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Max Trescott interviews Dr. John Trowbridge, a physician and former senior Aviation Medical Examiner, to tackle a hidden yet critical safety topic: how over-the-counter (OTC) and prescription medications contribute to general aviation accidents. Studies have found that up to 40% of fatal accidents involve pilots with impairing substances in their system—ranging from allergy medications to sleep aids to alcohol. The problem? Many of these substances are legal and even commonplace, yet can significantly degrade judgment, memory, attention, and coordination. Dr. Trowbridge emphasizes that many pilots—and even their doctors—are unaware of FAA wait-time guidelines. He explains the FAA's “5x rule,” which states that a pilot must wait five times the recommended dosage interval before flying. So if a medication is taken every six hours, the pilot should wait 30 hours after the last dose. For 24-hour medications like Zyrtec, the wait time stretches to five full days. The discussion highlights the particular dangers of first-generation antihistamines like Benadryl (diphenhydramine), which are highly sedating and frequently found in sleep aids like Tylenol PM, NyQuil, and Unisom. These medications, even when taken the night before, can impair cognitive function well into the next day. Alarmingly, Benadryl is the most commonly detected OTC drug in fatal GA accidents. Dr. Trowbridge also warns about second-generation antihistamines like Zyrtec and Xyzal. While marketed as “non-drowsy,” these can still cause subtle sedation, especially in combination with alcohol or other medications. Alternatives like Allegra and Claritin are usually safer and FAA-approved—but only after personal ground-testing and AME consultation. Beyond antihistamines, they explore other drug categories. For pain relief, medications like aspirin, Tylenol, ibuprofen, and Aleve are generally safe, but anything with “PM” on the label likely contains sedating ingredients. Prescription painkillers like codeine are outright disqualifying. Dr. Trowbridge shares unconventional options too, like topical lidocaine, coconut oil, and even horse liniment—though with cautions about application and legality. Sleep aids are another minefield. Melatonin is the only one on the FAA's “go list,” and even it should be ground-tested first. Nasal decongestants such as Afrin and Sudafed can raise blood pressure and cause jitteriness, making natural remedies like saline rinses or cool vapor inhalation preferable. Cough medications also pose risks. Products with dextromethorphan (like DayQuil or Delsym) can sedate, as can multi-symptom formulas marked “PM” or “nighttime.” Gastrointestinal issues are more straightforward: most antacids like Tums and Maalox are safe, but anti-diarrheals like Imodium are not, due to sedation risks. UTIs are covered with non-sedating options like AZO and D-Mannose, but Dr. Trowbridge cautions pilots never to fly if symptomatic or on unfamiliar antibiotics. The conversation then turns to alcohol. The FAA's limit is 0.04%, but even lower levels can impair judgment, night vision, and reaction time—especially when combined with other medications or altitude-related hypoxia. Max cites an older FAA study showing that alcohol above 0.04% was found in 7% of fatal pilot crashes, with 3% involving both alcohol and drugs. Finally, Dr. Trowbridge emphasizes the importance of pilot self-awareness and due diligence. Most doctors are not trained in FAA regulations and may prescribe disqualifying medications unless reminded. He urges pilots to always research their medications, consult their AME, and even speak with pharmacists about interactions and cognitive side effects. Dr. Trowbridge's website, ClearedForTakeoff.info, offers in-depth presentations on pilot health concerns like sleep, sinus issues, inflammation, and safe alternatives to disqualifying drugs. His goal is to help pilots avoid both illness and medication risks, empowering them to stay flying—and stay safe. If you're getting value from this show, please support the show via PayPal, Venmo, Zelle or Patreon. Support the Show by buying a Lightspeed ANR Headsets Max has been using only Lightspeed headsets for nearly 25 years! I love their tradeup program that let's you trade in an older Lightspeed headset for a newer model. Start with one of the links below, and Lightspeed will pay a referral fee to support Aviation News Talk. Lightspeed Delta Zulu Headset $1299 Lightspeed Zulu 3 Headset $949Lightspeed Sierra Headset $749 My Review on the Lightspeed Delta Zulu Send us your feedback or comments via email If you have a question you'd like answered on the show, let listeners hear you ask the question, by recording your listener question using your phone. Mentioned on the Show Buy Max Trescott's G3000 Book Call 800-247-6553 Lightspeed Delta Zulu Headset Giveaway NTSB News Talk Podcast UAV News Talk Podcast Rotary Wing Show Podcast Dr. Trowbridge's website Dr. Trowbridge's book: The Yeast Syndrome FAA Go / NO List for Over-the-Counter Medications Free Index to the first 282 episodes of Aviation New Talk So You Want To Learn to Fly or Buy a Cirrus seminars Online Version of the Seminar Coming Soon – Register for Notification Check out our recommended ADS-B receivers, and order one for yourself. Yes, we'll make a couple of dollars if you do. Get the Free Aviation News Talk app for iOS or Android. Check out Max's Online Courses: G1000 VFR, G1000 IFR, and Flying WAAS & GPS Approaches. Find them all at: https://www.pilotlearning.com/ Social Media Like Aviation News Talk podcast on Facebook Follow Max on Instagram Follow Max on Twitter Listen to all Aviation News Talk podcasts on YouTube or YouTube Premium "Go Around" song used by permission of Ken Dravis; you can buy his music at kendravis.com If you purchase a product through a link on our site, we may receive compensation.
In this encore episode, we detail the gut-immune axis, focusing on the protective mucus layer and the role of lactoferrin in intestinal health. We discuss endogenous secretions and how lactoferrin functions as an antimicrobial, immunomodulatory, and iron-regulating glycoprotein, influencing microbial balance and intestinal barrier integrity. Additionally, we highlight lactoferrin testing and levels. We finish by going through supplementation as a phenomenal tool.Topics: 1. The Intestinal Barrier & Mucus Layer- The intestinal lumen, microbiome, mucus layer, epithelial cells, and lamina propria.- The mucus layer: antimicrobial peptides (AMPs) and secretory IgA (sIgA).- Intestinal epithelial cells including goblet cells and enterocytes.2. Immune Cells in the Gut- The lamina propria.- Macrophages, dendritic cells, neutrophils, B cells, T cells, mast cells, and more.3. Antimicrobial Peptides & Secretory IgA- AMPs and sIgA in the mucus layer regulate microbial balance and prevent pathogen adhesion.4. Lactoferrin: Functions & Sources- Iron-binding glycoprotein, antimicrobial and immunomodulatory properties.- Found in mucosal secretions, colostrum, and more.- Intestinal epithelial cells (IECs) and neutrophils.5. Lactoferrin's Role in Intestinal Health- Regulates iron absorption via lactoferrin receptors (LFR)on enterocytes.- Sequesters free iron, limiting bacterial growth, bacteriostatic.- Destabilizes bacterial membranes, cell lysis, bactericidal.6. Lactoferrin Levels- Neutrophils release lactoferrin during infection,increasing its presence in the large intestine.- Fecal lactoferrin levels.- Fecal calprotectin levels.7. Lactoferrin & Candida Overgrowth- Fungal membranes.- Aiding in the inhibition of biofilm formation.8. Lactoferrin Supplementation & Benefits- Supports gut microbiota, epithelial integrity, and immune modulation.- Bovine colostrum and as a supplement.9. Conclusion- The intestinal mucus layer is key to gut barrier function.- Lactoferrin plays a central role in microbial regulation and immune defense.Get Chloe's Book Today! "75 Gut-Healing Strategies & Biohacks" Follow Chloe on Instagram @synthesisofwellnessVisit synthesisofwellness.com
In this encore episode, we go through the pathophysiology of hydrogen sulfide (H₂S)-dominant small intestinal bacterial overgrowth (SIBO), focusing on its role in intestinal motility disruption, microbial dysbiosis, and epithelial barrier dysfunction. We detail the interplay between the enteric nervous system (ENS), interstitial cells of Cajal (ICCs), and migrating motor complex (MMC) in regulating small intestinal transit and how excess H₂S modulates smooth muscle activity, inflammatory signaling, and gastrointestinal transit time. Lastly, we detail symptoms and related SIBO subtypes.Topics:1. Introduction to Hydrogen Sulfide Dominant SIBO - Overview of hydrogen sulfide (H₂S) SIBO - Sulfate as an electron acceptor - H₂S production, sulfur-containing amino acids - Physiological roles of H₂S vs. in excess 2. Hydrogen Sulfide and Gastrointestinal Motility - Impact on transit time - Association with IBS-like symptoms, diarrhea 3. Intestinal Motility and Regulation - Role of the ENS, ICCs, smooth muscle cells, and neurotransmitters in motility 4. The Enteric Nervous System (ENS) and Gut Motility - ENS as the "second brain" and its control over digestion - Myenteric and submucosal plexuses: regulation of peristalsis, secretion, blood flow - Gut-brain axis involvement via vagus nerve signaling - ICCs as pacemaker cells generating slow-wave electrical activity - MMC's role in clearing debris and bacteria 5. Dysregulated Motility and SIBO Development 6. Overlapping Symptoms Across SIBO Subtypes - Shared symptoms - Hydrogen and H₂S-dominant SIBO vs. IMO 7. Gastric Acid and Its Role - HCl secretion by parietal cells and its role in digestion and microbial defense - Hypochlorhydria and bacterial overgrowth 8. Conclusion - Root cause approach.Get Chloe's Book Today! "75 Gut-Healing Strategies & Biohacks" Follow Chloe on Instagram @synthesisofwellnessVisit synthesisofwellness.com
In the In Conversation With series, a part of the free DDW podcast, DDW speaks with members of the drug discovery industry about their work and how it helps turn science into business. In this episode, Megan Thomas is in conversation with Dr Emil Lou, Professor of Hematology and Oncology at the University of Minnesota. They discuss the promising results of a recent clinical trial he led focused on gastrointestinal cancers, the potential impact of continued clinical success on the future of these hard-to-treat cancers, and the key challenges that must be addressed to sustain progress. Dr Lou also explores the evolving role of multiplexed gene editing in tackling immunosuppressive or heterogeneous solid tumours, the complexities of forging academia-industry partnerships to support early-phase innovation, and the scientific breakthroughs he believes will shape the next five years in cancer research. You can listen below, or find The Drug Discovery World Podcast on Spotify, Google Play and Apple Podcasts.
In this episode, we review the high-yield topic Primary Biliary Cholangitis from the Gastrointestinal section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic Ischemic Colitis from the Gastrointestinal section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic Acute Hepatitis from the Gastrointestinal section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic Mesenteric Ischemia from the Gastrointestinal section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
A patient with ascites is most likely to develop which of the following complications? Find it all out in the podcast! Be prepared for the NPTE so that you can pass with flying colors! Check out www.ptfinalexam.com/podcast for more information and to stay up-to-date with our latest courses and projects. #Npte #PT #ptboards #crushtheNPTE #study #studygram #spt #ptstudent #ptlife #sptprobs #physicaltherapystudent #physicaltherapy #physio #physiotherapist #ptlife #ptstudentstudy
In this episode, we review the high-yield topic Fulminant Liver Failure from the Gastrointestinal section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic Achalasia from the Gastrointestinal section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic of Celiac Trunk from the Gastrointestinal section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Primary Biliary Cholangitis from the Gastrointestinal section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Barrett Esophagus from the Gastrointestinal section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Crigler-Najjar Syndrome from the Gastrointestinal section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Ulcerative Colitis from the Gastrointestinal section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Islet Cell Tumors from the Gastrointestinal section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Gastrointestinal Tract Histology from the Gastrointestinal section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
Meg shares the terrifying experience of her puppy Muffin accidentally ingesting marijuana at a park and the emergency vet visit that followed, then opens up the conversation to listener stories about scary incidents with their dogs.• Collar dangers emerge as a common hazard, with multiple stories of dogs choking when collars become caught during play or in crate wires• Breakaway collars and removing collars during unsupervised time can prevent these dangerous situations• "He's friendly" dog greetings frequently lead to attacks and injuries, reminding owners that dogs don't need forced friendships• Gastrointestinal obstructions from toys, leashes, socks and other items cause expensive surgeries and near-death experiences• Toxic substances like ibuprofen and recreational drugs present serious dangers that many owners don't recognize until too late• Bloat (stomach torsion) can kill within hours, with one in five German Shepherds experiencing it in their lifetime• Short-nosed breeds need special supervision during feeding to prevent choking incidents• Remaining calm during emergencies is crucial for making life-saving decisionsJoin our Virtual Shadow Program starting May 26th if you're interested in becoming a dog trainer and learning more about prevention and safety for dogs.Visit us at Theeverydaytrainer.com
In this episode of the Pediatric and Developmental Pathology, our hosts Drs. Mike Arnold (@MArnold_PedPath) and Dr. Jason Wang speak with Dr. Saeeda Almarzooqi, Assistant Dean for Medical Education and Professor of Pathology at United Arab Emirates University, about her article in Pediatric and Developmental Pathology: Hereditary Multiple Intestinal Atresia With a Novel TTC7A Pathogenic Variant: Gastrointestinal Manifestations in Two Cases Featured public domain music: Summer Pride by Loyalty Freak
In this episode, Catherine Fahey, MD, PhD; Alexandra Leary, MD, PhD; Funda Meric-Bernstam, MD; and Zev A. Wainberg, MD, explore the mechanisms of HER2-targeted antibody–drug conjugates (ADCs) and emerging clinical data with these agents across genitourinary, gastrointestinal, and gynecologic cancers.Mechanisms of action of ADCs: how ADCs selectively deliver potent chemotherapy to tumor cellsClinical data across tumor types: highlights from recent trials with trastuzumab deruxtecan and exploration of emerging data on agents such as disitamab vedotinChallenges and future directions:key considerations for combining HER2-targeted ADCs with immunotherapy or chemotherapy, and sequencing ADC therapiesPresenters:Catherine Fahey, MD, PhDAssistant ProfessorDivision of OncologyUniversity of North Carolina at Chapel HillChapel Hill, North CarolinaAlexandra Leary, MD, PhDPresident, GINECO GroupCo-Director, Department of Medical OncologyMedical Oncologist GynecologyTeam Leader, Gynecologic Translational Research Lab, INSERM u981Institut Gustave RoussyVillejuif, FranceFunda Meric-Bernstam, MDChair, Department of Investigational Cancer TherapeuticsMedical Director, Institute for Personalized Cancer TherapyNellie B. Connally Chair in Breast CancerThe University of Texas MD Anderson Cancer CenterHouston, TexasZev A. Wainberg, MDProfessor of Medicine and SurgeryCo-Director of GI OncologyDirector, Early Phase Clinical Research ProgramJonsson Comprehensive Cancer CenterUCLA School of MedicineLos Angeles, CaliforniaLink to full program:https://bit.ly/42iEDjVTo claim credit for listening to this episode, please visit the podcast online at the link above.
In this episode, we highlight vitamin D₃ in gastrointestinal health, with a focus on intestinal barrier function and the gut-immune axis. We discuss how vitamin D is metabolized into its active form, 1,25-dihydroxyvitamin D, and how 1,25-dihydroxyvitamin D can support the intestinal mucosa, while highlighting the intestinal epithelium and immune cells in the lamina propria. Through this, we further detail the role of regulatory T cells in supporting immune balance and modulating immune function.Topics:1. Introduction - Highlighting intestinal barrier function and the gut-immune axis with a focus on vitamin D₃ 2. Vitamin D Synthesis and Metabolism - Skin and 7-dehydrocholesterol; dietary intake.- Transported through the bloodstream bound to vitamin D binding protein.- First hydroxylation in the liver to form 25-hydroxyvitamin D₃ (25(OH)D₃).- Testing.- Second hydroxylation in the kidney to form the active 1,25 dihydroxyvitamin D₃ (1,25(OH)₂D₃).- Local activation also occurs. 3. Intestinal Barrier Anatomy - The intestinal epithelium forms a selectively permeable monolayer that interfaces with the gut lumen.- Covered by a mucus layer: mucins, antimicrobial peptides, secretory IgA.- Mucus layer provides physical and biochemical protection.- Tight junction proteins and paracellular permeability.- Molecules crossing the epithelium. - Disruption of tight junctions, immune cell exposure to luminal contents.- The lamina propria and Gut-Associated Lymphoid Tissue (GALT). - Maintaining tolerance while defending against pathogens. 4. Vitamin D's Role in Barrier Support and Immune Modulation - 1,25-dihydroxyvitamin D₃, tight junction integrity, immune regulation, and more.- Regulatory T Cells (Tregs) and immune balance. 5. Vitamin D₂ and D₃- D₃ (cholecalciferol) is more biologically effective and binds DBP more strongly. 6. Vitamin D Levels - Levels observed in autoimmune conditions, IBS, and more.- Symptoms.- Insufficient and excessive levels of vitamin D can be detrimental.- Multi-system. 7. Conclusion - Multifactorial: Numerous factors regulate vitamin D levels.- Gastrointestinal health root cause approach.Thanks for tuning in!Get Chloe's Book Today! "75 Gut-Healing Strategies & Biohacks" Follow Chloe on Instagram @synthesisofwellnessFollow Chloe on TikTok @chloe_c_porterVisit synthesisofwellness.com to purchase products, subscribe to our mailing list, and more!
Do you have breast implants? Have you thought about getting them or do you know others with them? The conversation about breast implants' impact on health is a real one for a lot of women. We get into all the cases: You have implants and feel fine You have implants and are feeling symptoms you have just chalked up to menopause Whether for yourself, or to share with a friend or daughter, this one doesn't end with breast implants. It only starts there. Stay all the way to the end for the no-cut facelift details! My Guest: Dr. Robert Whitfield, MD is AMERICA'S BREAST IMPLANT ILLNESS EXPERT™ with over 25 years of experience as a plastic surgeon and more than 16 years board-certified. He specializes in Breast Implant Illness (BII), explant surgery, and advanced cosmetic procedures like his signature “No-Cut” Facelift. He is also the creator of SHARP (Strategic Holistic Accelerated Recovery Program)—a protocol designed to reduce inflammation and support both pre- and post-surgical healing. Dr. Whitfield earned his medical degree from the University of Nevada, Las Vegas, followed by surgical training and a plastic surgery residency at Indiana University Medical Center, and a microsurgery fellowship in Nevada. He later taught at the Medical College of Wisconsin before moving to Austin in 2012. He began private practice in 2017. Questions We Answer in This Episode: [00:07:42] What is Breast Implant Illness (BII)? [00:08:01] What are the BII signs and symptoms? [00:08:43] Why does BII occur, and how common is it? [00:15:36] What to do if you suspect you have BII? What tests are available? Is there a holistic approach? [00:22:52] Is it covered by insurance? [00:22:36] How is BII treated? [00:30:11] What is the No-cut Facelift? What is Breast Implant Illness (BII)? Chronic inflammatory response to breast implants. Implants are foreign bodies which may cause ~29% chance of bacterial contamination, not mold. What are the Symptoms? Brain fog Fatigue and loss of motivation Gastrointestinal issues (e.g. bloating) Joint pain Hormonal imbalance Thyroid dysfunction What to Do If You Suspect BII? Educate yourself through long-form content and patient stories Consider testing for: Detox capabilities Hormonal panels Gut health and infections Look into explant surgery with comprehensive detox and recovery (e.g. SHARP protocol) The No-Cut Facelift Designed to lift and rejuvenate without surgery or visible scars The Procedure: Fiber optics for deep neck tightening FaceTite (radiofrequency tightening beneath the skin) Micro-coring: removes tiny pieces of skin to tighten surface without visible scars Benefits: Natural results with minimal scarring Boosts collagen production Customizable depending on the patient's skin, hormones, and detox status Key Takeaways BII is real and often overlooked, frequently mistaken for menopause or autoimmune disorders. Chronic inflammation and bacterial contamination (not mold) are major culprits. A new biomarker test (oxylipin 10-HOME) could soon improve diagnosis. Personal genetics, lifestyle, and environmental exposure significantly influence risk. Explant surgery should be holistic, addressing toxins, hormones, and gut health before and after. No-Cut Facelift, a minimally invasive facial rejuvenation, is a safer, scar-free alternative to traditional facelifts, emphasizing natural results. Connect with Dr. Robert: Website of Dr. Robert Facebook - Dr. Robert Whitfield Instagram - @breastimplantillnessexpert YouTube - @breastimplantillnessexpert Podcast - Apple Podcasts - Explant Breast Surgery & Recovery Other Episodes You Might Like: Previous Episode - Is This Perimenopause or Something Else? More Like This - Younger for Life with America's Holistic Plastic Surgeon® Resources: Short & Easy Exercise videos in this 5 Day Flip Challenge. Get the planner to track your menopause health habits with the 90 Day Planner: Tracking the Flip. Get ready to lift, tone, and turn heads with the The Ultimate Glute Challenge. Flip the switch on your midlife metabolism with the Metabolism Makeover 2.0.
In this episode, Zev A. Wainberg, MD; Funda Meric-Bernstam, MD; Alexandra Leary, MD, PhD; and Catherine Fahey, MD, PhD, explore testing for HER2 alterations and the incidence of HER2-positive disease in the treatment of genitourinary, gastrointestinal, and gynecologic malignancies. HER2 Testing in Advanced Cancers: Recommendations for when and how to test for HER2 in advanced cancers and how these tests guide therapy selectionVariability in HER2 Expression Across Tumor Types: Insights into the heterogeneity of HER2 expression and amplification in different cancersChallenges in Standardizing HER2 Testing: The complexities of scoring and testing HER2 in different cancers and institutions, and the need for better harmonization of guidelines and approachesPresenters:Zev A. Wainberg, MDProfessor of Medicine and SurgeryCo-Director of GI OncologyDirector, Early Phase Clinical Research ProgramJonsson Comprehensive Cancer CenterUCLA School of MedicineLos Angeles, CaliforniaFunda Meric-Bernstam, MDChair, Department of Investigational Cancer TherapeuticsMedical Director, Institute for Personalized Cancer TherapyNellie B. Connally Chair in Breast CancerThe University of Texas MD Anderson Cancer CenterHouston, TexasAlexandra Leary, MD, PhDPresident, GINECO GroupCo-Director, Department of Medical OncologyMedical Oncologist GynecologyTeam Leader, Gynecologic Translational Research Lab, INSERM u981Institut Gustave RoussyVillejuif, FranceCatherine Fahey, MD, PhDAssistant ProfessorDivision of OncologyUniversity of North Carolina at Chapel HillChapel Hill, North CarolinaLink to full program:https://bit.ly/42iEDjVTo claim credit for listening to this episode, please visit the podcast online at the link above.
In this episode, we detail the role of vitamin B1 (thiamine) in supporting gastrointestinal function, highlighting intestinal motility through vitamin B1's involvement in acetyl-CoA and acetylcholine synthesis. We discuss thiamine insufficiency as well as how small intestinal bacterial overgrowth (SIBO) can further affect thiamine availability. We further detail host defense mechanisms—including gastric acid, pancreatic enzymes, and gastrointestinal motility—that work in concert to regulate microbial balance in the small intestine.Topics: 1. Introduction- Focus on SIBO, intestinal motility, and vitamin B1 (thiamine) 2. Small Intestine and Microbial Regulation- Low bacterial load under healthy conditions - Protective mechanisms: gastric acid, enzymes, motility… 3. Overview of SIBO Subtypes - H₂-SIBO, hydrogen-producing bacteria - IMO, methane-producing archaea - H₂S-SIBO, hydrogen sulfide-producing bacteria - Subtypes can coexist, share underlying factors 4. Host Factors in Microbial Regulation - Gastric acid, motility, pancreatic enzymes, bile acids, and immune surveillance 5. Gastric Acid and Parietal Cells - Hydrochloric acid and intrinsic factor - Acid environment supports digestion and microbial regulation - Protein denaturation and pepsin activation 6. Chief Cells and Enzyme Function - Pepsinogen and gastric lipase - Pepsinogen activated by acidic pH 7. Hypochlorhydria and Downstream Effects 8. Pancreatic Enzymes in the Small Intestine 9. Intestinal Motility and the Enteric Nervous System (ENS)- Coordinated smooth muscle contractions - Myenteric and submucosal plexuses 10. Intestinal Wall Anatomy - Epithelium and lamina propria - Submucosa contains the submucosal plexus - Myenteric plexus located between muscle layers 11. Vitamin B1 (Thiamine) and Gastrointestinal Function - Acetylcholine synthesized from choline and acetyl-CoA - Acetyl-CoA formation, thiamine availability - Acetylcholine signaling 12. SIBO and Nutrient Availability- Bacterial overgrowth can affect nutrient absorption - Thiaminases 13. Conclusion - Root cause approach, multi-factorial Thanks for tuning in!Get Chloe's Book Today! "75 Gut-Healing Strategies & Biohacks" Follow Chloe on Instagram @synthesisofwellnessFollow Chloe on TikTok @chloe_c_porterVisit synthesisofwellness.com to purchase products, subscribe to our mailing list, and more!
CancerNetwork® visited Sibley Memorial Hospital of Johns Hopkins Medicine to speak with a variety of experts about therapeutic advancements and ongoing research initiatives across several different cancer fields. As part of each discussion, clinicians highlighted how collaboration across different departments has positively impacted treatment planning, decision-making, and outcomes at their institution. These experts included the following: · Rachit Kumar, MD, an assistant professor of Radiation Oncology and Molecular Radiation Sciences at Johns Hopkins School of Medicine and a radiation oncologist specializing in genitourinary and gastrointestinal cancers at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center for Sibley Memorial Hospital and Suburban Hospital; · Michael J. Pishvaian, MD, PhD, director of Gastrointestinal, Developmental Therapeutics, and Clinical Research Programs, and associate professor of Oncology at Johns Hopkins School of Medicine; · Nina Wagner-Johnston, MD, a professor of Oncology and the director of Lymphoma Drug Development at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, director of Hematologic Malignancies National Capital Region, and co-director of Clinical Research for Hematologic Malignancies; · Valerie Lee, MD, an assistant professor of Oncology at Johns Hopkins University School of Medicine and a medical oncologist at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital; · Armine Smith, MD, the director of urologic oncology at the Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, and an assistant clinical professor of Urology at the Brady Urological Institute of Johns Hopkins University School of Medicine; · Pouneh Razavi, MD, the director for Breast Imaging in the National Capital Region and an instructor in Radiology and Radiological Science; · and Curtiland Deville Jr., MD, medical director of the Johns Hopkins Proton Therapy Center and clinical director of Radiation Oncology at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital. Altogether, their insights demonstrated how multidisciplinary teamwork has improved outcomes ranging from patient survival to healthcare resource utilization across a wide range of diseases including breast cancer, gastrointestinal cancer, genitourinary cancer, hematologic malignancies, and others.
In today's episode, we detail the enteric nervous system and regulation of gastrointestinal motility. We discuss factors including dysautonomia, stress, microbial overgrowth, and more, with regards to potential effects upon gastrointestinal motility. We further detail symptoms of altered GI motility. Topics:1. Introduction to Gastrointestinal Motility- Orchestrated contraction of smooth muscles that propel contents along the digestive tract. - Roles in mixing, absorption, and preventing bacterial overgrowth.- Disruptions in motility. 2. The Enteric Nervous System (ENS) and Its Role- Myenteric and submucosal plexus.- Coordinating contractions and relaxations for effective motility. - Mucosa includes epithelium, lamina propria, and muscle. - Submucosa houses the submucosal plexus. - Muscularis externa. - Inner circular and outer longitudinal muscle layers with the myenteric plexus in between. 3. The Role of Interstitial Cells of Cajal (ICCs)- Specialized pacemaker cells in muscular layers - Generate slow-wave electrical activity to synchronize smooth muscle contractions - Critical for peristalsis.- Work with neural inputs to fine-tune gut motility 4. Dysautonomia and Its Impact on Gut Motility- Dysfunction of the autonomic nervous system (ANS) - Motility impacts- Microbial overgrowth, SIBO 5. Gastrointestinal Dysmotility- Neurological dysregulation - Structural abnormalities and smooth muscle dysfunction - Hormonal imbalances - Microbial overgrowth - Autoimmunity 6. The HPA Axis- Hypothalamus, pituitary gland, adrenal glands - Central to the stress response and interlinked with gut function - The amygdala and PVN of the hypothalamus - CRH stimulates ACTH, leading to cortisol release from adrenal glands 7. Cortisol and Gut Barrier Function- Cortisol is a glucocorticoid that modulates immune function and gut physiology - Chronic cortisol exposure can impair tight junction (TJ) integrity - Increases paracellular permeability and allows passage of antigens and endotoxins 8.Stress-Induced Changes in Gut Motility- Slow gastric motility - Increased colonic motility 9. Symptoms of GI Dysmotility10. Addressing Root Cause(s)Thank you to our episode sponsor:1. Shop Fresh Press Farms'Peach Cider Vinegar at Sprouts locations nationwide, and check out their full collection here. Get Chloe's Book Today! "75 Gut-Healing Strategies & Biohacks" Follow Chloe on Instagram @synthesisofwellnessVisit synthesisofwellness.com
Welcome to another episode of the Oncology Brothers! In this episode, Drs. Rahul and Rohit Gosain are joined by their brother, Dr. Timothy Brown from UT Southwestern, to discuss the latest treatment paradigms for upper gastrointestinal (GI) malignancies, specifically focusing on esophageal and gastroesophageal junction adenocarcinoma, as well as gastric cancer. Episode Highlights: • Early Disease Management: perioperative FLOT versus concurrent chemoradiation. • Adjuvant Nivolumab: Insights from the Checkmate 577 trial and its implications for patients with residual disease post-chemoradiation. • Biomarker Testing: The importance of testing for MSI, HER2, Claudin 18.2, and PD-L1 to guide treatment decisions in metastatic settings. • Patient-Centered Care: Emphasizing the significance of shared decision-making and multidisciplinary approaches in managing complex cases. Join us as we unpack the nuances of upper GI malignancies and share key takeaways from recent studies and clinical practices. YouTube: https://youtu.be/UNyi71u2wIw Follow us on social media: • X/Twitter: https://twitter.com/oncbrothers • Instagram: https://www.instagram.com/oncbrothers • Website: https://oncbrothers.com/ Don't forget to like, subscribe, and hit the notification bell for more updates on treatment algorithms and oncology insights!
Nicole Rincon https://www.nicolerincon.comNicole's X https://x.com/NicoleRinconPARossignol Clinic https://rossignolmedicalcenter.comTACA Info: https://tacanow.org/wp-content/uploads/2019/10/F-H-2-Nicole-Rincon-Beginning-Biomed.pdfTACA Talks: https://www.nicolerincon.com/videosPublications https://rossignolmedicalcenter.com/articles-publications/#published-2024-2-articlesNicole Episode 1 https://www.youtube.com/watch?v=BBkdgwVfcZINicole Episode 2 https://www.youtube.com/watch?v=auLReV0DHkQDaylight Computer Company https://daylightcomputer.comuse "autism" in the discount code for $25 coupon.This is the future of tech.Chroma Light Therapy https://getchroma.couse "autism" for a 10% discount,***THIS IS NOT MEDICAL ADVICE***0:00 Nicole Rincon1:10 Daylight Computer Company; DC-15:33 Pre-pregnancy checks; Vitamin D8:37 MTHFR, Folate; Mitochondria; CPR, ESR, Inflammation11:12 GI; CSA; Bacteria, Fungus, Parasites, Calprotectin; Zonalin; MS & Proteus Mirabilis13:06 Organic Acid Test (OAT); Clostridia15:24 MTHFR; C677, 1298; Folinic Acid19:02 Folate's role in pregnancy and development; Critical info about types and duration22:35 Cholesterol; Maternal & Child; Speech & Communication25:06 Telepathy; Autism Rates26:40 Dysbiosis; PCOS29:30 Cholesterol ranges & symptoms; mood, irritability, cognition, aggression; Cortisol & Hormones37:02 Dysbiosis symptoms; Self-Injurious, Posturing41:08 Identifying symptoms in Non-Verbal; Self-Injurious45:08 Importance of Gut Health & Checks; Vitamin D, Electrical Efficiency & Biological Energy48:17 Autistics and pale skin; too many are pale; supplementing Vitamin D, K2; Brands51:00 Proprietary blends warning; abbreviated doses; Fungal overgrowth, Yeast55:49 "Binders;" Magnesium61:00 Fungal Overgrowth & Autism; OAT, Clostridia, C. diff, aggression, self-injurious; Antibiotics & Probiotics1:05:42 Telepathy Tapes, Autism, Water (Cytochrome C Oxidase), Coherence; Luc Montagier NOT Emilio Del Giudice; Distal Connections via Water and NOT axons; OutroX: https://x.com/rps47586Hopp: https://www.hopp.bio/fromthespectrumYT: https://www.youtube.com/channel/UCGxEzLKXkjppo3nqmpXpzuAemail: info.fromthespectrum@gmail.com
Los problemas gastrointestinales son afecciones que impactan el sistema digestivo y pueden afectar la calidad de vida de quienes la viven. Entre los más comunes se encuentran el reflujo gastroesofágico, la gastritis, el síndrome de intestino irritable, el estreñimiento y la diarrea. Estos trastornos pueden tener diversas causas, como malos hábitos alimenticios, infecciones, estrés o enfermedades crónicas. En este podcast de El Expresso de las 10 nos acompaña la Dra. Roxana Martínez Médica con especialidad en Gastroenterología y Endoscopía con quien hablamos de enfermedades gastrointestinales, Cáncer de colón y nos presenta una innovación para su diagnóstico.
Michael chats with Nir Salomon, Co-founder and Head of R&D at Evinature. Together, they discuss importance of speaking up and educating others about gastrointestinal functions, strategies to managing the stigma and challenging emotions that come with living with gastrointestinal diseases, Evinature's latest study into the effects and science behind how CurQD is helping patients heal from ulcerative colitis and Crohn's, and much more. Read Evinature's study.
Dr. Brandon K.K. Fields speaks with Dr. Jennifer Holter-Chakrabarty about her groundbreaking research on fluorine-18 fluorothymidine (FLT) PET in the imaging of gastrointestinal graft-versus-host disease (GVHD) after allogeneic stem cell transplantation. Together, they explore a potential future role for FLT-PET in detection of early and/or subclinical GVHD, which may serve to guide future treatment strategies for transplant patients in years to come. 18F-FLT PET and Blood-based Biomarkers for IdentifyingGastrointestinal Graft versus Host Disease after Allogeneic CellTransplantation. Holter-Chakrabarty and McNally et al. Radiology: Imaging Cancer 2025; 7(1):e240096.
In this episode, we detail the gut-immune axis, focusing on the protective mucus layer, antimicrobial peptides, and the role of lactoferrin in intestinal health. We discuss endogenous secretions and how lactoferrin functions as an antimicrobial, immunomodulatory, and iron-regulating glycoprotein, influencing microbial balance and intestinal barrier integrity. Additionally, we highlight lactoferrin testing and levels. We finish by going through supplementation as a phenomenal tool.Topics: 1. The Intestinal Barrier & Mucus Layer- The intestinal lumen, microbiome, mucus layer, epithelial cells, and lamina propria.- The mucus layer: antimicrobial peptides (AMPs) and secretory IgA (sIgA).- Intestinal epithelial cells including goblet cells and enterocytes.2. Immune Cells in the Gut- The lamina propria.- Macrophages, dendritic cells, neutrophils, B cells, T cells, mast cells, and more.3. Antimicrobial Peptides & Secretory IgA- AMPs and sIgA in the mucus layer regulate microbial balance and prevent pathogen adhesion.4. Lactoferrin: Functions & Sources- Iron-binding glycoprotein, antimicrobial and immunomodulatory properties.- Found in mucosal secretions, colostrum, and more.- Intestinal epithelial cells (IECs) and neutrophils.5. Lactoferrin's Role in Intestinal Health- Regulates iron absorption via lactoferrin receptors (LFR)on enterocytes.- Sequesters free iron, limiting bacterial growth, bacteriostatic.- Destabilizes bacterial membranes, cell lysis, bactericidal.6. Lactoferrin Levels- Neutrophils release lactoferrin during infection,increasing its presence in the large intestine.- Fecal lactoferrin levels.- Fecal calprotectin levels.7. Lactoferrin & Candida Overgrowth- Fungal membranes.- Aiding in the inhibition of biofilm formation.8. Lactoferrin Supplementation & Benefits- Supports gut microbiota, epithelial integrity, and immunemodulation.- Bovine colostrum and as a supplement.9. Conclusion- The intestinal mucus layer is key to gut barrier function.- Lactoferrin plays a central role in microbial regulationand immune defense.Thank you to our episode sponsors:1. Shop Fresh Press Farms'Peach Cider Vinegar at Sprouts locations nationwide, and check out their full collection here. 2. Shop CYLN's full skincare line here.Get Chloe's Book Today! "75 Gut-Healing Strategies & Biohacks" Follow Chloe on Instagram @synthesisofwellnessVisit synthesisofwellness.com
Contributor: Ricky Dhaliwal, MD Educational Pearls: Ketorolac and ibuprofen are NSAIDs with equivalent efficacy for pain in the emergency department Oral ibuprofen provides the same relief as intramuscular ketorolac IM ketorolac is associated with the adverse effect of a painful injection IM ketorolac is slightly faster in onset but not significant Studies have assessed the two medications in head-to-head randomized-controlled trials and found no significant difference in pain scores IM ketorolac takes longer to administer and has a higher cost Ketorolac dosing Commonly given in 10 mg, 15 mg, and 30 mg doses However, higher doses are associated with more adverse effects Gastrointestinal upset, nausea, and bleeding risk Studies have demonstrated equal efficacy in pain reduction with lower doses References Motov S, Yasavolian M, Likourezos A, et al. Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2017;70(2):177-184. doi:10.1016/j.annemergmed.2016.10.014 Neighbor ML, Puntillo KA. Intramuscular ketorolac vs oral ibuprofen in emergency department patients with acute pain. Acad Emerg Med. 1998;5(2):118-122. doi:10.1111/j.1553-2712.1998.tb02595.x Summarized & Edited by Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/
Did you know that nearly twenty-five percent of adolescents suffer from chronic pain, and for some, it's severe enough to impact daily life? In this episode of Pediatric Meltdown, Dr. Lia Gaggino and guest Dr. Lonnie Zeltzer talk about the complexity of chronic pain in children and adolescents—a subject often misunderstood and inadequately addressed in pediatric medicine. Through personal anecdotes and expert insights, Dr. Zeltzer shares her journey from a curiosity about adolescent medicine to specializing in pediatric chronic pain using modern pain science. This conversation not only unravels the preconceived beliefs surrounding chronic pain but also offers potential pathways and methods to manage and reframe the experience of pain in young individuals. The episode is an eye-opener for anyone seeking to understand and support children grappling with chronic pain.[00:00 - 17:02] Prevalence and Challenges of Pediatric Chronic PainChronic pain affects 15–30% of adolescents globally, with 15% experiencing severe impairment. 70% of adolescents with untreated chronic pain develop adult chronic pain. Pediatricians often lack training in modern chronic pain management concepts. Subspecialists frequently struggle to address chronic pain after ruling out organic causes. [17:02 - 27:55] Neurobiological and Psychosocial Factors Chronic pain correlates with limbic system hyperactivity and prefrontal cortex underdevelopment in adolescents. Neurodiverse individuals may experience heightened sensory sensitivity, amplifying pain perception. Hypnotherapy and cognitive behavioral therapy (CBT) retrain pain-related neural pathways. POTS (postural orthostatic tachycardia syndrome) reflects autonomic nervous system dysregulation linked to chronic pain. [27:56 - 21:06] Gastrointestinal and Autonomic Dysregulation Irritable bowel syndrome (IBS) stems from brain-gut axis dysfunction, not structural gastrointestinal issues. Autonomic dysregulation in POTS requires salt intake, hydration, and compression garments for management. Acupuncture and acupressure offer nonpharmacologic relief, particularly for needle-tolerant patients. Abdominal pain often involves muscular tension, addressed through targeted physical therapy. [21:07 - 48:48 ] Practical Clinical Interventions Brief in-office mindfulness exercises (e.g., guided breathing) provide immediate stress relief. Motivational interviewing helps adolescents identify achievable goals, like gradual physical activity. Parent-child dyads benefit from joint mindfulness apps (e.g., Insight Timer) to reduce household stress. The "five golden minutes" of non-directed play or connection improve emotional regulation.[48:49 - 54:23] Dr. Lia's Takeaways Connect with Lonnie Zeltzerhttps://linktr.ee/mychyphttps://www.instagram.com/my_chyp/https://www.linkedin.com/company/creative-healing-for-youth-in-pain/https://www.facebook.com/creativehealingforyouthinpainResources mentioned in the...
Dr. Shouhed is a nationally renowned, board-certifiedminimally invasive weight loss surgeon with expertise in Robotic Bariatric, Gastrointestinal, and Complex General Surgery. He was born and raised in Los Angeles, California, and graduated summa cum laude from UCLA with adegree in Human Physiology. Dr. Shouhed earned early recognition, a Phi Beta Kappa induction, and a near-perfect MCAT score, which secured him a placeat UCSD School of Medicine with the highest merit-based scholarship. Dr. Shouhed completed his general surgery residency training at Cedars Sinai (#2Hospital in the country), where he graduated as Administrative Chief Resident. He completed his fellowship at Mount Sinai Hospital in New York, the first fellowship in the country, where he focused on minimally invasive bariatric, foregut and complex general surgery. Dr. Shouhed is also Medical Director of the Bariatric Surgery and Metabolic Weight Loss Center, Providence Saint John's Hospital. Our focus today is really about the vascularabdominal syndromes that we can see so prevalent in connective tissue disorders & complex conditions. Please get us started with a description of the anatomy of the abdomen, including the GI organs, but also the ligaments &connective tissue that holds these organs in place and the vasculature that feeds them oxygen & carries away metabolic wastes. Now, let's get into the syndromes that we wantto focus on today & we're going from the top down because that's how they might be unlocked, meaning closest to the heart to the most distant to the heart and in the pelvis, that's from chest to pelvis direction. a. MALS: median arcuate ligament syndromeb. SMAS: superior mesenteric artery syndrome(duodenal comp) (meat?)c. Nutcracker: renal vein compressiond. May Thurner: iliac vein compressione. Pelvic congestion syndromes including pelvicvenous insufficiency, vaginal/ labial varices For each we talk about: a. Symptomsb. Evaluation c. Treatment: ancillary tx? Visceral manipulation? What would a patient look for in a provider? Whois doing this care? How easy/ common are folks doing these treatments? Howoften can or do treatments go wrong? We end with discussing: where is research going with this? To find out more about our clinic (and request a call back): https://www.neurovedahealth.com/- Phone: 206-379-1213- Email Reception@neurovedahealth.com
Contributor: Aaron Lessen, MD Educational Pearls: Colchicine is most commonly used for the prevention and treatment of gout There is research investigating the anti-inflammatory and cardioprotective effects of colchicine This drug has a narrow therapeutic index: a small margin between effective dose and toxic dose Colchicine overdoses can be unintentional or intentional and are associated with poor outcomes Phase 1: 10 - 24 hours after ingestion Patient looks well but may have mild symptoms mimicking gastroenteritis Phase 2: 24 hours - 7 days after ingestion Multiple organ dysfunction syndrome (MODS) Phase 3: recovery is usually within a few weeks of ingestion Treatment for colchicine overdose Treat early and aggressively Gastrointestinal decontamination with activated charcoal and orogastric lavage Dialysis and ECMO for MODS treatment References Finkelstein Y, Aks SE, Hutson JR, Juurlink DN, Nguyen P, Dubnov-Raz G, Pollak U, Koren G, Bentur Y. Colchicine poisoning: the dark side of an ancient drug. Clin Toxicol (Phila). 2010 Jun;48(5):407-14. doi: 10.3109/15563650.2010.495348. PMID: 20586571. Gasparyan AY, Ayvazyan L, Yessirkepov M, Kitas GD. Colchicine as an anti-inflammatory and cardioprotective agent. Expert Opin Drug Metab Toxicol. 2015;11(11):1781-94. doi: 10.1517/17425255.2015.1076391. Epub 2015 Aug 4. PMID: 26239119. Summarized by Meg Joyce, MS1 | Edited by Meg Joyce & Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/
In this episode, we go through the pathophysiology of hydrogen sulfide (H₂S)-dominant small intestinal bacterial overgrowth (SIBO), focusing on its role in intestinal motility disruption, microbial dysbiosis, and epithelial barrier dysfunction. We detail the interplay between the enteric nervous system (ENS), interstitial cells of Cajal (ICCs), and migrating motor complex (MMC) in regulating small intestinal transit and how excess H₂S modulates smooth muscle activity, inflammatory signaling, and gastrointestinal transit time. Lastly, we detail symptoms and related SIBO subtypes.Topics:1. Introduction to Hydrogen Sulfide Dominant SIBO - Overview of hydrogen sulfide (H₂S) SIBO - Sulfate as an electron acceptor - H₂S production, sulfur-containing amino acids - Physiological roles of H₂S vs. in excess 2. Hydrogen Sulfide and Gastrointestinal Motility - Impact on transit time - Association with IBS-like symptoms, diarrhea 3. Intestinal Motility and Regulation - Role of the ENS, ICCs, smooth muscle cells, and neurotransmitters in motility 4. The Enteric Nervous System (ENS) and Gut Motility - ENS as the "second brain" and its control over digestion - Myenteric and submucosal plexuses: regulation of peristalsis, secretion, blood flow - Gut-brain axis involvement via vagus nerve signaling - ICCs as pacemaker cells generating slow-wave electrical activity - MMC's role in clearing debris and bacteria 5. Dysregulated Motility and SIBO Development 6. Overlapping Symptoms Across SIBO Subtypes - Shared symptoms - Hydrogen and H₂S-dominant SIBO vs. IMO 7. Gastric Acid and Its Role - HCl secretion by parietal cells and its role in digestion and microbial defense - Hypochlorhydria and bacterial overgrowth 8. Conclusion - Root cause approach.Thank you to our episode sponsors:1. Check out Ulyana Organics'Tallow Wild Yam Cream and Healing Facial Oil, and use code CHLOE10 10% off your order.2. Shop the Scalp Cleanser and Scalp Essence from T Stem Care. Get Chloe's Book Today! "75 Gut-Healing Strategies & Biohacks" Follow Chloe on Instagram @synthesisofwellnessVisit synthesisofwellness.com
In this episode, we discuss the relationship between the intestinal mucus layer and secretory immunoglobulin A (sIgA), highlighting both as key components of the gut's first line of defense against pathogens, toxins, and environmental stressors. We detail how dysbiosis and microbial overgrowths can impact sIgA levels and can disrupt mucus integrity and function, contributing to increased intestinal permeability and inflammation. We then examine several additional factors influencing sIgA production. Topics: 1. Introduction: Importance of Secretory IgA and Intestinal Mucus - Intestinal epithelial lining and its protective mucus layer - Focus on intestinal dysbiosis and sIgA 2. Anatomy of the Gastrointestinal Lining - Intestinal lumen, microbiome, mucus layer, epithelial cells, tight junctions, lamina propria, and smooth muscle - Role of goblet cells in mucus secretion and epithelial integrity 3. Role of the Protective Mucus Layer - Dual function of the mucus layer as a physical and biochemical barrier - Composition of mucus: mucins, antimicrobial peptides, immunoglobulins 4. Goblet Cells and Mucin Production - Mechanisms of mucin secretion and hydration - Variability in goblet cell density across the intestinal tract - Dysfunctions linked to conditions like IBD and IBS 5. Microbial Interactions with Mucins - Glycan structures in mucins - Roles of commensal and pathogenic bacteria in mucin degradation and mucus turnover - Importance of regulated mucus production for gut homeostasis 6. Dysbiosis and Mucus Degradation - Excessive mucin degradation leading to thinning of the mucus layer - Consequences of increased intestinal permeability and inflammation - Role of dysbiosis in disrupting the mucus layer 7. Overview of Secretory IgA - Introduction to secretory IgA (sIgA) and its role in mucosal immunity - Mechanisms of immune exclusion and pathogen neutralization 8. Production and Function of Secretory IgA - sIgA production by plasma cells in the lamina propria - Translocation of IgA through epithelial cells into the gut lumen - sIgA binding to mucins and its immunological role in the mucus layer 9. Factors Affecting Secretory IgA Levels - Possible contributing factors to low sIgA levels - Implications of low and high sIgA levels for immune defense and intestinal health 10. Interactions Between Secretory IgA and Dysbiosis - Cyclical relationship between low sIgA, dysbiosis, and infections - Examples of overgrowths, like candida, disrupting sIgA - Importance of addressing immune dysregulation to break the cycle 11. Bioindividual Root Cause Approach - Factors to consider Thank you to our episode sponsors: 1. Shop Fresh Press Farms' Peach Cider Vinegar at Sprouts locations nationwide, and check out their full collection here. 2. Check out Spectrum Sciences' Serums and The Vitamin B12 Protocol here, and use code CHLOE15 for 15% off. Get Chloe's Book Today! "75 Gut-Healing Strategies & Biohacks" Follow Chloe on Instagram @synthesisofwellness Visit synthesisofwellness.com
In this episode, we review the high-yield topic of Achalasia from the Gastrointestinal section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic Bowel Perforation from the Gastrointestinal section at Medbullets.com Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic Small Bowel Obstruction from the Gastrointestinal section at Medbullets.com Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
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: E.L: Hi Dr. Cabral, I had an endoscopy done in Jan 2024 and found gastrointestinal intestinal metaplasia in the stomach. In July I had a 2nd endoscopy done (to take a more deeper look and map it) and the results were the same and “stable” (no change), the Gastro said that it looked more like autoimmune gastritis because I tested positive for the antibody, she explained it to be one in the same. She said not to worry because the chances it become malignant (dysplasia and on) were slim and monitor it (repeat the endoscopy) in 2 years. Had a GI Map done per my Int Doc that ruled out H. pylori, which she said was not real data and disregarded it. Taking gastric gum and GI benefits, manuka honey on occasion. How long should I take these supplements for? For ever? What can I do? Can it be reversed? Alicja: Hi Dr. Cabral, I recently asked you about very high levels of vit. B12 that my blood work shows (despite not supplementing with B12, other than what's in my Multi) You said it may be a liver issue - that perhaps my liver is not processing my B12 and that's why the vitamin keeps circulating in my bloodstream. Can you please elaborate on this? How can I check if my liver does not process my B12? What kind of tests should I run for my liver? Thank you so much for your help. Alicja: Hi again. What is your opinion about electric cars? Is it true that they are big "EMF boxes" Ever since someone mentioned that, I can't help but wonder if it's true. I would love if you could make a show about this, perhaps with results of what EMF readers show inside a Tesla, Cyber truck and the self driving Weymo. Thank you again for spreading your amazing knowledge. Kelsey: Hi Dr. Cabral. I was wondering if you have heard of the brand of cookware called Hexclad. It advertises as getting the cooking experience of stainless steel, nonstick, and cast iron all in one hybrid pan. They say the nonstick is called TerraBond which is PTFE free and free from forever chemicals, and is a patented technology. Thanks for your input!! Jasmine: Hey there, Firstly, I want to thank you for all the podcasts you put out, and all that you give. I am in the best health now at 36 years old, because of how much I've learned & applied from all you've discovered and shared with us. I had my first baby last March, and plan to try for another next year, in hope that they are. somewhere close to 2 + years apart. I noticed the veins on my arms and hands enlarged during pregnancy and have remained enlarged post pregnancy (9 months now). They often ache. I started out at a healthy weight, 5' 9” 136lbs, gained 23 lbs during the pregnancy. I am wondering if there is anything I should consider doing/taking to help with the veins on my next pregnancy, maybe increasing my blood flow etc. would love to hear you thoughts. Thanks so much! 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/3277 - - - 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!
In this episode, we review the high-yield topic Ulcerative Colitis from the Gastrointestinal section at Medbullets.com Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic Ascending Cholangitis from the Gastrointestinal section at Medbullets.com Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic Hepatic Encephalopathy from the Gastrointestinal section at Medbullets.com Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic Chronic Pancreatits from the Gastrointestinal section at Medbullets.com Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic Boerhaave Syndrome from the Gastrointestinal section at Medbullets.com Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
References:Weight loss on GLP-1 receptor agonistsMoiz A, Levett JY, Filion KB, et al. Long-Term Efficacy and Safety of Once-Weekly Semaglutide for Weight Loss in Patients Without Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Cardiol 2024, 222:121-130.Highlights: On average, weight loss on semaglutide (Ozempic) is approximately 15% of body weight.Gastrointestinal adverse effects of GLP-1 receptor agonistsSodhi M, Rezaeianzadeh R, Kezouh A, Etminan M. Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss. JAMA 2023.Nutrient Density and Satiety:Drewnowski, A.. Concept of a nutritious food: toward a nutrient density score. The American Journal of Clinical Nutrition 2005. Nutrient-dense foods like greens and beans have been shown to promote satiety, support weight loss, and provide essential micronutrients.Highlights: Nutrient-dense foods can naturally regulate appetite and reduce caloric intake without sacrificing nutrition.Anti-Angiogenic Effects of Vegetables and Mushrooms:Li WW, Li VW, Hutnik M, Chiou AS. Tumor angiogenesis as a target for dietary cancer prevention. J Oncol 2012, 2012:879623. Certain foods, like cruciferous vegetables and green tea, have anti-angiogenic properties that not only combat tumor growth.Corvera S, Solivan-Rivera J, Yang Loureiro Z. Angiogenesis in adipose tissue and obesity. Angiogenesis 2022, 25:439-453.Cao QZ, Lin ZB. Antitumor and anti-angiogenic activity of Ganoderma lucidum polysaccharides peptide. Acta pharmacologica Sinica 2004, 25:833-838.Highlights: Anti-angiogenic foods limit blood vessel growth in fat cells, aiding in long-term weight management.Role of Fiber in Appetite Suppression:Slavin, JL. Dietary fiber and body weight. Nutrition. 2005. High-fiber foods, such as beans and greens, slow digestion, lower postprandial glucose levels, and enhance satiety, contributing to sustainable weight loss.McRorie JW, Jr., McKeown NM. Understanding the Physics of Functional Fibers in the Gastrointestinal Tract: An Evidence-Based Approach to Resolving Enduring Misconceptions about Insoluble and Soluble Fiber. J Acad Nutr Diet 2017, 117:251-264.Highlights: Fiber promotes healthy gut microbiota, which indirectly regulates appetite, and viscous fiber directly regulates appetite by slowing breakdown of macronutrients.Green Tea and Weight Regulation:Neyestani TR, Nikooyeh B. A comprehensive overview on the effects of green tea on anthropometric measures, blood pressure, glycemic and lipidemic status: An umbrella review and meta meta-analysis study. Nutr Metab Cardiovasc Dis 2022, 32:2026-2040. Green tea's catechins and mild caffeine content have been shown to modestly increase fat oxidation and support metabolic health.Highlights: Green tea is a natural complement to weight-loss strategies.Nut Consumption and Caloric Absorption:Tindall AM, Petersen KS, Lamendella R, et al. Tree Nut Consumption and Adipose Tissue Mass: Mechanisms of Action. Curr Dev Nutr 2018, 2:nzy069.Highlights: Whole nuts, not oils, reduce caloric intake without compromising satisfaction.
This Real Science Exchange podcast episode was recorded during a webinar from Balchem's Real Science Lecture Series. You can find it at balchem.com/realscience.Feeding rumen-protected choline in early lactation has consistently increased milk yield and energy-corrected milk yield, which is more pronounced when cows are fed diets low in metabolizable methionine. Choline feeding also increases milk fat and protein yield, minimizes body condition loss in early lactation, and reduces postpartum disease incidence. Dr. McFadden presents three topics about choline biology in the dairy cow. (01:45)Why should we consider fatty acid feeding when feeding methyl donors like choline and methionine?Choline degradation in the rumen and small intestine, focusing on the role of triethylamine oxide Why should we consider lysophosphatidylcholine as an immunomodulator in fresh cows and preweaning calves?Fatty acid nutrition to optimize methyl donor efficiency. (4:02)Fatty liver is a concern for fresh cows because of its relationship with ketosis, poor fertility and compromised milk production. Cows with fatty liver exhibit low circulating concentrations of phosphatidylcholine, which is a component of very low-density lipoproteins (VLDL) that transport triglycerides out of the liver. Feeding rumen-protected choline lowers liver triglyceride deposition by supporting the synthesis of phosphatidylcholine and thus, VLDL. Dr. McFadden goes on to explain the two different pathways for phosphatidylcholine in the liver and how those interact with fatty acid metabolism. He describes several experiments that have investigated how rumen-protected choline and supplemental fatty acids interact in lactating cows. Low phosphatidylcholine supply is a key feature of fatty liver in dairy cows, likely due to low polyunsaturated fatty acid (PUFA) and low choline supplies. Delivery of post-ruminal PUFA may support phosphatidylcholine synthesis with accompanying improvements in insulin sensitivity, body condition maintenance, and inflammation, but interactions with dietary fatty acid digestibility should be considered. Dr. McFadden gives a list of considerations for fresh cow diets incorporating fat and choline supplementation. Gastrointestinal choline degradation and trimethylamine N-oxide (TMAO) (16:58)Unprotected choline is almost totally degraded in the rumen. Microbes convert choline into trimethylamine (TMA) which is then converted to TMAO in the liver. Rumen-protected choline allows for a large proportion of choline to reach the small intestine intact. However, research shows that choline can also be degraded by microbes in the small intestine in the same pathway, limiting choline bioavailability. Plasma TMAO accumulation is associated with non-alcoholic fatty liver disease, inflammation, insulin resistance, obesity, oxidative stress, and cardiovascular disease in rodent and human models. Little research was available regarding if the relationship between TMAO and poor health was causative or just associative. Dr. McFadden's lab infused cows intravenously with TMAO and found that TMAO did not modify milk production or glucose tolerance in early lactation cows. TMAO does not appear to influence energy metabolism or health in early lactation cows. Choline is subject to both ruminal and lower-gut degradation to TMA, and that influence on choline bioavailability needs to be defined. Data in non-ruminants suggests that unsaturated fatty acid feeding can shift the gut microbes to slow TMA formation. Lysophosphatidylcholine and immunomodulation (28:45)Dr. McFadden gives an overview of neutrophil activation and the oxidative burst that contributes to pathogen killing. The ability to elicit the oxidative burst is diminished in pre-weaned calves and transition cows. When cows were given endotoxin to cause an immune response, circulating lysophosphatidylcholine was decreased. In rodent models, lysophosphatidylcholine promotes the oxidative burst and suppresses long-term inflammation in response to bacterial infection. Dr. McFadden cultured neutrophils from pre-weaned calves with lysophosphatidylcholine and observed an enhanced oxidative burst.Immunosuppression is characterized by low circulating lysophosphatidylcholine concentrations in dairy cows. In vitro data suggests lysophosphatidylcholine can activate neutrophils, and rumen-protected choline increases circulating lysophosphatidylcholine. Future research is likely to define an immunomodulatory role for choline. Dr. McFadden takes questions from the webinar audience. (38:07)Please subscribe and share with your industry friends to invite more people to join us at the Real Science Exchange virtual pub table. If you want one of our Real Science Exchange t-shirts, screenshot your rating, review, or subscription, and email a picture to anh.marketing@balchem.com. Include your size and mailing address, and we'll mail you a shirt.
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