generally prohibit raking during the term; prescribed fire is fine but schedule it 2–3 years ahead of the first rake. Dr. David Dickens https://warnell.uga.edu/directory/people/dr-david-dickens Talk to Steve Chapman about your land! https://nationalland.com/real-estate-agent/steve-chapman  National Land Realty https://www.nationalland.com 

Osteomyelitis in children is common enough to miss and serious enough to matter. In this episode of PEM Currents, we review a practical, evidence-based approach to pediatric acute hematogenous osteomyelitis, focusing on diagnostic strategy, imaging decisions including FAST MRI, and modern antibiotic management. Topics include age-based microbiology, empiric and pathogen-directed antibiotic selection with dosing, criteria for early transition to oral therapy, and indications for orthopedic and infectious diseases consultation. Special considerations such as MRSA, Kingella kingae, daycare clustering, and shortened treatment durations are discussed with an emphasis on safe, high-value care. Learning Objectives After listening to this episode, learners will be able to: Identify the key clinical, laboratory, and imaging findings that support the diagnosis of acute hematogenous osteomyelitis in children, including indications for FAST MRI and contrast-enhanced MRI. Select and dose appropriate empiric and pathogen-directed antibiotic regimens for pediatric osteomyelitis based on patient age, illness severity, and local MRSA prevalence, and determine when early transition to oral therapy is appropriate. Determine when consultation with orthopedics and infectious diseases is indicated, and recognize clinical features that warrant prolonged therapy or more conservative management. References Woods CR, Bradley JS, Chatterjee A, et al. Clinical practice guideline by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America: 2021 guideline on diagnosis and management of acute hematogenous osteomyelitis in pediatrics. J Pediatric Infect Dis Soc. 2021;10(8):801-844. doi:10.1093/jpids/piab027 Woods CR, Bradley JS, Chatterjee A, et al. Clinical practice guideline by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America: 2023 guideline on diagnosis and management of acute bacterial arthritis in pediatrics. J Pediatric Infect Dis Soc. 2024;13(1):1-59. doi:10.1093/jpids/piad089 Stephan AM, Platt S, Levine DA, et al. A novel risk score to guide the evaluation of acute hematogenous osteomyelitis in children. Pediatrics. 2024;153(1):e2023063153. doi:10.1542/peds.2023-063153 Alhinai Z, Elahi M, Park S, et al. Prediction of adverse outcomes in pediatric acute hematogenous osteomyelitis. Clin Infect Dis. 2020;71(9):e454-e464. doi:10.1093/cid/ciaa211 Burns JD, Upasani VV, Bastrom TP, et al. Age and C-reactive protein associated with improved tissue pathogen identification in children with blood culture-negative osteomyelitis: results from the CORTICES multicenter database. J Pediatr Orthop. 2023;43(8):e603-e607. doi:10.1097/BPO.0000000000002448 Peltola H, Pääkkönen M. Acute osteomyelitis in children. N Engl J Med. 2014;370(4):352-360. doi:10.1056/NEJMra1213956 Transcript This transcript was provided via use of the Descript AI application Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast. As always, I'm your host, Brad Sobolewski, and today we're covering osteomyelitis in children. We're going to talk about diagnosis and imaging, and then spend most of our time where practice variation still exists: antibiotic selection, dosing, duration, and the evidence supporting early transition to oral therapy. We'll also talk about when to involve orthopedics, infectious diseases, and whether daycare outbreaks of osteomyelitis are actually a thing. So what do I mean by pediatric osteomyelitis? In children, osteomyelitis is most commonly acute hematogenous osteomyelitis. That means bacteria seed the bone via the bloodstream. The metaphysis of long bones is particularly vulnerable due to vascular anatomy that favors bacterial deposition. Age matters. In neonates, transphyseal vessels allow infection to cross into joints, increasing the risk of concomitant septic arthritis. In older children, those vessels involute, and infection tends to remain metaphyseal and confined to bone rather than spreading into the joint. For children three months of age and older, empiric therapy must primarily cover Staphylococcus aureus, which remains the dominant pathogen. Other common organisms include group A streptococcus and Streptococcus pneumoniae. In children six to 36 months of age, especially those in daycare, Kingella kingae is an important and often underrecognized pathogen. Kingella infections are typically milder, may present with lower inflammatory markers, and frequently yield negative routine cultures. Kingella is usually susceptible to beta-lactams like cefazolin, but is consistently resistant to vancomycin and often resistant to clindamycin and antistaphylococcal penicillins. This has direct implications for empiric antibiotic selection. Common clinical features of osteomyelitis include fever, localized bone pain, refusal to bear weight, and pain with movement of an adjacent joint. Fever may be absent early, particularly with less virulent organisms like Kingella. A normal white blood cell count does not exclude osteomyelitis. Only about one-third of children present with leukocytosis. CRP and ESR are generally more useful, particularly CRP for monitoring response to therapy. No single CRP cutoff reliably diagnoses or excludes osteomyelitis in children. While CRP is elevated in most cases of acute hematogenous osteomyelitis, the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America note that high-quality data defining diagnostic thresholds are limited. A CRP above 20 milligrams per liter is commonly used to support clinical suspicion, with pooled sensitivity estimates around 80 to 85 percent, but no definitive value mandates the diagnosis. Lower values do not exclude disease, particularly in young children, as CRP is normal in up to 40 percent of Kingella kingae infections. CRP values tend to be higher in Staphylococcus aureus infections, especially MRSA, and higher levels are associated with complications such as abscess, bacteremia, and thrombosis, though specific cutoffs are not absolute. In summary, CRP is most useful for monitoring treatment response. It typically peaks two to four days after therapy initiation and declines rapidly with effective treatment, with a 50 percent reduction within four days seen in the majority of uncomplicated cases. Blood cultures should be obtained in all children with suspected osteomyelitis, ideally before starting antibiotics when feasible. In children, blood cultures alone can sometimes identify the pathogen. Plain radiographs are still recommended early, not because they're sensitive for acute osteomyelitis, but because they help exclude fracture, malignancy, or foreign body and establish a baseline. MRI with and without contrast is the preferred advanced imaging modality. MRI confirms the diagnosis, defines the extent of disease, and identifies complications such as subperiosteal abscess, physeal involvement, and concomitant septic arthritis. MRI findings can also guide the need for surgical consultation. Many pediatric centers now use FAST MRI protocols for suspected osteomyelitis, particularly from the emergency department. FAST MRI uses a limited sequence set, typically fluid-sensitive sequences like STIR or T2 with fat suppression, without contrast. These studies significantly reduce scan time, often avoid the need for sedation, and retain high sensitivity for bone marrow edema and soft tissue inflammation. FAST MRI is particularly useful when the clinical question is binary: is there osteomyelitis or not? It's most appropriate in stable children without high concern for abscess, multifocal disease, or surgical complications. If FAST MRI is positive, a full contrast-enhanced MRI may still be needed to delineate abscesses, growth plate involvement, or adjacent septic arthritis. If FAST MRI is negative but clinical suspicion remains high, further imaging may still be necessary. The Pediatric Infectious Diseases Society and the Infectious Diseases Society of America recommend empiric antibiotic selection based on regional MRSA prevalence, patient age, and illness severity, with definitive therapy guided by culture results and susceptibilities. Empiric therapy should never be delayed in an ill-appearing or septic child. In well-appearing, stable children, antibiotics may be briefly delayed to obtain imaging or tissue sampling, but this requires close inpatient observation. For children three months and older with non–life-threatening disease, empiric therapy hinges on local MRSA rates. In regions with low community-acquired MRSA prevalence, generally under 10 percent, reasonable empiric options include cefazolin, oxacillin, or nafcillin. When MRSA prevalence exceeds 10 to 20 percent, empiric therapy should include an MRSA-active agent. Clindamycin is appropriate when local resistance rates are low, while vancomycin is preferred when clindamycin resistance is common or the child has had significant healthcare exposure. For children with severe disease or sepsis, vancomycin is generally preferred regardless of local MRSA prevalence. Some experts recommend combining vancomycin with oxacillin or nafcillin to ensure optimal coverage for MSSA, group A streptococcus, and MRSA. In toxin-mediated or high-inoculum infections, the addition of clindamycin may be beneficial due to protein synthesis inhibition. Typical IV dosing includes cefazolin 100 to 150 milligrams per kilogram per day divided every eight hours; oxacillin or nafcillin 150 to 200 milligrams per kilogram per day divided every six hours; clindamycin 30 to 40 milligrams per kilogram per day divided every six to eight hours; and vancomycin 15 milligrams per kilogram every six hours for serious infections, with appropriate monitoring. Ceftaroline or daptomycin may be considered in select MRSA cases when first-line agents are unsuitable. For methicillin-susceptible Staphylococcus aureus, first-generation cephalosporins or antistaphylococcal penicillins remain the preferred parenteral agents. For oral therapy, high-dose cephalexin, 75 to 100 milligrams per kilogram per day divided every six hours, is preferred. Clindamycin is an alternative when beta-lactams cannot be used. For clindamycin-susceptible MRSA, clindamycin is the preferred IV and oral agent due to excellent bioavailability and bone penetration, and it avoids the renal toxicity associated with vancomycin. For clindamycin-resistant MRSA, vancomycin or ceftaroline are preferred IV agents. Oral options are limited, and linezolid is generally the preferred oral agent when transition is possible. Daptomycin may be used parenterally in children older than one year without pulmonary involvement, typically with infectious diseases and pharmacy input. Beta-lactams remain the drugs of choice for Kingella kingae, Streptococcus pyogenes, and Streptococcus pneumoniae. Vancomycin has no activity against Kingella, and clindamycin is often ineffective. For Salmonella osteomyelitis, typically seen in children with sickle cell disease, third-generation cephalosporins or fluoroquinolones are used. In underimmunized children under four years, consider Haemophilus influenzae type b, with therapy guided by beta-lactamase production. Doxycycline has not been prospectively studied in pediatric acute hematogenous osteomyelitis. There are theoretical concerns about reduced activity in infected bone and risks related to prolonged therapy. While short courses are safe for certain infections, the longer durations required for osteomyelitis increase the risk of adverse effects. Doxycycline should be considered only when no other active oral option is available, typically in older children, and with infectious diseases consultation. It is not appropriate for routine treatment. Many hospitals automatically consult orthopedics when children are admitted with osteomyelitis, and this is appropriate. Early orthopedic consultation should be viewed as team-based care, not failure of medical management. Consult orthopedics when MRI shows abscess or extensive disease, there is concern for septic arthritis, the child fails to improve within 48 to 72 hours, imaging suggests devitalized bone or growth plate involvement, there is a pathologic fracture, the patient is a neonate, or diagnostic bone sampling or operative drainage is being considered. Routine surgical debridement is not required for uncomplicated cases. Infectious diseases consultation is also often automatic and supported by guidelines. ID is particularly valuable for antibiotic selection, dosing, IV-to-oral transition, duration decisions, bacteremia management, adverse reactions, and salvage regimens. Even in straightforward cases, ID involvement often facilitates shorter IV courses and earlier oral transition. Osteomyelitis is generally not contagious, and clustering is uncommon for Staphylococcus aureus. Kingella kingae is the key exception. It colonizes the oropharynx of young children and spreads via close contact. Clusters of invasive Kingelladisease have been documented in daycare settings. Suspicion should be higher in children six to 36 months from the same daycare, with recent viral illness, mild systemic symptoms, refusal to bear weight, modest CRP elevation, and negative routine cultures unless PCR testing is used. Public health intervention is not typically required, but awareness is critical. There is no minimum required duration of IV therapy for uncomplicated acute hematogenous osteomyelitis. Transition to oral therapy should be based on clinical improvement plus CRP decline. Many children meet criteria within two to six days. Oral antibiotics must be dosed higher than standard outpatient regimens to ensure adequate bone penetration. Common regimens include high-dose cephalexin, clindamycin, or linezolid in select cases. The oral agent should mirror the IV agent that produced clinical improvement. Total duration is typically three to four weeks, and in many cases 15 to 20 days is sufficient. MRSA infections or complicated cases usually require four to six weeks. Early oral transition yields outcomes comparable to prolonged IV therapy with fewer complications. Most treatment-related complications occur during parenteral therapy, largely due to catheter-related issues. Take-home points: osteomyelitis in children is a clinical diagnosis supported by labs and MRI. Empiric antibiotics should be guided by age, illness severity, and local MRSA prevalence. Early transition to high-dose oral therapy is safe and effective when clinical response and CRP support it. Orthopedics and infectious diseases consultation improve care and reduce variation. FAST MRI is changing how we diagnose osteomyelitis. Daycare clustering is uncommon except with Kingella kingae. That's all for this episode. If there are other topics you'd like us to cover, let me know. If you have the time, leave a review on your favorite podcast platform. It helps more people find the show and learn from it. For PEM Currents, this has been Brad Sobolewski. See you next time.    

Get my newest workshop replay, BRILLIANT - Understanding the Somatic Intelligence of Over- & Underfunctioning.Lindsey pulls back the curtain on two sets of her bloodwork (June 2024 → December 2025) to show how healing the nervous system — and lowering the total life load — changes measurable physiology. She explains why over-functioning isn't a personality trait; it's a survival physiology that drives inflammation, insulin, thyroid conservation, liver burden, and stress-lipid patterns. She walks through each lab marker in plain language, contrasts meds/supplements alone with nervous-system and lifestyle change, and shares the supportive protocol she used alongside big shifts in emotional, domestic, and relational load. She closes with how the BRILLIANT workshop and CRUCIBLE practice space fit into this work.Show notesBig ideasOver-functioning is physiology, not personality; your body keeps the score.You can't out-supplement or medicate chronic over-functioning; support helps, and change lands when load drops and safety increases.Low-threat, well-nourished, well-rested physiology shows up clearly in labs: inflammation, insulin, thyroid conversion, lipids, and liver enzymes all move toward safety.Lab highlights (June 2024 → December 2025)CRP (inflammation): 3.0 → 0.9 (≈ 66% drop; low-inflammation range)Fasting insulin: 17.7 (insulin-resistant) → 6 (insulin-sensitive)Thyroid: TSH 3.22 → 1.23; Free T4 0.81 → 1.15; Free T3 2.88 → 3.2 (robust conversion)Liver enzyme (ALT): 33 → 15 (burden eased)Triglycerides: 105 → 68LDL-C: 126 → 97DHEA: 58 → 48 (healthy downshift within the improved overall pattern)What changed besides the numbersLoad reduction: less emotional labor, less domestic/relational over-functioning, fewer sensory demands, more boundaries.Inputs: consistent eating (enough), deeper sleep, real rest, improved circulation/movement without overdrive.Result: cortisol normalized — inflammation down, insulin normalized, thyroid conversion improved, liver less burdened, hair loss reversed, energy steadier.Supportive protocol (alongside the lifestyle shift)NP Thyroid (desiccated), bioidentical progesterone (vaginal delivery), low-dose naltrexone 4.5 mg.Magnesium (glycinate + l-threonate), glycine (~ 3 g/day), vitamin D3 + K2.GLP-1 experience: brief full-dose trial (too suppressive) → discontinued; later micro-dosed retatrutide after nutrition and rest were restored.Who this episode helpsOver-functioners who “look fine” but see inflammation, insulin resistance, sluggish thyroid conversion, stressed liver enzymes, or stress-lipids.Under-functioner/over-functioner couples wanting physiology-and-practice-based next steps.Mentioned resources & linksPrevious episode for backstory — Episode 131: Listen on SpotifyLindsey's ebooks: When Rest Feels WrongWhen Action Feels WrongSupplements Lindsey uses/loves: Glycine supplementHemaplexD3 + K2Magnesium glycinateMagnesium l-threonateFree Video Series:Unfiltered Real Talk About OverfunctioningThe Underfunctioner's Wake-Up CallNotes & gentle disclaimerThis episode shares one person's labs, context, and protocol decisions. Work with a trusted clinician for your own evaluation and dosing — and use these insights to track the impact of real rest, nourishment, and load reduction over time.

A new clinical analysis based on the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) found that older adults taking a daily cocoa extract supplement saw an 8.4% annual drop in high-sensitivity C-reactive protein (hs-CRP), a key marker of chronic inflammation The supplement provided 500 milligrams of cocoa flavanols daily, including 80 milligrams of (-)-epicatechin, which is the same bioactive compound found naturally in cacao Researchers said this anti-inflammatory effect may help explain a 27% lower risk of cardiovascular mortality previously observed in the larger COSMOS trial Taking a cocoa flavanol supplement appears to support vascular and immune health by calming NF-κB signaling and improving endothelial function Unlike dark chocolate, standardized cocoa extract supplements are free of sugar and fat, delivering clinically studied doses in capsule form

In this episode of the Birdshot Podcast, Nick Larson welcomes back Ted Koch, for an important conversation on prairie grouse conservation, grassland loss, ranching, and the future of upland habitat across North America. Ted also shares unforgettable elk-hunting stories, ruffed grouse parallels, and urgent insights into habitat fragmentation and the decline of gamebird populations. Ted Koch is a retired endangered species biologist and CEO of the North American Grouse Partnership. With decades of experience in western wildlife conservation, Ted works directly with ranchers, agencies, and conservation partners to protect prairie grouse species, including sharp-tailed grouse, greater prairie-chickens, lesser prairie-chickens, and sage-grouse. Expect to Learn Why prairie grouse populations are collapsing across North America How grassland loss and fragmentation impact sharptails, prairie-chickens, and sage-grouse Why ranching is essential to upland bird habitat How public-land and private-land management affect upland hunting access What hunters can do to support prairie conservation and rangeland stewardship Episode Breakdown with Timestamps [00:00:00] - Introduction [00:04:36] - What's keeping Ted Busy [00:19:20] - Storytelling, memory, and the hunt [00:20:42] - Introduction to the North American Grouse Partnership [00:25:18] - Private-land rangelands and public perception [00:37:05] - How Conservation Practices Create Real Value for Wildlife and Habitat [00:43:37] - Rangelands, Cattle Production and Food Output [00:56:12] - Comparing The Approach with CRP [01:00:50] - National Grasslands Conservation Act and Its Role in Farm Bill Funding [01:04:40] - Learn More about The North American Grouse Partnership and Membership Follow the Guest Ted Website: grousepartners.org  Facebook: https://www.facebook.com/GrousePartners  Instagram: https://www.instagram.com/na_grouse_partnership/?hl=en  Saving Ranching to Save Wildlife: https://www.youtube.com/watch?v=lxM6vvEoRgc Follow the Host Nick: Instagram: @birdshot.podcast Website: www.birdshotpodcast.com Listening Links: Spotify: https://open.spotify.com/show/17EVUDJPwR2iJggzhLYil7 Apple Podcasts: https://podcasts.apple.com/us/podcast/birdshot-podcast/id1288308609 YouTube: http://www.youtube.com/@birdshot.podcast SUPPORT | http://www.patreon.com/birdshot Use Promo Code | BSP20 to save 20% on https://www.onxmaps.com/hunt/app Use Promo Code | BS10 to save 10% on https://trulockchokes.com/ The Birdshot Podcast is Presented By: https://www.onxmaps.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Tax season doesn't have to be a scramble — and today's guests show farmers exactly how to get ahead. We're joined by two ag-focused CPAs: Mackenzie Sprain from LattaHarris and Hannah Mann from Pioneer Accounting LLC. One brings deep ag tax expertise, the other specializes in helping farmers build cleaner records and better financial visibility — together, they give producers a complete roadmap for winning tax season before it starts.We open with an honest look at the 2025 tax landscape: inflation pressures, high interest rates, shifting policy environments, and the growing relevance of tools like Section 180 deductions, R&D credits, conservation program rules, CRP tax treatment, and more. Mackenzie and Hannah outline how year-round planning beats last-minute spending — and why quarterly conversations with your accountant can save thousands.From there, we dig into the power of modern recordkeeping. Tools like Ambrook allow producers to tag expenses by enterprise, monitor breakevens in real time, organize receipts, and make equipment or land decisions with clarity instead of guesswork. The CPAs share real stories of farmers who uncovered hidden savings, improved profitability, or avoided costly mistakes simply by keeping organized, digital records.We also cover common mistakes farmers make — outdated depreciation schedules, misclassified wages, partnership changes not reported, misunderstood conservation payments, or relying on handshake agreements without tax implications in mind. Mackenzie and Hannah walk through the opportunities available for 2025: Section 179 planning, bonus depreciation limits, energy tax credits, R&D credits for agronomy trials, and strategies to minimize interest-driven tax impacts.We close with actionable takeaways: start early, track continuously, communicate often, and use technology to transform tax planning from compliance into strategy. If you want to reduce stress, avoid surprises, and make tax season another profit tool for your operation, this episode is packed with practical, CPA-approved guidance you can apply immediately. Want Farm4Profit Merch? Custom order your favorite items today!https://farmfocused.com/farm-4profit/ Don't forget to like the podcast on all platforms and leave a review where ever you listen! Website: www.Farm4Profit.comShareable episode link: https://intro-to-farm4profit.simplecast.comEmail address: Farm4profitllc@gmail.comCall/Text: 515.207.9640Subscribe to YouTube: https://www.youtube.com/channel/UCSR8c1BrCjNDDI_Acku5XqwFollow us on TikTok: https://www.tiktok.com/@farm4profitllc Connect with us on Facebook: https://www.facebook.com/Farm4ProfitLLC/ Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode, Ben Azadi breaks down five science-backed metabolic drinks that naturally reduce arterial plaque, boost nitric oxide, lower inflammation, and support metabolic health — without medications or side effects. You'll learn: • Why arterial inflammation — not cholesterol — is the real silent killer• How pomegranate juice reversed arterial plaque by 30% in human studies• The surprising cardiovascular benefits of high-quality coffee with butter, olive oil, and salt• Why raw cacao improves arterial flexibility by up to 400% (Harvard study)• How apple cider vinegar and cinnamon lower fasting glucose, HbA1c, and triglycerides• The anti-inflammatory power of turmeric + black pepper and how it calms the arteries Ben also explains:• Which drink is best for diabetics• How to rotate the drinks weekly for maximum benefit• What markers to test before and after 30 days to measure progress (ApoB, CRP, fasting insulin, triglycerides, HDL, CAC score, and more) Plus, he shares a free guide revealing the five vegetables silently inflaming your gut and slowing your metabolism — and what to eat instead. A simple daily cup could dramatically upgrade your cardiovascular and metabolic health. FREE GUIDE: 5 Vegetables You Must Avoid To Lose Weight & Belly Fat - https://bit.ly/48CIprn

Developing strong, lifelong social bonds helps slow biological aging by influencing how your genes, immune system, and stress hormones function People with higher "cumulative social advantage," meaning consistent emotional support throughout life, show younger cellular profiles on aging clocks like GrimAge and DunedinPACE Those with rich social connections have lower levels of inflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP), reducing the risk of heart disease, diabetes, and neurodegeneration Social isolation not only accelerates aging but also contributes to nutrient deficiencies, with lonely older adults showing lower intake of magnesium, potassium, vitamins B6 and C, and folate Rebuilding connection, such as through community, shared meals, and meaningful daily interactions, restores biological balance, lowers inflammation, and supports longer, healthier living

In this Huberman Lab Essentials episode, my guest is Dr. David Sinclair, PhD, a professor of genetics at Harvard Medical School and a leading expert on the biology of aging. We discuss the cellular and molecular mechanisms of aging—and how specific behaviors, such as fasting, regular exercise and NAD⁺-boosting compounds like NMN, can activate the body's natural longevity pathways. This discussion highlights how lifestyle choices profoundly influence the aging process and may even slow or reverse key aspects of biological aging. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AGZ by AG1: https://drinkagz.com/huberman David: https://davidprotein.com/huberman Eight Sleep: https://eightsleep.com/huberman Timestamps (0:00) David Sinclair (0:20) Longevity, Anti-Aging, Aging as a Disease (2:27) Causes of Aging; Epigenome & Genes (4:53) CD & Scratches Analogy, DNA, Silencing & Expressing Genes (6:44) Physical Appearance & Aging (7:36) Sponsor: David (8:54) Childhood Development & Aging, Horvath Clock, Accelerate Aging (11:30) Rates of Puberty & Aging, Growth Hormone (12:37) Body Size & Longevity; Epigenetics (13:07) Fasting, Calorie Restriction & Longevity, Sirtuins, Insulin & Glucose (16:31) Tool: Skip a Meal (17:07) Longer Fasts & Autophagy, “Deep Cleanse” (18:07) Sponsor: AGZ by AG1 (19:36) Fasting, Fluids, Electrolytes (20:16) Sirtuins, Glucose, mTOR & Fasting; Leucine, Tool: Pulsing Behaviors (24:24) Breaking a Fast, Tools: Do Your Best; Transitions (27:00) Sirtuins, NAD, NMN Supplementation (29:04) Sponsor: Eight Sleep (31:10) Iron & Senescent Cells; Personalize Medicine (32:40) Tool: Blood Markers, CRP (34:50) Tool: Aerobic & Resistance Exercise (35:55) Estrogen, Fasting & Fertility; Aging & Rejuvenation (38:20) Acknowledgements Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

Modern joint pain isn't just wear and tear—it's a systemic, metabolic disease that starts years before symptoms show. In this episode, you'll learn how inflammation, mitochondria dysfunction, and immune imbalance trigger cartilage loss… and how to reverse it using targeted cytokine modulation, cellular regeneration, and smarter supplements for longevity and human performance. Watch this episode on YouTube for the full video experience: https://www.youtube.com/@DaveAspreyBPR Host Dave Asprey sits down with Kiran Krishnan, a research microbiologist and Chief Scientific Officer at Calroy Health Sciences. He's the founder of Microbiome Labs—one of the most trusted microbiome-focused brands in functional medicine—and a formulator behind cutting-edge supplements like Arterosil and Vascanox. With over two decades of experience, Kiran has launched multiple health ventures, authored scientific textbook chapters, published clinical trials, and holds global patents in human health. He's a leading authority on systemic inflammation, mitochondrial dysfunction, and gut-driven disease—and one of the few voices making complex biology accessible for real-world results. He breaks down their new supplement Cartigenix HP, and how cytokines like IL-6 and TNF-alpha flip your cartilage cells from anabolic repair to catabolic destruction, how mitochondrial decline speeds up joint damage, and why most modern painkillers make your joints worse. You'll learn how a specialized blend of boswellia and celery seed reprograms inflammation, why walking beats medication in clinical trials, and how fasting, nitric oxide, and gut health work together to optimize joint regeneration. You'll learn: • How cartilage cells (chondrocytes) rely on mitochondria for tissue repair • Why global cytokines like IL-6 and TNF-alpha drive joint degradation and brain fog • How cartilage begins to break down in your teens—and what to do about it now • The surprising clinical data on walking distance, inflammation markers, and recovery • Why most supplements and NSAIDs fail—and what actually rebuilds joints • How diet and leaky gut create 5-day inflammation spikes from a single fast-food meal • The mitochondrial link between joint pain, cardiovascular risk, and depression • Why perimenopausal women are at 10x higher risk for arthritis—and how to prevent it • How to track your biological joint age using imaging and systemic inflammation labs This is essential listening for anyone serious about biohacking, functional medicine, pain-free aging, and human performance. Whether you're lifting heavy, walking daily, or just trying to stay mobile into old age, this episode gives you the science and tools to reverse joint degeneration and extend your healthspan. Dave Asprey is a four-time New York Times bestselling author, founder of Bulletproof Coffee, and the father of biohacking. With over 1,000 interviews and 1 million monthly listeners, The Human Upgrade brings you the knowledge to take control of your biology, extend your longevity, and optimize every system in your body and mind. Each episode delivers cutting-edge insights in health, performance, neuroscience, supplements, nutrition, biohacking, emotional intelligence, and conscious living. New episodes are released every Tuesday, Thursday, Friday, and Sunday (BONUS). Dave asks the questions no one else will and gives you real tools to become stronger, smarter, and more resilient. Keywords: Joint cartilage regeneration, IL-6 inflammation suppression, TNF-alpha cytokine modulation, Chondrocyte mitochondrial repair, Catabolic to anabolic tissue shift, Osteoarthritis reversal, Rheumatoid arthritis inflammation, Mitochondria and collagen synthesis, Boswellia seratol extract, Celery seed COX inhibition, Matrix metalloproteinase (MMP) inhibition, Synovial fluid inflammation, Leaky gut and joint pain, Six-minute walk test improvement, Global cytokine markers, High sensitivity CRP reduction, ESR sedimentation rate, Uric acid crystal formation, Post-prandial glucose walking, Cartilage MRI biomarkers, Functional medicine joint support, Fasted repair stacking, Vasodilation and nitric oxide, Anti-inflammatory supplement stacking, NF-kB pathway reduction, Joint space biological age, Microvascular circulation and cartilage, Caloric load and cytokine spike, Perimenopause and arthritis risk, Joint tissue anabolic activation **Get an exclusive discount for podcast listeners at calroy.com/dave : https://calroy.com/product/cartigenix-hp/?lp=dave ** Thank you to our sponsors! -BodyGuardz | Visit https://www.bodyguardz.com/ and use code DAVE for 25% off. -BiOptimizers | Go to http://bioptimizers.com/dave and use code DAVE15 to get 15% off your order. -Quantum Upgrade | Go to https://quantumupgrade.io/Dave for a free trial. -Caldera + Lab | Go to https://calderalab.com/DAVE and use code DAVE at checkout for 20% off your first order. Resources: • Danger Coffee: https://dangercoffee.com/discount/dave15 • Dave Asprey's BEYOND Conference: https://beyondconference.com • Dave Asprey's New Book – Heavily Meditated: https://daveasprey.com/heavily-meditated • Upgrade Collective: https://www.ourupgradecollective.com • Upgrade Labs: https://upgradelabs.com • 40 Years of Zen: https://40yearsofzen.com Timestamps: 0:00 — Trailer 1:25 — Introduction 2:01 — Why Modern Medicine Fails at Joint Pain 3:07 — Painkillers That Accelerate Joint Damage 7:35 — Rheumatoid vs. Osteoarthritis Explained 8:54 — Cytokines That Destroy Cartilage 12:10 — Arthritis Begins in Your Teens 15:35 — 75% Pain Reduction in 7 Days 18:35 — The Science Behind Boswellia & Celery Seed 24:10 — Six-Minute Walk Test Results 25:45 — The $200/Month Painkiller Trap 28:53 — Proof Cartilage Can Regrow 31:01 — Mitochondria and Joint Repair 32:29 — Inflammation Links to Heart Disease 35:52 — Why Glucosamine Doesn't Work 37:07 — Silent Arthritis in 90% of Adults 40:44 — Why Women Face Higher Joint Risk After 40 45:52 — Food as the #1 Inflammation Trigger 47:23 — Fasting & Cartogenics Stack for Repair 50:27 — Movement Snacks and Efficient Training 55:54 — Why Joints Heal Slower Than Muscles 57:48 — Dave's Stack and Final Takeaways See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.